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When the pain of birth just goes on

20 November 2020

Rebecca Paveley investigates postpartum psychosis and how it can react with faith

Deb Vickers, with three-year-old Jade and six-week-old Elliot, four days before being taken into hospital in June 2013. She returned home to them in the September

Deb Vickers, with three-year-old Jade and six-week-old Elliot, four days before being taken into hospital in June 2013. She returned home to them in t...

MARGERY KEMPE was a 14th-century Christian mystic who wrote, through the use of a scribe, what is thought to be the first spiritual autobiography in the English language. It also happens to be the first detailed depiction of postpartum — also known as postnatal — psychosis: a severe mental illness that strikes some mothers, abruptly and without warning, after childbirth.

The Book of Margery Kempe begins with the difficult birth of her first child, and the hallucinations that followed, including physical and verbal torments by devils, from which she was rescued by a visitation from Christ. For Kempe, these visions marked the beginning of a radical and remarkable new life as a penitent and pilgrim.

Although our understanding of mental illness has changed and deepened dramatically in recent decades, many new mothers are still not aware of postpartum psychosis. But it is devastating for those women who experience it, and their families. For women of faith, the impact on their sense of self and their relationship with God can be severe and long-lasting.

The charity Action on Postpartum Psychosis says that the symptoms of postpartum psychosis (which is frequently abbreviated to PP) can include strange beliefs that cannot be true; hearing, seeing, or feeling things that aren’t there; and severe confusion. For some women, the hallucinations can have a religious or spiritual dimension, as they did nearly 700 years ago for Kempe.

The Revd Vanessa Lawrence is chaplain at Melbury Lodge, in Winchester, which has a mother-and-baby unit where mothers with a severe mental illness can stay with their babies. It looks after many women with postpartum psychosis.

The Revd Vanessa Lawrence in her office at Melbury Lodge, Winchester, based at the Royal Hampshire County Hospital

It is fairly common for mothers with PP to experience hallucinations with a religious or spiritual dimension, Ms Lawrence says.

“We often don’t think about greater meaning in our lives until we have a crisis that shatters our identity, or security. When you have a child, it just rocks our world, and makes you ask big questions about your life. It is such a seismic shift in how you see the world. Christianity is still the folk religion in this country, and it can often feature in psychosis.”

Some women have experienced hallucinations, or episodes, during which they believe that they are the Virgin Mary, or that their baby is Jesus, she says. “If someone believes they are Mary, that is a such a responsibility to carry: to experience that as your reality is just huge.”

The part she plays is to talk to women, regardless of their faith, and listen carefully to their fears. “I practise really careful listening to that person, and what these thoughts and experiences mean for them. For example, a woman who thinks she is Mary: what does it mean for her to think that, and what impact does her thinking that have on her child? She must, for example, feel great fear and anxiety because she is caring for a child who is so, so precious.”


DEB VICKERS has been through two episodes of PP after both her first and second child. She is a Christian, but says that, although she had a “heightened” sense of her faith during both episodes of the illness, she did not, as far as she is aware, experience religious hallucinations.

But because of the link between religious hallucinations and the illness, she found that doctors and nurses treated her faith with suspicion.

“My Christian faith was a double-edged sword. Because religious grandeur can be part of psychosis, I don’t think I had hallucinations, or believed I was something else; but my spirituality was definitely heightened. I found it difficult in the public-health system when I was asking for a chaplain, or I wanted a Bible given to every patient at Christmas. I think it was a heightened version of my normal self, but clinicians saw it as a warning sign.”

Ms Lawrence says that she has also worked with women who are worried about the response of doctors to their faith. “On my first day on a ward — not here in Melbury — I asked someone if they would like prayer. They said yes, but not to tell anyone, as they were concerned doctors would think it was part of their condition. There is definitely a worry for some women about how religious faith might be perceived.”

Mrs Vickers, who is in Australia, where there are very few mother-and-baby units, was admitted as an emergency to a general psychiatric ward for several weeks before going to a mother-and-baby unit run by a Roman Catholic hospital. She found hospital chaplains invaluable, and has recently discovered notes that a chaplain made in her Bible, alongside the Psalms, while she was in hospital.

“I was reading Psalm 71 when my second child was born, and I latched on to it. . . Was it part of God’s plan that I would read that psalm that speaks so much of mothers and babies as I was about to have this experience? Or was it because of the illness that it said something extra to me? I don’t know.”

While on the general psychiatric ward, she was forced into isolation for some periods; she also underwent electro-convulsive therapy.

“One night, I was put into an isolation ward with just a mattress in the middle of the floor: no pillow or sheets, so you can’t hurt yourself. The purpose of that room was that you would be on your own. Instead, I had a clear sense of God’s presence with me in that place.

“Though they had done everything to separate me, nothing could separate me from God’s love. It was intended for those at risk of self-harm, and, though that wasn’t a major risk-factor to me, it was used for when I was upset or uncooperative.

“I have been very fortunate to know God since childhood. All the times he has cared for me and I have learned from the scriptures were all preparing me to go through that bit of my life. I really valued the times I had the word of God hidden in my heart, tucked away — a memory verse, a song — so that, when I did not have a Bible with me, or I was so muddled I couldn’t read the words, the love of God sprang out from inside me.”

Ms Lawrence tries to link women she has ministered to in Melbury Lodge to a church in their home town, to provide continued support as they recover and reintegrate into their families and wider communities. Because of the rarity of PP (one to two women per 1000 are believed to experience it), women come to the unit from all over the country.

She said: “PP does have a huge impact on someone’s faith, long-term. We need to ask, as churches, how we support women in this situation, but also how we support all women who are new mothers.

“Women in the unit can struggle with their faith and the medication they have to take. I’ve had mothers say to me, ‘I shouldn’t feel this way because I am a Christian.’ I try to help them accept there are a variety of experiences of motherhood, and it’s OK. It important for women having these experiences to be able to share them with a person of faith.”

Mrs Vickers, who has since been diagnosed with bi-polar disorder, says that she never found herself blaming God for her experience. “I questioned God, as the psalmists do, but I didn’t question his faithfulness to me.”

She has gone on to set up a group in Australia to enable women with PP to support one another. “One thing my experiences have left me with is a sense that God is in control. I might plan to have a happy marriage and conveniently spaced children, but God is holding these things in his hand. God has equipped me, through this, to come alongside others in similar situations.”

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