Risk and childbirth in psychiatry

The relationship between childbirth and serious mental illness has been known since the time of Ancient Greece. It was first described in the psychiatric literature by Esquirol and later by his pupil Marce in 1857. A substantial number of women become mentally ill, often for the first time, following childbirth. There are few events associated with such a measurable and predictable risk to mental health as childbirth, with its nine months warning. Despite this, there is little awareness amongst general psychiatrists of the predictable and manageable risk that faces many of their female patients should they become pregnant, nor of the risks that mentally ill mothers may pose for their children. This article discusses the likely contribution of childbirth and parity to the excess of affective morbidity in women, the risk posed by childbirth to women who were previously well and to those with pre-existing psychiatric disorder.