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The Uses of Maternal Distress in British Society, C.1948-1979

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The Uses of Maternal Distress in British Society, C.1948-1979 The Uses of Maternal Distress in British Society, c.1948-1979 Sarah Crook A thesis submitted to Queen Mary University of London, in partial fulfilment of the requirements for the degree of Doctor of Philosophy in History School of History 1 ABSTRACT After the Second World War mothering became an object of social, political, medical and psychiatric investigation. These investigations would in turn serve as the bases for new campaigns around the practice, meaning and significance of maternity. This brought attention to mothers’ emotional repertoires, and particularly their experiences of distress. In this thesis I interrogate the use of maternal distress, asking how and why maternal distress was made visible by professions, institutions and social movements in postwar Britain. To address this I investigate how maternal mental health was constituted both as an object of clinical interrogation and used as evidence of the need for reform. Social and medical studies were used to develop and circulate ideas about the causes and prevalence of distress, making possible a new series of interventions: the need for more information about users of the health care service, an enhanced interest in disorders at the milder end of the psychiatric ‘spectrum’, and raised expectations of health. I argue that the approaches of those studying maternal distress were shaped by their particular agendas. General practitioners, psychiatrists, activists in the Women’s Liberation Movement, clinicians interested in child abuse and social scientists, sought to understand and explain mothers’ emotions. These involvements were shaped by the foundation of the National Health Service in 1948 and the crystallization of support for alternative forms of care into self-help groups by 1979. The story of maternal distress is one of competing and complementary professional and political interests, set against the backdrop of increasing pessimism about the family. I argue that the figure of the distressed mother has exerted considerable influence in British society. As such, this research has important implications for our understanding of how mental distress developed into a mode of social and political critique across the late twentieth century. 2 I, Sarah Rose Crook, confirm that the research included within this thesis is my own work or that where it has been carried out in collaboration with, or supported by others, that this is duly acknowledged below and my contribution indicated. Previously published material is also acknowledged below. I attest that I have exercised reasonable care to ensure that the work is original, and does not to the best of my knowledge break any UK law, infringe any third party’s copyright or other Intellectual Property Right, or contain any confidential material. I accept that the College has the right to use plagiarism detection software to check the electronic version of the thesis. I confirm that this thesis has not been previously submitted for the award of a degree by this or any other university. The copyright of this thesis rests with the author and no quotation from it or information derived from it may be published without the prior written consent of the author. Signature: Date: 16.09.2016 3 TABLE OF CONTENTS Title Page 1 Abstract 2 Statement of Originality 3 Table of Contents 4 Acknowledgements 5 Abbreviations 6 Introduction 7 Chapter One 60 The General Practitioner and Maternal Mental Health in Early Postwar Britain Chapter Two 105 The Abortion Act 1967: Psychiatry, Risk and Women’s Mental Health Chapter Three 139 The Women’s Liberation Movement, Motherhood and Distress Chapter Four 200 Violence Against Children and Maternal Mental Health, c.1960-1979 Chapter Five 239 Mothers’ Feelings in Social Science and Sociology c.1960-c.1979 Conclusion 286 Bibliography 304 4 ACKNOWLEDGEMENTS I would like to first extend warm thanks to my supervisor, Rhodri Hayward. This project could not have been completed without his encouragement and support. The staff of the School of History at Queen Mary University of London have been generous with their time and wisdom throughout. I am grateful to Helen McCarthy and Barbara Taylor, both of whom have kindly pushed me to present and discuss my work. Chris Millard and Rebecca ONeal have provided solidarity, advice and camaraderie. Matt Jacobsen has been a supportive, perceptive and patient cheerleader. I have been fortunate in having the opportunity to teach brilliant undergraduate students, who have consistently provided stimulation and inspiration. I am grateful to the Wellcome Trust for funding this project, and for its active support for historians of medicine. That I have joined such a vibrant community is in no small part due to the Trust’s generosity. Librarians, staff and archivists at the BFI, Wellcome Library, British Library, Royal College of General Practitioners, the Association for Post-Natal Illness, and Mary Lynne Ellis and Brid Greally from the Islington Women and Mental Health Project have patiently and generously helped me to access the research materials I required. I could not be more thrilled to have worked alongside such splendid early career academics. Charlie Jeffries and Kate Turner have offered unwavering support as they complete their own exciting research. Jenny Crane, Jack Saunders, Chris Bovis, Joanne Paul, Liz Gray and Kerrie Holloway have provided edits or academic advice. My friends outside History have provided distraction, food, laughter, political acumen and love: Alex Beetles, Alex Bordoli, Rachel Edge, Jo Massie, Radhika Madhani, Sarah Waite, Rhiannon Smith, Fionna Tod, David Wearing, Sam Connor, Rosie Langridge, Ben Mandler, Roos de Gues. Many of those mentioned have read my work. Any mistakes that remain are my own. My dad didn’t get to see this completed, but I think he would have been pleased. Finally, I am so grateful to my own very wonderful mum. Funded by the Wellcome Trust, grant number 099362/Z/12/Z 5 ABBREVIATIONS AGM Annual General Meeting ALRA Abortion Law Reform Association APNI Association for Post-natal Illness BBC British Broadcasting Corporation BGA Bishopsgate Institute Archive BL British Library BMA British Medical Association BSA British Sociological Association CR Consciousness-Raising DSM Diagnostic and Statistical Manual of Mental Disorders GP General practitioner HMSO Her Majesty’s Stationary Office ICD International Classification of Diseases IWMHP Islington Women and Mental Health Project LSE London School of Economics MP Member of Parliament NAC National Abortion Campaign NHS National Health Service NSPCC National Society for the Prevention of Cruelty to Children RCGP Royal College of General Practitioners RCOG Royal College of Obstetricians and Gynaecologists SPU Medical Research Council’s Social Psychiatry Unit UCL University College London WA Wellcome Library Archive WHO World Health Organization WLM Women’s Liberation Movement WTC Women’s Therapy Centre 6 INTRODUCTION USING A MEDICAL DIAGNOSIS AS A SOCIAL DIAGNOSTIC In an article published in The Guardian newspaper in 2012, Kate Figes, author of Life After Birth, argued that the enhanced risk of postnatal depression was symptomatic of the weaknesses of late-twentieth century modernity: unlike a century ago, she proposed, mothers are likely to be socially isolated; to have heightened expectations of the maternal role; to experience a loss of professional identity; and to struggle to reconcile the public values of individualism with the self sacrificial requirements of the maternal role.1 Three assumptions underpin these claims. First, that the individual experience of postnatal distress matters at a social level. Second, that women are now more likely to experience postnatal depression than they were in the past, with the caveat that this is difficult to quantify as the phenomenon is often ignored or misdiagnosed. And finally, that social conditions are responsible for this shift. This implies that maternal suffering can be alleviated not only through management at an individual level but also through meaningful reform of social and political structures. In this way, extracting maternal distress from the domestic sphere turns it into a public and policy object. It is this process that I am interested in. The central research question of this thesis is this: how and why was maternal distress made visible by professions, institutions and social movements? Put another way, how has maternal distress been used in postwar Britain? In order to probe this, three constitutive inquiries run through the following five chapters. I investigate who has sought to assert expertise over maternal distress, how the figure of the distressed mother 1 Kate Figes, ‘Postnatal Depression: The Pressures New Mothers Face, Now More Than Ever’, The Guardian 3 November 2012 <http://www.theguardian.com/society/2012/nov/03/postnatal-depression- widespread-felicia-boots> [accessed 26 April 2016]. 7 was constructed, and why she came to be a distinctive figure in the years following the Second World War. The first of these questions forms the organising principle of the following five chapters that are arranged around communities with particular investments in mothers across the postwar years: GPs, politicians and psychiatrists, feminists, doctors interested in child battery, and academics. These track the emergence of the mentally disordered mother between the foundation of the NHS (1948) and the establishment of the Association for Post-natal Illness (APNI) in 1979. In Chapter One, I ask which mechanisms were used by general practitioners in 1960s Britain to uncover maternal distress and why mothers were of such interest. In Chapter Two, I unpick how maternal mental illness was instrumentalised during the passage of abortion reform in the 1960s, thereby drawing out how it performed as a policy object in the political arena. In Chapter Three, I shine a light on how the Women’s Liberation Movement (WLM) in the late 1960s to the late 1970s mobilized evidence of women’s psychic suffering as proof of the need for social change and framed the concept of maternal mental disorder as a symptom of patriarchal social structures.
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