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Study of 100 postpartum patients pointed to a syndrome comprised of feelings of shame, helplessness, and confusion. Lack of difference between these patients and control subjects in performance on serial-7 subtractions and digit span as well as in frequency analysis of the EEG militates against the existence of a toxic delirious state. Conflict over assuming the mothering role was a central precipitating stress. For the most part, this conflict stemmed from the rejection of the patient's own mother as an adequate model and distorted communications about care of the infant. Problems in maternal identification may be accentuated in the puerperium by the neonate's incapacity to specify guidelines for his care. Since the ambiguities of infant care are greater in the early puerperium, this factor may, in part, account for the high recurrence rate of postpartum distress in these women as well as the onset of illness largely within the first 10 days postpartum.
Frederick T. Melges (Mon,) studied this question.