From the Curator’s Desk: The Four Ages of Woman, Perinatal Mental Health

In this new series of posts about the exhibition ‘The Four Ages of Woman’ (which is currently closed to the public, along with the museum), I’ll be writing about the art on display, and how we put it all together. In this first instalment I focus on how perinatal mental health is represented in the exhibition by comparing artworks that were created 130 years apart. I was due to attend a symposium (now cancelled) at the Foundling Museum focusing on Maternal Mental Health on 23rd March, organised to coincide with their current (also closed) exhibition ‘Portraying Pregnancy: from Holbein to Social Media’ https://foundlingmuseum.org.uk/events/portraying-pregnancy/. The aim of the symposium was to have raised awareness of the issues around maternal mental health, provide a forum for new conversations and partnerships, and enabled arts and business to better support maternal wellbeing.

In ‘The Four Ages of Woman,’ the ‘middle age’ section is introduced by two drawings of Elizabeth Jeffreys, who was ‘seized by puerperal mania three days after the birth of her first child’ and was admitted to Bethlem Hospital. These drawings, and others in the exhibition were commissioned by Alexander Morison, physician to Bethlem in the 1830s and 1840s, and are on loan from the Royal College of Physicians of Edinburgh. The notes that accompany the drawing of Elizabeth Jeffreys state that ‘she is very noisy, and screams; she attempted to jump out at a window, is disposed to tear her clothes, and frequently drops on her knees; her conversation is incoherent, sometimes she says that she is strange, that she is mad, that she shall destroy her child, or cut her own throat; restraint is found necessary.

In the second image, Elizabeth is ‘cured,’ the notes accompanying the drawing state that ‘a blister applied to the nape of the neck, and a discharge kept up by the application of Savine Ointment, appeared to expedite the recovery, which was completed by the use of Sulphate of Quinine, in about nine months from the commencement of the disorder.’ The clear, clinical description of Eliabeth’s treatment and recovery are reductive - her own perspective (aside from parts of her conversation that the physician has chosen to note down) is not represented; it is after all a subjective medical record, and we can’t ignore the time and context in which it was made.

Painted over a century later, Maureen Scott’s Mother and Child at Breaking Point steps into this perspectival void, the stoic expression on the mother’s face thinly veiling the effect of the chaos of the background, and the screaming child in her arms.

The cluttered scene represents the multitude of tasks that can cumulatively take their toll on caregivers; washing, cooking and cleaning alongside the responsibility of looking after a small child. The title of the painting suggests that both mother and child are at breaking point, but whilst the child’s anguish is evident through their contorted face and strained body, the mother’s expression is that of resigned endurance. Although her own breaking point is not as overtly physical as her child’s, the repression of her feelings shown through her stoicism is symptomatic of the overarching pressure to hold everything together, which can sometimes feel impossible.

It is a point at which mental health services and support networks can be vital. It is so important that maternal wellbeing is supported, especially as studies, such as The National Childcare Trust (NCT)’s campaign ‘Hidden Half’ showed that, of surveyed women, approximately 50% had a mental health problem that had not been identified by a health professional. Many of these mothers were too ‘embarrassed or afraid of judgement to seek help.’ In response to the need for increased access to services and assistance, in 2019 the NHS pledged funds to support increased access to specialist perinatal mental health care, including community and inpatient care. Organisations like ‘Pregnant then Screwed’ provide support to women who are discriminated against by their employers either before or after giving birth, and writer Candice Brathwaite’s social media campaign ‘Make Motherhood Diverse’ aims to highlight the broad spectrum of experiences of motherhood, and includes stories from women about mental health problems, class, race and sexuality. Experiencing post natal depression and anxiety are unfortunately common, and are often caused by a combination of hormone changes and sleep disturbances coupled with difficult births and the pressure of caring for a newborn. Mothers who suffer from severe post natal mental health problems may be admitted to a special Mother and Baby Unit within a psychiatric hospital, which enables them to receive treatment whilst caring for their baby in a supportive clinical setting.

Bethlem Royal Hospital’s own celebrated Mother and Baby Unit was featured in a documentary film in 2019 entitled Louis Theroux: Mothers on the Edge, which you can still see on BBC iplayer https://www.bbc.co.uk/programmes/m00052dk