A prospective study of postpartum psychoses in a high-risk group. 5. Relationship to psychosocial aspects of labor and delivery.

Within a sample of 88 pregnant index women with a history of nonorganic psychosis, the psychosocial aspects of labor and delivery, assessed through personal observation, were studied in relation to the development of 22 postpartum psychotic episodes (PPPs) occurring during the first 6 months postpartum. As compared with index cases not developing PPPs, cases with PPP onset after 3 weeks postpartum had been significantly more anxious, had received significantly less help from the midwife, and their husbands tended to have attended the birth less often. Cases with PPP onset within 3 weeks of delivery had not been more anxious, but their husbands had been significantly more anxious and the midwives tended to have helped less. Early Onset (but not Later Onset) mothers had had slightly more frequent negative reactions towards the newborn, while the husbands in both groups tended to have been more positive towards the newborn than were other husbands.