Psychiatric aspects of labour and the puerperium

The psychiatric complications occurring during the three stages of labour are described, together with those factors which predispose to delivery-room complications or abnormalities. The predisposing factors include conflicts in relation to feminine identity, repressed traumatic experiences during the early stages of psychosexual development, adverse social, educational and economic situation, and excessive fear and anxiety, particularly in the absence of support from the husband. The triad of fear-tension-pain, the influence of socio-economic and cultural factors, and the methods utilized to reduce both anxiety and fear are discussed. The interrelation between environmental, hormonal and psychological manifestations in the postpartum period is briefly described, with specific emphasis on depression.