Madness and Motherhood in Black and White: Racial Logics in Medical Responses to Maternal Mental Illness and Deviance in the United States, 1890 - 1970

Abstract

This dissertation investigates how racial science and racialized construction of motherhood informed the evolving classification, diagnosis, and treatment of maternal mental illnesses (i.e., mental disorders associated with pregnancy, childbirth, and the postpartum period) in the United States from 1890 to 1970. Since the nineteenth century, maternal mental illnesses have offered both a defense and explanation for women who have transgressed the boundaries of ideal motherhood – whether by exhibiting emotional or mental instability, neglecting themselves, children, or home, or engaging in violence or self-harm. Yet, despite their designation as a race-neutral, gender and sex- based diagnostic category, this dissertation argues that evolving medical understandings of maternal mental illnesses have centered and privileged an imagined white female sufferer and, ultimately, reinforced the pathologization of non-white and low-income mothers, particularly Black women. Recognizing that concepts of motherhood, insanity, and deviance are deeply embedded in larger racial discourses, this dissertation asks how medical constructions of maternal mental illness have been both informed by and (re)produced the American sociocultural ideal of a mother who is white, middle-class, and domestic. In doing so, it illustrates how racialized diagnostic and therapeutic practices associated with maternal mental illness protected hegemonic constructions of white womanhood by reinforcing the conflation between “whiteness” and “good mothering” and “blackness” and “pathological mothering.” Consequently, this dissertation introduces the concept of “diagnostic privilege”: the idea that bestowing (or withholding) certain diagnoses can humanize or dehumanize patients along racialized constructions that privilege and reinforce whiteness. This dissertation adopts a long durée approach and examines four case studies in which medical understandings of maternal mental illness were intertwined with broader racial and gender politics and debates regarding the demographic trajectory of the United States. Drawing upon published and archival materials, the chapters explore the history of race and maternal mental illness by examining a criminal trial that centered on the permissibility of the insanity defense, a eugenic sterilization law and compulsory sterilization, a government-funded research study that considered how the psychological experience of pregnancy impacted children’s development, and an initiative aimed at reducing poverty by controlling fertility. In doing so, this dissertation sheds light on developing discourses of maternal deviance, maternal mental illness, race, reproduction, and psychiatry across the late nineteenth and mid-twentieth centuries. Further, by foregrounding the relationship between maternal mental illness, racial science, and motherhood, this dissertation illuminates how historical constructs of maternal mental illness continue to pose barriers for non- white and low-income mothers – especially Black women – within medical, legal, and social systems today.