Case Scenario: Puerperal Psychosis

Mrs. S. is a 30 year-old mother of three children who had been married

for five years. She lives with her husband and in-laws in a village within
the Belize District. Mrs. S. had given birth to her third child 6 weeks
ago. Her pregnancy and labor had been uneventful, as she had delievered
baby boy at the general hospital within the city.
Prior to giving birth, Mrs. S. was noted as being a cheerful, active and
religious person. A good house wife, mother an active member of her
village and church. She maintained the home and assisted her other two
children with their school assignments and after school activities. She
occasionally attends community church functions and activities at least
twice in a week. She also had taken up sewing as a hobby and way to
make extra money for her family.
After the birth of her last child, family and friends of Mrs. S noticed a
change in her overall mood. She was no longer cheerful and was
constantly feeling tired. She had lost interest in her daily and
community activities. Though her family and friends had noticed the
change in her behavior, it was not a cause of concern. Everyone
attributed the change as a form of baby blues or postpartum
depression.
For a month after the delivery of her baby, things began to take a most
drastic turn. She became irritable, agitated and was having difficulty
sleeping. She became more religious and talked about God and the
Devil obsessively. She also stated that she started to hear God talking to
her and that she would need to sacrifice her baby to cleanse the sins of
her family. Her husband who is the primary breadwinner of the family
during this period was focused on working and providing for the family
and didnt pay attention to this wife. He never asked her what she meant
by sacrifice or to clarify what she was talking about.
After three consecutive sleepless nights, her anxiety increased and she
was consumed with the idea of saving her family by sacrificing her baby.
One evening when her husband came home, he noticed a burning smell
coming from their bedroom. When he opened the door he saw a pile of
cloths burning in the middle of the room and his wife holding the baby
above the flames. Out of fright and concerned, he asked her what she
was doing. She began to cry uncontrollably and explained that she
needs to save her family by burning the baby as a sacrifice. He then tried
to reason with her to put the baby in a safe place for them to talk. She
explained that she was confused and sacared as to why God wanted her
to sacrifice her baby.

Whenever she began to voice these opinions her family members try to
talk to her, but she shouts and yell atthem that God is talking though her.
Since she is a stay at home mother, the rest her family were busy with
their daily lives and seemed indifferent to her condition as she is a
religious person. She began to felt that some unseen force was coming
for her son overwhelmed her, she became hyper protective not allowing
anyone, not even her husband, to hold the baby. Two weeks later after
three consecutive sleepless nights, anxiety and fear consumed her to the
point where her son had to be physically removed from her and she was
forcefully taken to the general hospital in the city. She was admitted
and diagnosed as suffering from puerperal psychosis