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‘Spilt Milk’ deals with two dreadful aspects of human experience; the death of a baby at the time of its birth and the psychological breakdown of the postpartum mother. The book is utterly compelling, indeed I read it almost at one sitting, but the material is hard to be with; it took me months to sit down and write about it. Despite the bleakness of the material, the six contributors are surefooted, treading a line that is neither overly sentimental nor coldly clinical, but respectful, thoughtful and humane.
The book consists of six lectures given at the Institute of Psychoanalysis in London during the eighties and nineties, on the subject of perinatal loss and breakdown. It is perhaps inevitable that with several different writers the book has a somewhat uneven texture to it, but this is a small criticism, easily outweighed by the quality of the individual lectures.
There is a generous introduction by Joan Raphael-Leff in which she begins by reminding us that pregnancy, whilst a natural experience, is also one which arouses primitive feelings and can revive archaic feelings from one's own infancy and birth, even when all goes well. When the worst happens and the parents find themselves facing a loss where a baby should have been, the result can be breakdown. Raphael-Leff introduces the reader to the complex and varied technical issues facing the practitioner who finds herself working with not only the new and depressed mother, but with the baby in the consulting room as well. There are plenty of vivid clinical examples that bring the theory to life.
Each of the six lectures focuses on the psychological impact of either losing a baby or losing one's mind at the time of giving birth. The lectures span a wide continuum. Dana Birkstead Breen takes a developmental approach to pregnancy, in which she stresses that in the most ordinary and healthy pregnancy there is a need for substantial introspective work to process the various losses involved in child-bearing. At the oth