Depresión posparto

Depresión posparto becomes both a medical subject and a social question in the book: the condition can persist beyond the brief emotional upheaval common after childbirth, yet the shame surrounding maternal unhappiness may keep women from asking for help. At Alice Espanet’s trial, Dr. Leclercq explains the distinctions to the court, while the narrator’s own account of motherhood shows why distress can be difficult to separate from expectations that a mother should find fulfillment in care.

Clinical distinctions and the silence around care

Dr. Leclercq, the Belgian psychiatrist who had treated Alice for a year, gives one of the trial’s longest testimonies. Based in Barcelona, he had conducted his sessions with Alice in French and had undertaken pioneering research into postpartum depression and postpartum psychosis in his native country in the late 1970s. At the request of Carmela Basaguren, he sets out a spectrum of postpartum conditions rather than treating every sign of distress as the same illness.

The most common experience, he explains, is baby blues, which affects about 80 percent of mothers in the puerperium but is not considered pathological. Hormonal changes in the immediate aftermath of birth contribute to it, while fatigue and lack of sleep can intensify it. A mother may feel sad, cry without an apparent reason, or feel overwhelmed by the work of caring for a child; anxiety and guilt are also characteristic. In the usual course, these feelings recede on their own within a few weeks.

Persistence changes the clinical picture. If symptoms continue or worsen after two or three months, Dr. Leclercq says, further assessment is needed. Appropriate care includes reviewing the mother’s history and psychosocial circumstances and conducting tests to rule out physical causes. At that point the concern may be postpartum depression, which he describes as a serious illness that can require both psychiatric medication and psychotherapy. Recovery may take years. In some cases the illness develops into postpartum psychosis, which can involve a genuine risk that the mother will harm herself or the baby and may therefore require immediate hospital admission and round-the-clock care.

The defense asks why Alice had not sought medical attention. Dr. Leclercq answers that the failure to seek help is common: research in the United States and Europe suggested that only around 15 percent of mothers with postpartum depression looked for help. He identifies the illness as a continuing taboo and links that silence to the pressure placed on mothers. A woman may find it painfully difficult to admit to herself, her family, and then medical authorities that motherhood has not made her happy but has instead left her feeling sunk. His testimony does not make every ambivalent or exhausted mother ill; it explains how social expectations can make serious suffering hard to name and harder to disclose.

Maternal ambivalence and the pressure to appear fulfilled

The Narrator’s account of early motherhood gives social context to the distress discussed at Alice Espanet’s trial without presenting ordinary ambivalence as a diagnosis. After giving birth, The Narrator says that walking alone—something that rarely happened—made her feel exposed, incomplete, and fraudulent. She imagined that strangers could not understand her unless they knew she was a mother, even when she was physically apart from her child. The separation did not bring the freedom she sometimes wanted: on solitary walks, she still carried the baby in her consciousness.

The change reaches beyond a momentary feeling of loneliness. After three months without sleeping more than three hours at a time, repeated visits to the nurse to monitor the newborn’s weight, and close attention to the baby’s bodily symptoms and functions, The Narrator feels that maternal identity has displaced her other selves. Writer, worker, wife, daughter, and former versions of herself seem exiled. This account conveys how fatigue and the constant demands of care can narrow a person’s sense of identity; it does not, on its own, establish a clinical condition.

The Narrator also remembers initially blaming Niclas for the pregnancy, knowing that he wanted to become a father and was already familiar with the equipment and concepts associated with infant care. After several uncertain days, however, she accepts the responsibility and begins to desire the expected baby. The movement from silent resentment to attachment shows that conflicting feelings can coexist with care and can change over time. It offers a counterpoint to the expectation, described by Dr. Leclercq, that motherhood should naturally produce happiness.

A further pressure is the dull, repetitive labor that public accounts of motherhood often leave out. The Narrator describes days filled with breastfeeding, changing diapers, trying to settle a crying baby, and checking whether the baby is breathing after falling asleep. The work occupies her around the clock, while the rest of the world appears to continue at its usual pace. She compares its low social regard to cleaning toilets, work she had herself done, and identifies a contradiction in a society that celebrates self-giving while leaving maternal care isolated and undervalued.

That tension also enters The Narrator’s ambitions as a writer. When Erik comes toward her happily at daycare pickup, she recognizes the intensity and vitality of their physical closeness and wonders whether absorbing that experience might eventually become visible in her writing. Yet she remains uncertain that love and contact with life will resolve the conflict between care and creative selfhood. The scene holds tenderness and doubt together rather than treating either as proof of what a mother ought to feel.

The book sets these private uncertainties against a change in the press’s treatment of Alice during her five days in custody. After initially taking another approach, newspapers began describing her as shattered and suggested that postpartum depression might explain her condition; the possibility first appeared through an untraceable neighbor and then through psychiatrists’ speculation about symptoms and percentages. The Narrator notes that the shift could have served the media’s appetite for prolonged curiosity, even as readers welcomed a move from crime reportage toward tragedy. The juxtaposition makes the diagnostic language consequential but not self-explanatory: it can open attention to maternal suffering while also becoming part of the public story built around a crime.

Public visibility and the pregnant body

Before motherhood, The Narrator found that public attention rarely centered on her being an author; even the critics who treated her worst were among the few who seemed to care that she had written something. The response changed when she appeared pregnant. People wanted to touch her belly, asked the baby’s sex and possible name, and offered suggestions of their own. The contrast makes pregnancy a more publicly legible identity than authorship: strangers show intense interest in the body carrying a child while the writer’s work goes largely unnoticed.

The Narrator links this disproportionate excitement, with dry irony, to the country’s poor birth rate, then contrasts it with the uncontrolled reproduction of books, which she regards as a nuisance. The joke sharpens the difference between the social value assigned to biological reproduction and the relative indifference shown to literary creation. After the birth, her sense of being incomplete when alone in public suggests the cost of that shift: pregnancy had made her conspicuous, while motherhood made her feel that others could not understand her unless they knew she was a mother.

Alice Espanet’s case and the limits of diagnosis

The clinical distinctions mattered in court because Alice Espanet’s condition had been observed at more than one point in her treatment. The two psychiatrists who first saw her at Hospital de Santiago confirmed that she had been in a state of shock during her admission, showing disorientation, amnesia, and denial of reality. Dr. Leclercq’s testimony then placed her later history within the discussion of postpartum depression and postpartum psychosis, drawing on a year of treatment rather than on the brief public descriptions that had circulated after the deaths.

The distinction between those diagnoses remained important: when asked whether depression led directly to psychosis, Dr. Leclercq agreed that the progression was not so straightforward, while calling Alice’s case clear. The testimony therefore neither makes postpartum depression a universal explanation for maternal distress nor erases the clinical complexity of Alice’s condition. It sets out a serious illness, the pressures that can conceal it, and the difficulty of interpreting an individual case through the simplified narratives available to a courtroom and a reading public.