The Yellow Wallpaper and the Baby Blues: A Book Review with Historical Context

‘The Yellow Wallpaper’ by Charlotte Perkins Gilman is a ten-page short story chronicling a new mother’s descent into postpartum depression (PPD) and psychosis. It is the protagonist’s secret diary, logging her experiences of the “Rest Cure” forced upon her by her husband and physician, John. Confined to a room in a colonial mansion, and increasingly obsessed with its yellow wallpaper, the protagonist becomes convinced there is a woman trapped behind it. The story ends with the protagonist tearing the paper off the walls, believing that she is the woman seeking to break free. Gilman gives us a snapshot of this female experience, a powerful commentary on patriarchy and attitudes towards mental health in the 19th century (Gilman, 1892). Using the lens of Gilman’s short story, we can trace ties from the past to how we view puerperal mental health today.

“I’m getting dreadfully fretful and querulous. I cry at nothing, and cry most of the time.”

It is common for women in the days after birth to experience the “baby blues” as a result of the extensive hormonal shift that has taken place in their bodies during labour. If the low mood, loss of appetite, and anhedonia last for over two weeks, the diagnosis may become PPD. PPD affects 10-15% of all women having a baby (Green, 2018). Previous history of psychological issues is a key risk factor. Even negative attitudes toward pregnancy can be enough to precipitate a depressive state (Gaedrhamati et al, 2017). Pitt first recognised PPD and Postpartum Psychosis as a perinatal mental health continuum in 1968 (Pitt, 1968). Around 1 in 500 women will experience postpartum psychosis and report feelings of paranoia, as well as visual or auditory hallucinations (Green, Heron, and Jones, 2022).

The current focus of clinical practice is prevention. It is now common practice to discuss mental health in antenatal checkups (Di Fiorio and Jones, 2023). But this more robust questioning was not always the standard. The ghost of mental health stigma past haunts the attitudes of women to this day.

The Needs of Mother and Baby

“Such a dear baby! And yet I cannot be with him, it makes me so nervous”

The first noticeable absence from ‘The Yellow Wallpaper’, is the protagonist’s baby. There are few mentions of her son, and the protagonist is kept away from him as part of her “Rest Cure”. This was a common occurrence for women until the implementation of Mother and Baby Units (MBUs) in psychiatry, which began in the late 1940s. “The child must be separated from the mother at all costs”, reads one physician’s advice in 1924 (C.P Van Der Host and Van Der Veer, 2010). Concerned with “melancholic filicide”, psychiatric textbooks at this time advised that “no patient should be returned to the care of house and children until several months have elapsed after apparent recovery”.

Joint admissions in MBUs were not intended for the mothers’ benefit. Wartime drove children away from their families, and after the war, the bond between mother and child was recognised (C.P Van Der Host and Van Der Veer, 2010). This aligned with the movement to push women back into traditional roles in the home and the scarcity of third-party childcare. The first psychiatric admission of a mother with her child happened in 1948 due to a lack of alternative childcare (Howard, 2000). As this practice grew, the benefits to the mother were documented. Dr Gwen Douglas wrote the first report of a joint admission for postpartum psychosis in 1956 (Douglas, 1956).

Social Integration as a Remedy

“Personally, I believe that congenial work, with excitement and change, would do me good.”

The protagonist is subjected to “Rest Cure” – a therapeutic technique involving prolonged bed rest, overfeeding, and seclusion, developed by physician Weir Mitchell, in the 19th century (Stiles, 2023). Gilman describes seclusion from her support system as worsening her condition, and expresses a desire to participate in the activities that bring her fulfilment: “I sometimes fancy that in my condition if I had less opposition and more society and stimulus -” before stopping herself from disagreeing with her husband on paper (Gilman, 1892). Social isolation as an exacerbating factor in PPD was further noted by women in the 1960s; activist Betty Friedan even alleged that this may have been the root cause of PPD in housewives in 1963 (Elliott, Millard and Sabroe, 2020). The ability to engage in activities other than mothering is protective against postpartum depression. With the rise of community psychiatry and family therapy in the 1960s, women were able to continue to participate in daily life, correlating with decreased admissions and improved prognoses (Howard, 2000). The Women’s Liberation Movement in the 1970s birthed community forums – giving mothers the language with which to communicate about shared experiences. It is noticeable that Gilman’s ‘The Yellow Wallpaper’ is devoid of medical jargon, as the protagonist lacked the vocabulary to accurately describe her symptoms (Gilman, 1892). Women’s Liberation activists pushed for increased media coverage of birth trauma. This collective advocacy pushed for a change in attitudes from the psychiatric community.

Taking Women Seriously “John is a physician and perhaps… that is one reason I do not get well faster. You see he does not believe I am sick!” Believing women is not a new obstacle in medicine. The legacy of physicians not trusting women with their own bodies remains. 58% of women experiencing postpartum mood disorders do not report them, choosing to suffer in silence (Sandraluz Lara-Cinisomo, Wood and Fujimoto, 2018). By 1960, most births no longer took place at home. The medicalisation of birth led to patriarchal paternalism in a space previously women-led. Consultant-led care meant that mothers felt they were no longer the protagonists in their own labours. Now, birth trauma is a well-recognised risk factor for PPD, building on insights made by Ann Oakley in 1981 – “the way in which a birth is managed could influence a woman’s whole experience of being a mother” (Elliott, Millard and Sabroe, 2020). The impact of compassionate healthcare practitioners was identified in 1892 by Gilman on the very first page of her short story.  Conclusion, though progress has been made, further work remains in reaching out to mothers who face considerable barriers to care. ‘The Yellow Wallpaper’ endures not only as a literary classic, but as a reminder that stigma, isolation, and medical paternalism are not relics of the 19th century. Gilman’s story asks us to consider whose voices are believed in medicine — and whose suffering is still confined behind closed doors.

Dr Paula Lago Burity

F1, North West of England Foundation School

May 2026

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The views expressed in this article are those of the author’s, and do not necessarily reflect the official stance of the UKFPO.