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about the i r mari t a l s tat us, wh ich t hey considered illeg al
be cause certain traditional rites h a d not been performed . In
India, the birth of a f e ma l e i n fan t was observed t o be an
important contributory factor to t he occurrence of puerperal
psychosis (2 45] . The populations in the developing wo r ld
i nc l ud e large numbers of d i f f erent e t h ni c groups and there are
a s many postpartum cUltura l practices as there are ethnic
g rou ps . Th e incidences o f puerperal mental d i sorders, and of
its determinants, may need to b e s tudied separately i n each
e thnic society if e r reot.Lve measures f or modifying the
occu r r e nce of puerperal psyctliatric morb i d ity are to be
undertake n .
The devastating eff ects o f puerperal psychosis in the
Af rican setting however , can b e best a pp r e c i a t e d whe n the
findings presented by Ma kan j uola I s s t udy in Nigeria
reviewed [ 244] . Of t he 57 psychosis cases seen i n a year, 30
ha d stopped breast-feeding because of their illness . For t he
infant in thi s region t his marks t he be ginnings of mal­
nutrition since artificial feeds are expensive and are not
readily available . Seven babies d i e d a nd seven othe rs ne eded
ho spital admission for s evere i ll-he a :Lt h. Elev e n husbands
deserted their wi ves [ 24 4 J . These findings can be compared
with that of ua Silva et a r , i n t he United Kirgdom where o nly
2 of 50 babies from 47 pu e rperal c ases died. Of these deaths
only one coul d be attributed to t he mothe r's ill ne s s because
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