Inferno: harrowing account of postpartum psychosis

Inferno: A Memoir

Author: Catherine Cho

ISBN-13: 978-1526619082

Publisher: Bloomsbury

Guideline Price: £16.99

Catherine Cho’s Inferno begins with her description of a Korean tradition: “After a baby is born, mother and baby do not leave the house for the first twenty-one days. There are long cords of peppers and charcoal hung in the doorway to ward away guests and evil spirits.” The mother should keep her body warm and eat seaweed soup, to give her strength. After 100 days, the family should throw a big party, a “celebration of survival, with pyramids of fruit and lengths of thread for long life”.

Catherine and her husband James were recently married Korean-Americans living and working in London in 2017– a place and time when the overwhelming majority of newborns survive their first 100 days. While their Korean-born parents reminded them about “sitting out” the period after birth, Cho writes, “I didn’t see why we had to pay attention to Korean traditions or superstitions, as I thought of them”. Instead, she made what she calls a “fateful” decision: she and James would spend several weeks of their parental leave in the US, taking their baby home for an extended visit to their friends and families. Soon enough, this urge to celebrate the birth with a vacation collided with the reality of her son’s round-the-clock demands.

Cho’s pregnancy and childbirth had been more challenging than most, including gestational diabetes, a stalled labour, and an emergency Caesarean: “My scar burned, I could feel it, a broad slash across my abdomen”. During an extra week spent in the hospital due to sepsis, she was “so constantly being groped and poked and told to do skin-to-skin that eventually I just took off my clothes and sat on the bed with the baby on my chest. I felt mammalian; there to exist, just to listen to what I’d been told”. She writes powerfully about the disorienting shift in her sense of self: “In the blur of those hours, I stopped thinking of myself as having a name, I was a body. I had no identity.”

It wasn’t just her baby, Cato, who was demanding. Older women in her life had long told Catherine that the role of women is to submit. Her grandmother’s stories of heroines from Korean folktales taught that love requires sacrifice. Her mother-in-law told her: “When you’re married . . . you have to surrender.” Years earlier, Cho had moved to Hong Kong to be with her boyfriend Drew, who turned out to be violently abusive. His mother begged her to be more patient with him, “less American”, until one day Cho fled the apartment in a thin nightdress, carrying only her wallet and phone. Traumatic memories of Drew’s violence and his mother’s pleas haunt her during her postpartum ordeal.

Manic and sleepless, suffocating with the nearness of her husband's parents and their sidelong glances at her, she looked at her baby and saw devils in his eyes

The postnatal trip to the US began happily enough, with the wedding of friends on the west coast. But Cho had difficulty feeding her continually squalling boy. While they were staying with James’s brother in a gleaming suburban house, she left her breasts exposed in order to clear up a case of thrush until she realised in a panic that all of her actions were being recorded on the household’s Nest Cam. Staying with James’s anxious and judgmental parents, her rapidly deteriorating mental condition blossomed into pure paranoia when she learned that there too, the entire house was surveilled with Nest Cam.

Manic and sleepless, suffocating with the nearness of her husband’s parents and their sidelong glances at her, she looked at her baby and saw devils in his eyes. She heard a voice saying: “Your son needs to die.” Just a week before her in-laws were planning to host the 100th-day celebration, she found herself in an involuntary psychiatric unit.

Inferno contains excerpts from a notebook Cho kept during her hospitalisation, while she was still uncertain how she came to be there and how best to be released. In her pocket, she kept a folded paper so that she could read her “truths” over and over:

"My son is three months old. Real.
My husband and son are waiting for me. Real
I have postpartum psychosis. Real."

Postpartum psychosis, a rare illness that occurs in roughly one in 1,000 births, is not necessarily connected with an underlying psychiatric illness, and Cho doesn’t mention any previous or subsequent diagnosis. But it’s hard not to conclude that intrusive family members have assailed Cho’s mind, already fragile with sleeplessness, with their relentless anxiety for the baby, and with their insistence on Korean traditions wreathed with fear and superstition.

Given that becoming a mother is haloed with sentimentality for too many people, Cho is courageous in sharing her harrowing descent into postpartum psychosis. With its clear-eyed view of how a family’s cultural expectations can torment a well-educated, cosmopolitan woman giving birth for the first time, Inferno is a welcome addition to the small and growing shelf of memoirs where, as in Rachel Cusk’s A Life’s Work and Anne Enright’s Making Babies, women tell true stories of the often overwhelming cost of bringing a child into the world.

Mary Cregan is author of The Scar (Lilliput Press)