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Puerperal psychosis is a rare complication of childbirth, with an incidence of about 1 to 2 per 1000 births.
The onset is usually 2 to 4 days after delivery and it is often characterised by clouding of consciousness, perplexity, delusions and hallucinations. The majority of these conditions are affective in nature, either depressive or hypomanic; some are schizophrenic and a mixed picture is not uncommon.
Paranoid delusions often centre around the child, for example a belief that the child is the devil, or that the world is too evil for the child to live in. Consequently there may be a risk of infanticide or injury to the child. Apart from this specific risk the child may suffer neglect or inappropriate treatment at the hands of a psychotic mother.