The tragic case of Charlotte Bevan{0}

TRIGGER WARNING:  This post deals with depression and suicide

Just watching the video gives me chills.  A new mother, post-birth tummy roundness still visible, walks out of hospital in her slippers, clutching her newborn and no-one stops her.  She heads to a bridge in Bristol and jumps.  Two days later their two bodies are found at the bottom of a gorge.  What must have been going through Charlotte Bevan’s mind is impossible for anyone who has not lived with depression and schizophrenia to imagine.
Charlotte’s family have paid tribute to the hospital staff, but legitimate questions have been raised about her care and why a woman with diagnosed mental illness was able to leave hospital with her baby.  These questions will be answered in due course, and we shouldn’t prejudge the outcome of the hospital’s own inquiry, and the likely coroner’s inquest also.

However, as someone with a deep interest in baby feeding, I couldn’t help but notice this sentence in many of the news reports.  “The 30-year-old may have stopped taking medication for depression so that she could breastfeed Zaani. She is also understood to have been treated for schizophrenia and was also severely sleep deprived.”

The report from The Times said the hospital wouldn’t comment on whether she had had depression medication removed – in other words, we don’t know if it’s true or not.  That said, it looks as though it is at least possible this was the case.

No-one knows Charlotte Bevan’s personal circumstances yet.  I can only hope she had good care before she gave birth, and made an informed choice about the risks of going off her medication in order to breastfeed, if indeed that’s what did happen.  I would hope that given what appears to be her long-history of mental illness that she was put under no pressure to breastfeed, and if she was on one of the depression medications that can’t be taken while breastfeeding that she was encouraged to stay on her meds, for the sake of her and her baby.

I’m not coming at this from an average punter’s perspective.  More than a year ago a friend of mine jumped to her death, leaving her seven week-old baby without a mother, and her adoring husband without a wife.  She had a long history of depression, and was on day release from a mother and baby unit.

She had written to me a few weeks before her death telling me how she was struggling to breastfeed her daughter, and how she felt so guilty about it.  I asked her to give me a call, as I didn’t know which country she was in, but she never did.  A couple of weeks later she died.  I don’t know what the situation with her medication was, but I do know that breastfeeding her baby, despite her fragile mental health state, was still a priority for her, and a source of anguish when it didn’t work out.  I’m by no means saying that this was what caused her death – she was very ill and had been even before the baby was born – but it certainly didn’t help her mental state.

Ultimately, mothers are rightly in charge of their own decisions about what medications they take, and how they feed their babies.  I only hope that in the case of Charlotte Bevan it was a fully informed and supported choice.

We know that most women say they want to breastfeed.  We also know that many women feel under pressure to breastfeed, and that if it doesn’t work out as planned, this can increase their risk of post-natal depression.  We know, conversely, that successfully breastfeeding can help to stave off PND.  And we know that it is possible to take some anti-depressants and continue to breastfeed.

In a culture which relentlessly tells us that ‘good mothers breastfeed’ special care needs to be taken of women for whom breastfeeding may not be the best option.  Are we giving enough care to those women?  I don’t know.  Probably in some cases yes, and in others, no.  This yet another reason why, in my opinion, we need to ditch universal breastfeeding targets in favour of individualised feeding plans, as I wrote about in The Guardian recently, and also in Guilt-Free Bottle-Feeding.

Charlotte Bevan’s case could simply be a tragic aberration, but I wonder how many near misses there have been of women who felt so much pressure and/or desire to breastfeed that they went off medication which was saving their lives.  From reading accounts online, as speaking to my friend Nicole Highet of COPE, I suspect there are a few.

All of our thoughts are undoubtedly going to Charlotte’s family.  I hope, for everyone’s sake, that this was simply an unavoidable tragedy.  But if it was avoidable, I hope we can learn the lessons.