Postpartum Psychosis: Recognition, Treatment, and Advocacy with Dr. Susan Feingold

 
Susan Feingold
 

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Episode Notes

In this episode of Perinatal & Reproductive Perspectives, host Becky Morrison Gleed speaks with clinical psychologist and advocate Dr. Susan Feingold about postpartum psychosis—a rare but severe perinatal mental health condition that is often misunderstood, misidentified, or minimized.

Dr. Feingold explains how postpartum psychosis differs from more common perinatal mood and anxiety disorders, why it is considered a psychiatric emergency, and how it can present suddenly, even in individuals with no prior mental health history. The conversation explores clinical features such as loss of contact with reality, paranoia, delusions, hallucinations, sleep disruption, and fluctuating symptoms that can complicate recognition.

The episode also addresses systemic gaps: the absence of postpartum psychosis as a standalone diagnosis in the DSM, the implications for clinical care and legal outcomes, and ongoing legislative efforts in the U.S. to prioritize treatment over punishment when postpartum mental illness intersects with the legal system. Throughout, Dr. Feingold emphasizes prevention, early identification, appropriate hospitalization, and the strong potential for recovery with timely, evidence-based treatment.

Topics Discussed

  • What postpartum psychosis is—and how it differs from postpartum depression and anxiety

  • Prevalence, risk factors, and why prior mental health history is often absent

  • Core symptoms: psychosis, paranoia, delusions, hallucinations, and impaired judgment

  • Why postpartum psychosis is a psychiatric emergency requiring hospitalization

  • The role of sleep deprivation, hormonal shifts, and possible biological mechanisms

  • “Waxing and waning” symptoms and why they increase risk if misinterpreted

  • Clinical decision-making for generalists and non-specialist providers

  • Hospital treatment, medication, and recovery trajectories

  • Stigma, shame, and the psychological aftermath even when no harm occurs

  • Legislative advocacy to recognize postpartum psychosis in law and policy

  • Prevention, education, and systems-level responsibility across healthcare and legal settings

Guest information

Dr. Susan Feingold is a clinical psychologist, author, advocate, and internationally recognized expert in perinatal mental health. With more than 30 years of clinical experience, she specializes in perinatal mood and anxiety disorders, including postpartum psychosis. Dr. Feingold serves on the advisory board of Postpartum Support International and has been a leading voice in legislative efforts to reform how postpartum mental illness is understood and addressed within the U.S. legal system.

She is co-author of Advocating for Women with Postpartum Mental Illness: A Guide to Changing the Law on a National Level, which documents the passage of the first U.S. postpartum psychosis criminal law in Illinois and offers a framework for advocacy and reform in other states.

Resources

  • Book: Advocating for Women with Postpartum Mental Illness: A Guide to Changing the Law on a National Level
    Available via Amazon and Rowman & Littlefield

  • Website: Dr. Susan Feingold

  • New York Times article referenced in the episode
    (linked in show notes for additional context on postpartum psychosis and public awareness)

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Perinatal Mental Health Screening as a Public Health Imperative