Nursing Book Club

Inferno: A Memoir of Motherhood and Madness by Catherine Cho

A troubling account of postpartum psychosis

Who we are is not only a product of our DNA, as we all know. Our culture and the sum of our individual experiences also help to make us into the adults we become. We ignore this at our own peril, as author Catherine Cho reveals in her postpartum memoir, Inferno.

Inferno unfolds in a series of flashbacks, which describe vividly how Cho, a Korean-born woman who was living in London when her young son was born, came to be in an inpatient psychiatric unit in New Jersey.

Unhappy Upbringing

Through these flashbacks, we slowly learn the source of the lifelong unhappiness that culminated in Cho’s psychological breakdown.

Her father is described as a largely silent man with a bad temper, simmering with rage. Her mother is ambitious, wanting better for her daughter than she had herself. After gaining an education in the U.S., her mother moved far away, leaving the family separated. None of this was addressed or resolved within the family, which left the author and a younger brother to navigate life between two unhappy parents.

After this difficult childhood came a series of terrible, dangerous relationships with men. You might wonder why it took so long for Cho’s psychiatric symptoms evident — or if anyone was even looking.

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100 Days

Korean families mark the first 100 days of a baby’s life with a celebration. Normally, baby and mother are kept at home, tucked away, safe from disease, getting to know each other and establishing routines before finally emerging.

Cho and her husband instead decided that they would spend the first 100 days flying from London to California and then driving across the United States, meeting family along the way and finishing with a big party in New Jersey.

Any mother reading this memoir will long to reach out and tell Cho that this is an unrealistic plan that can only result in stress and heartbreak — as indeed it did.

Beyond the Baby Blues

Postpartum depression is quite common. Scientists now think that up to 50 percent of all new mothers may suffer some period of “blues,” much of which can be attributed to hormonal changes, lack of sleep, changing relationships with family and friends, and alterations in the new mother’s own self-identity.

Postpartum psychosis, which eventually landed Cho in the psychiatric ward, is much rarer, occurring in only 1-2 new mothers per 1,000. Marked by a complete break with reality, the condition is more common following a first pregnancy and in patients having a personal or family history of bipolar disorder.

RN Career Events

It’s easy to look in the rearview mirror and say that the first indications of Cho’s mood disorder were there all along — the unhappy parents, the inability to disentangle herself from damaging relationships. But we can also marvel at how bravely Cho continued her life, striving constantly for a sense of normalcy.

New mothers are often unable themselves to determine whether their mood shifts are normal or not. Even if they’re feeling sad at the end of a pregnancy, they often believe they should feel thrilled with the infant they have been waiting nine months for, and are reluctant to disclose any unhappy feelings. This is why in most states, postpartum depression screenings are part of the initial pediatric visits. Simple questions can determine who needs help, even in situations less extreme than Cho’s.

Inferno is sometimes uncomfortable to read. The author is lucky to have a husband whose devotion never wavered, and to have found the care she needed. Her willingness to share this deserves a medal.  Inferno is an important book and should certainly be on the reading list of anyone dealing with new mothers.

Inferno: A Memoir of Motherhood and Madness by Catherine Cho (Henry Holt and Co., 2020)


CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, from infants to geriatrics.


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