Alison Pedley’s text might seem like a typical book about nineteenth-century asylums, with its eight chapters (including introduction and conclusion) covering the pathways into the institution, aspects of life inside, and the routes out. Yet this study of women who had killed or harmed their children, often in a state of puerperal insanity—an ancestor of postpartum psychosis and depression—and were admitted to the spaces designated for criminal lunacy in England and Wales is different. Embracing all three specialist sites in England, as well as a representative county asylum, the book centers on the lives of the women, rather than the running of the asylum. This summarizes the value of the volume, and also undersells what Alison Pedley has produced.

We do indeed learn about the facilities. Bethlem Royal Hospital in London, the oldest asylum in the country, erected criminal lunatic wards in 1815. The private Fisherton House asylum in Wiltshire in southwestern England offered overspill places to the state from 1848. Broadmoor opened in 1863 in Berkshire (west of London) as the first criminal lunatic asylum for England and Wales. Northwestern Lancashire’s Rainhill county asylum in Liverpool, which, like its counterparts elsewhere, could hold those on remand, was chosen because, outside of London, “the highest number of court cases for maternal infanticide and child murder was the north-west of England, and Liverpool had more cases than other cities” (20). The sweep of the facilities alone is unique. However, it is the attention devoted to the women that is most impressive. They are humanized and given the same care that they often received from the men who shepherded them through the system, from their initial crime and frequently to the end of their days. Though perhaps counterintuitive to readers, the sympathy the author found in the press, and from police surgeons and prison doctors, judges, alienists (proto-psychiatrists), chaplains, and supporters, as well as the women’s family members, glows from every page.

Indeed, the family resides at the very heart of the study. The women and their place in their own families, including as single mothers and among the children they harmed, is a constant in the text, as are the relationships they formed inside the asylums. The bedrock of the book is Pedley’s framing of moral therapy at nineteenth-century institutions as paternalistic and organized along familial lines, with the medical superintendent as father, the matron as mother, and the other staff as further relatives. Yet, like kith and kin could be, treatment was itself fickle; Pedley’s work demonstrates that the Victorian medico-legal system was not Gradgrindian, but could be pragmatic and even sentimental. The devotion and kindness of many (though not all) of the alienists, chaplains, and staff are closely considered in chapter 6. The humanizing of the men responsible for operating the system, raising their own families, and caring for their current or former wards is an important difference from much of the historiography. Moreover, the value of family history methodologies is clear throughout. In just one example from 1881, nineteen years after the criminal lunatic Martha Lewis, wife of master shoemaker William, received a Royal Pardon and was released from Bethlem, the couple were working respectively as Head Attendant and Head Storekeeper at Warwickshire County Lunatic Asylum (113).

There are, however, issues with the book. The author is rightly pleased with the material she has gathered; running between 1835 and 1901, her database is put at “well over 300” women considered infanticidal (20). The mining of the impressive range of material accrued is, though, limited. Rich are the anecdotal details, and certainly there are pie charts and tables, but a full breakdown of the data is lacking. A first chapter that extrapolated all the statistical information about the women, including age, number of children, length of stay, and class, to mention but a few, would have presented insights against which the humanity of the rest of the book could have unfurled. Class is the perfect case in point, as it is a touchstone throughout, especially in key discussions around respectability and social attitudes. Yet we do not really know the proportions from each class, whether the ratio between differently classed women inside corresponds to that of wider society, or if pre-1863 admissions were influenced by social standing, or whether class altered medical diagnosis.

The absence of analysis is evident via the inclusion of women detained as criminal lunatics but who had not harmed their children. It is incredibly valuable that they are included, but much is lost by not comparing the two groups statistically or otherwise, and sometimes I was left wondering to which group the woman being written about actually belonged. That might be a shortcoming of the reader, of course, but that religion is only a peripheral and not a core part of the study is problematic, especially in considering that both the modern penal system and the York Retreat—to which the author returns frequently—were predicated on religion, for the former as a cure for criminality and a means to save souls. These issues mean that the key questions of the book, as outlined by the author, are not convincingly answered:

Nevertheless, the study is triumphant in its “aim … to contextualise the women and their lives, [and] to assign some distinctiveness to each of them, before they became cogs in the wheels of the medico-legal system” (181). Arguably, the humanity of the book is unsurpassed in the field. What is more, with such a wealth of information drawn from so diverse a range of sources and methodologies—from court reports to genealogical insights—this research is far from exhausted. I look forward to reading more from Alison Pedley and about the companions she walks alongside in her tender and worthwhile endeavors.