Women's accounts of 'puerperal psychosis' (PP) and 'postnatal depression' (PND) were analysed using a qualitative approach (Interpretive Phenomenological Analysis). The study aimed to explore experiences of PP and PND from women's own perspectives; to see whether accounts of PP and PND can be differentiated from each other; and to see whether taking a gendered perspective and drawing on psychological theories of psychosis can offer ways of understanding the experience of PP. Although only women with a diagnosis of PP reported unusual beliefs or hearing voices (as would be expected since it was these reports that resulted in the diagnosis), there were no differences between groups on other forms of distress such as low mood, anxiety and fear of harm to the baby. There were also no differences in the social and material contexts of women's lives (e. g. financial difficulties, lack of support). The importance of exploring the social and relational context of unusual experiences is emphasised and the content of 'delusions' 'hallucinations' 'paranoia' and 'rumination' (traditionally viewed as incomprehensible), as well as feelings of depression, were found to be related to the difficult transition to motherhood and ambivalence about pregnancy, childbirth and the baby within the context of overwhelmingly positive sociocultural discourses of motherhood. The impact of this context on self-identity (as a woman and a mother) and on having to take control and responsibility whilst remaining powerless in their wider context, were themes common to all six women. The clinical and theoretical implications are discussed, and areas identified for further research.