Ambivalence toward mothers who kill: an examination of 45 U.S. cases of maternal neonaticide

Filicide and criminal justice outcomes: Are maternal and paternal perpetrators treated differently?

BACKGROUND

Most child homicides are committed by a perpetrator who has a maternal or paternal relationship with their victim which is commonly referred to as filicide. Previous research has examined differences in how maternal and paternal perpetrators are discussed in the media but there is a paucity of research comparing the treatment of maternal and paternal perpetrators in the criminal justice system.

OBJECTIVE

The goal of this study is to examine whether criminal justice outcomes vary for male and female perpetrators of filicide.

PARTICIPANTS AND SETTING

This study examines 298 cases of filicide between 1985 and 2018 in Ontario, Canada.

METHODS

Bivariate and multivariate analyses are used to compare charges, convictions, conviction types, sentence types, and sentence lengths imposed on maternal and paternal filicide perpetrators.

RESULTS

Results show that maternal perpetrators are less likely to be convicted (Odds = 0.279, p < 0.01), less likely to be convicted of murder (Odds = 0.364, p < 0.01), less likely to receive a prison sentence (Odds = 0.087, p < 0.01), and receive sentences that are shorter on average (B = -2.183, p < 0.001) compared to paternal perpetrators.

CONCLUSIONS

Future research should examine how criminal justice actors weigh and consider the motives and broader social and structural factors that may lead to filicide when determining criminal justice outcomes. An integrated social role and medicalization framework may allow researchers to develop a better understanding of these results.

Ethical Dilemmas and Countertransference in Legally Mandated Reporting of Fatal Child Neglect

In the fall of 2019, a much-publicized court case brought to national attention the issues of patient-doctor confidentiality when it comes to reporting the deaths of newborns in the United States. It is unclear whether the recent overturning of Roe v. Wade will lead to more cases like this. This article discusses issues of countertransference, as well as the ethical and legal implications were it to be a psychiatrist, in active treatment of such a patient, who would be required to make such a report. More specifically, as in the publicized court case, the patient could be a minor at the time, receiving treatment from a child psychiatrist. The implications of such a case include how countertransference affects the perception of fatal child neglect compared to intentional neonaticide; the ethical dilemma of generating a mandated report with the goal of child safety when such a report could lead to real legal consequences for a minor child; and considerations regarding continued treatment of a patient after such a report is made. It is likely that countertransference, shaped by attitudes toward mothers and idealized views on mothering, may play a large role in all these circumstances.

Towards a new understanding of pregnancy denial: the misunderstood dissociative disorder

Pervasive pregnancy denial is a misunderstood reproductive anomaly which compromises the health of both mother and the developing fetus. Because in extreme cases, the death of the neonate at the hands of his/her mother has criminal repercussions, research has attempted to explain the origins of this clinical phenomenon. The purpose of this review is to analyze the evolution of understanding the association between pregnancy denial and neonaticide. This paper identifies the consistent similarities in symptom presentation, particularly dissociation, when a denied pregnancy ends with the death of the newborn. The common thread across the progression of the literature over time serves as a foundation for considering the development of diagnostic criteria for future inclusion in the Diagnostic and Statistical Manual of Mental Disorders. This paper reviews the seminal research from 1969 to current research up to 2020 addressing pregnancy denial and its connection to neonaticide. Peer reviewed and published articles related to key terms around "pregnancy denial," "pregnancy concealment," "neonaticide," and "dissociation" were retrieved from major databases such as PubMed, PsychINFO, JSTOR, ProQEST, ScienceDirect, and Google Scholar. Reference lists of relevant articles were also scanned to search for further papers pertaining to similarities in symptom presentation across demographic profiles. Papers were excluded if they were not available in English, or if they did not contribute to identifying consistencies in clinical presentation when a pregnancy is denied. There are clear repetitive markers that occur across studies which pertain not only to the frequent absence of certain expected indicators of pregnancy, (i.e. no morning sickness, weight gain, or sensations of fetal movement), but also the misattribution of pregnancy-related symptoms, and the consistent experience of a dissociative episode while giving birth that can unintentionally result in neonaticide. This paper concludes that dissociation is a consistently seen symptom in pervasive pregnancy denial. Dissociation, in addition to other commonly seen symptoms across cases, suggests specific diagnostic criteria that lend themselves to inclusion in the Diagnostic and Statistical Manual of Mental Disorders.

Neonaticide rate unchanged in Japan despite a decrease in the birth rate

BACKGROUND

Neonaticide is the murder of a newborn baby within 24 hours of birth. It has been reported in various countries, but there has been little recent research on the current state of neonaticide in Japan.

AIM

To elucidate the epidemiological features of neonaticide in Japan using public long-term, population-based data collected over 14 years and 9 months from July 2003 to March 2018.

METHODS

A descriptive analysis of public data from 2003 to the present was conducted related to deaths which had been retrospectively investigated and deemed by the authorities to be caused by child abuse or neglect.

RESULTS

Between July 2003 and March 2018, there were 149 cases of 'known' neonaticide in Japan and the incidence was 0.96/100,000 live births. The majority of perpetrators were mothers, accounting for 135 (91%) of cases, and in 70 (48%) cases they were young mothers under the age of 25. None of the infants was delivered in a medical facility. Nine (6%) murders were committed by both parents together and only one (1%) by the father alone.

CONCLUSION

The number of births in Japan has been declining gradually but the rate of neonaticide is the same.

Gender differences in legal outcomes of filicide in Austria and Finland

Female offenders of filicide have been found to receive more lenient legal handling than male offenders. We aimed to discover these possible gender differences in the legal outcome of filicide cases. This was a binational register-based study covering all filicide offenders in Austria and Finland 1995-2005. We examined the legal outcomes of the crimes of all living offenders (64 mothers and 26 fathers). Mothers received a conviction of murder and life imprisonment less often than fathers. Within psychotic and personality-disordered offenders, infanticides, and offenders convicted for life, gender differences were less evident. Even though there seems to be some gender differences within the legal outcomes of filicide, ruling seemed more consistent than expected within distinct subgroups of offenders. Gender-based assumptions should not hinder equal and just handling of filicide cases.

Filicide in the United States

In the United States the Accreditation Council of Graduate Medical Education determines the curriculum required for fellows in forensic psychiatry to become board certified as a subspecialist. Areas that must be covered during the one year fellowship include criminal issues, such as insanity; civil issues, such as tort law and Workers' Compensation; legal regulation of psychiatry, such as confidentiality and involuntary hospitalization; and correctional psychiatry issues, such as dual agency and prisoner's rights. Fellows are also expected to have knowledge about juvenile courts, the structure of the legal system, and child custody issues. In addition, fellows are required to analyze complex cases and write forensic reports which are well reasoned. Teaching methods include lectures, storytelling, use of video vignettes, and mock trials. Additional teaching methodologies include group supervision of fellows in their report writing and direct observation of giving testimony. During the year we see fellows evolve and shift their orientation from being an advocate for patients to perceiving their role as serving justice.

Infanticide and illegal infant abandonment in Malaysia

Infant abandonment and infanticide are poorly understood in Malaysia. The information available in the public arena comes predominantly from anecdotal sources. The aim of this study was to describe the prevalence and characteristics of infanticide and illegal infant abandonment in Malaysia and to estimate annual rates for the most recent decade. Summaries of data about infanticide and illegal infant abandonment were gathered from police records; the annual number of live births was ascertained from the national registry. The estimated inferred infanticide rates for Malaysia were compared with the infanticide rates among countries of very high, high, medium, and low rankings on the Human Development, Gender Inequality, and Gini indices. From 1999 to 2011, 1,069 cases of illegal infant abandonment were recorded and 1,147 people were arrested as suspected perpetrators. The estimated inferred infanticide rate fluctuated between 4.82 and 9.11 per 100,000 live births, a moderate rate relative to the infanticide rates of other countries. There are substantial missing data, with details undocumented for about 78-87% of cases and suspected perpetrators. Of the documented cases, it appeared that more boys than girls were victims and that suspected perpetrators were predominantly Malays who were women, usually mothers of the victim; the possibility of arrest bias must be acknowledged. Economic and social inequality, particularly gender inequality, might contribute to the phenomena of infanticide and abandonment. Strategies to reduce rates of infanticide and illegal infant abandonment in Malaysia will require strengthening of the surveillance system and attention to the gender-based inequalities that underpin human development.

Psychosomatic disorders of gravida status: false and denied pregnancies

OBJECTIVE

The authors review the literature on two dramatic psychosomatic disorders of reproduction and offer a potential classification of pregnancy denial.

METHOD

Information on false and denied pregnancies is summarized by comparing the descriptions, differential diagnoses, epidemiology, patient characteristics, psychological factors, abdominal tone, and neuroendocrinology. Pregnancy denial's association with neonaticide is reviewed.

RESULTS

False and denied pregnancies have fooled women, families, and doctors for centuries as the body obscures her true condition. Improvements in pregnancy testing have decreased reports of false pregnancy. However, recent data suggests 1/475 pregnancies are denied to 20 weeks, and 1/2455 may go undiagnosed to delivery. Factors that may contribute to the unconscious deception include abdominal muscle tone, persistent corpus luteum function, and reduced availability of biogenic amines in false pregnancy, and posture, fetal position, and corpus luteum insufficiency in denied pregnancy. For each condition, there are multiple reports in which the body reveals her true pregnancy status as soon as the woman is convinced of her diagnosis. Forensic literature on denied pregnancy focused on the woman's rejection of motherhood, while psychiatric studies have revealed that trauma and dissociation drive her denial.

CONCLUSIONS

False pregnancy has firm grounding as a classic psychosomatic disorder. Pregnancy denial's association with neonaticide has led to misleading forensic data, which obscures the central role of trauma and dissociation. A reappraisal of pregnancy denial confirms it as the somatic inverse of false pregnancy. With that perspective, clinicians can help women understand their pregnancy status to avoid unexpected deliveries with tragic outcomes.

Neonaticide in India and the stigma of female gender: report of two cases

Neonaticide is known to occur across the globe in both developed and developing countries, but has rarely been reported from India. Two similar cases of female neonaticide are presented which were committed by their mothers while in the maternity ward. The social issues and maternal provocation highlighted in this report are different from those reported in world reviews of neonaticide.

Mothers who kill: evolutionary underpinnings and infanticide law

Women who kill their children present a profound challenge to accepted notions of motherhood and the protection offered by mothers to their children. Historically, societies have varied in the sanctions applied to perpetrators of such acts, across both time and place. Where penalties were once severe and punitive for mothers, in modern times some two dozen nations now have infanticide acts that reduce the penalties for mothers who kill their infants. Embedded within these acts are key criteria that relate (a) only to women who are (b) suffering the hormonal or mood effects of pregnancy/lactation at the time of the offence which is (c) usually restricted to within the first year after delivery. Criticisms of infanticide legislation have largely centered on inherent gender bias, misconceptions about the hormonal basis of postpartum psychiatric disorders, and the nexus and contribution of these disorders to the offending in relation to issues of culpability and sentencing. Important differences between female perpetrators relative to the age of the child victim have also highlighted problems in the implementation of infanticide legislation. For example, women who commit neonaticide (murder during the first day of life) differ substantially from mentally ill mothers who kill older children. However, despite these shortcomings, many nations have in recent years chosen to retain their infanticide acts. This article reviews the central controversies of infanticide legislation in relation to current research and fundamental fairness. Using evolutionary psychology as a theoretical framework to organize this discussion, it is argued that infanticide legislation is at best unnecessary and at worst misapplied, in that it exculpates criminal intent and fails to serve those for whom an infanticide defense might otherwise have been intended.