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Klier CM, Ina B, Kuipers Y, Amon S. Denial of reproductive potential: a predictor of unperceived pregnancy in an Austrian neonaticide sample. Arch Womens Ment Health 2024:10.1007/s00737-024-01481-x. [PMID: 38890196 DOI: 10.1007/s00737-024-01481-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/07/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE This study aims to describe the phenomenon of unperceived pregnancy followed by neonaticide with a focus on the lack of awareness of reproductive potential in an Austrian sample. METHODS An explorative comparative study of neonaticide cases with single and repeat perpetrators was conducted using nationwide register-based data from 1995 to 2017. A total number of 55 cases out of 66 were included in the analysis. A standardized coding sheet was used and calculations were performed. RESULTS 48 women gave birth to 101 children, of which 55 were killed, 23 children lived out of home care and 23 lived with the perpetrator We found a higher fertility rate in both neonaticide perpetrators in the single (1,9) and the repeat group (4,25) in comparison to the general population (1,4). The use of contraception was only 31% among neonaticide perpetrators, deviating substantially from the general Austrian population age group (16-29yrs) which used contraception in 91%. The neonaticide perpetrators used an effective contraception method (pearl-index < 4) in only 2%, whereas 20% of the general population did so. The number of unperceived pregnancies was high in both groups (50/55) 91%. CONCLUSION Future case reports and forensic evaluations should take reproductive behavior into account, as it may offer valuable insights into the events leading up to neonaticide. Our findings suggest that denial of reproductive potential often precedes unperceived pregnancies. In the Austrian cohort, women who experienced unperceived pregnancies resulting in unassisted births and subsequent neonaticide showed a low prevalence of contraceptive use. This is particularly noteworthy given that the primary motive for neonaticide is unwanted pregnancy.
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Affiliation(s)
- Claudia M Klier
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
| | - Bozic Ina
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Vienna, Vienna, Austria
| | - Yvonne Kuipers
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, United Kingdom
| | - Sabine Amon
- Barmherzige Brüder Hospital, Vienna, Austria
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Shapiro MA, John SA, Muzwagi AB, Silverman AL, Soda T. Ethical Dilemmas and Countertransference in Legally Mandated Reporting of Fatal Child Neglect. Psychodyn Psychiatry 2024; 52:189-205. [PMID: 38829226 DOI: 10.1521/pdps.2024.52.2.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
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.
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Affiliation(s)
- Michael A Shapiro
- University of Florida College of Medicine Department of Psychiatry; Children's Hospital of the King's Daughters, Eastern Virginia Medical School
| | - Sheena A John
- University of Florida College of Medicine Department of Psychiatry
| | - Ashraf B Muzwagi
- University of Florida College of Medicine Department of Psychiatry
| | | | - Takahiro Soda
- University of Florida College of Medicine Department of Psychiatry
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Shamavu GK, Patrick KK, Sikakulya FK, Justin OR, Tukamushaba E, Odoch S, Jeannot BM, Adongo Ocol J. Exceptional Survival of a Buried Alive Newborn: A Case Report. Int Med Case Rep J 2024; 17:265-273. [PMID: 38585618 PMCID: PMC10999181 DOI: 10.2147/imcrj.s456956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction This report details the exceptional survival of a female newborn buried alive by her own mother after a clandestine and unassisted birth. Despite spending over six hours underground, the newborn remarkably survived without exhibiting signs of perinatal asphyxia or major complications, and did not require advanced resuscitation measures. Case Presentation Rescued following a shocking discovery in a garden and rushed to the hospital, this newborn experienced transient hypothermia, mild to moderate respiratory distress, and scattered skin bruises. After five days of hospital care, she was discharged in clinically stable condition with no infectious complications, displaying age-appropriate normal neurological examination findings and excellent feeding. Conclusion This case not only defies established expectations but also illuminates perinatal physiological adaptation complexities. It highlights a fortunate and exceptional outcome in dire circumstances, presenting a captivating enigma within scientific realms. This report sheds light on the critical importance of early intervention and timely rescue efforts in cases of neonaticide, emphasizing the significance of raising awareness and implementing prompt measures to safeguard newborns in vulnerable situations and collectively contribute to our understanding of handling similar distressing cases.
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Affiliation(s)
- Gabriel Kakuru Shamavu
- Department of Pediatrics, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Kumbowi Kumbakulu Patrick
- Department of Pediatrics, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Franck Katembo Sikakulya
- Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Odong Richard Justin
- Department of Pediatrics, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | | | - Simon Odoch
- Department of Pediatrics, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
- Department of Pediatrics, Lira Regional Referral Hospital, Lira, Uganda
| | - Baanitse Munihire Jeannot
- Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
| | - Juliet Adongo Ocol
- Department of Pediatrics, Faculty of Clinical Medicine and Dentistry, Kampala International University Western Campus, Ishaka-Bushenyi, Uganda
- Department of Pediatrics, Lira Regional Referral Hospital, Lira, Uganda
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Chechko N, Losse E, Stickel S. A case report involving the experience of pervasive pregnancy denial: detailed observation of the first 12 postpartum weeks. BMC Psychiatry 2022; 22:774. [PMID: 36494788 PMCID: PMC9732985 DOI: 10.1186/s12888-022-04377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Pervasive pregnancy denial is a rare condition associated with distress and unassisted delivery. CASE PRESENTATION The case involves a 38-year-old woman (NN), with two older children (ages 8 and 11), who was unaware, until delivery, that she had been pregnant. The case is discussed in the context of a 12-week observation of postpartum mood, stress, and mother-child attachment. NN and other 558 non-depressed women (mean age 32.41 years) were selected from the pool of participants in the RIPOD (risk of postpartum depression) study. All participants were recruited within 1-6 days of delivery. In addition to surveying depressed mood at childbirth, remote assessments of mood, mother-child attachment, and perceived stress were conducted at 3, 6, 9, and 12 weeks postpartum. Every other day, the participants also reported their current perceived stress levels based on a scale from 1 (low) to 10 (high). During the entire period of postpartum observation, NN reported no symptoms on the Edinburgh Postpartum Depression Scale, similar to only 1.6% of the sample, no stress as 0.7% of the sample, and above-average mother-infant bonding akin to only 4.6% of the sample. Her daily stress levels showed no disturbance, which was the case for only 3.32% of the total sample. On the day of delivery, NN reported a stress level of 1 (the minimum possible level), which was reported by only 4.2% of the total sample. However, NN reported the experience of delivery to be traumatic given that the child had fallen to the floor. CONCLUSION The experience of a denied pregnancy did not appear to disturb NN at any time point, not even on the day of delivery. Compared to NN, the other non-depressed participants reported wide fluctuations in stress levels during the observation period. NN did not report any risk factors for denied pregnancy. Thus, she belonged neither to any group of typical pregnancy deniers, as reported in the literature, nor to a typical postpartum group. We postulate, therefore, that the extent to which pregnancy denial can be deemed a normal variation, unrelated to a psychological or physiological condition, depends largely on personal traits.
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Affiliation(s)
- Natalia Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. .,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany. .,Institute of Neuroscience and Medicine, Brain & Behavior (INM-7), Research Center Jülich, Wilhelm-Johnen-Strasse, 52428, Jülich, Germany.
| | - Elena Losse
- grid.1957.a0000 0001 0728 696XDepartment of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Susanne Stickel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. .,Institute of Neuroscience and Medicine: JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany.
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Towards a new understanding of pregnancy denial: the misunderstood dissociative disorder. Arch Womens Ment Health 2022; 25:51-59. [PMID: 34392438 DOI: 10.1007/s00737-021-01176-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
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.
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Hellen F, Verhülsdonk S, Janssen B, Ritz-Timme S, Hartung B. Filicides - a case series analysis. AUST J FORENSIC SCI 2021. [DOI: 10.1080/00450618.2021.1921271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Florence Hellen
- Department of Psychiatry, LVR-Hospital Langenfeld, Langenfeld, Germany
| | - Sandra Verhülsdonk
- Department of Psychiatry, LVR-Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Birgit Janssen
- Department of Psychiatry, LVR-Hospital Langenfeld, Langenfeld, Germany
| | - Stefanie Ritz-Timme
- Institute of Legal Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Benno Hartung
- Institute of Legal Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Eisenwort B, Arias PF, Klier CM, Till B. News media representations of women who kill their newly born children. Arch Womens Ment Health 2021; 24:999-1005. [PMID: 34120253 PMCID: PMC8585832 DOI: 10.1007/s00737-021-01148-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 05/13/2021] [Indexed: 11/24/2022]
Abstract
This paper presents a first quantitative analysis of language in media reports of neonaticide and a comparative examination of language use within the reports. One thousand twenty-seven Austrian print media reports from 2004 to 2014 were retrieved; after exclusion, 331 were analysed using the Linguistic Inquiry and Word Count (LIWC) software. After a preliminary analysis, a comparative analysis was carried out between reports on the Graz case and all other cases. The preliminary analysis revealed that a majority of media reports were related to one repeat neonaticide case (Graz) despite not being clinically different from other cases identified for the same period. The comparative linguistic analysis shows some statistically significant differences relating to the domains of emotional words (less words of anxiety, sadness) and family and in the category of insight and certainty (more words). The unexpected media attention on the Graz case and the ensuing verdict, which was in contradiction with the Austrian infanticide act, might have been influenced by the way language was used by journalists and the media. The authors suggest guidelines on sensitive media reporting are required.
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Affiliation(s)
- B. Eisenwort
- grid.22937.3d0000 0000 9259 8492Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center Pediatrics, Medical University of Vienna, Vienna, Austria
| | - P. Fernandez Arias
- grid.1002.30000 0004 1936 7857Monash Deakin Filicide Research Hub, Department of Social Work, Monash University, Melbourne, Australia
| | - C. M. Klier
- grid.22937.3d0000 0000 9259 8492Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria ,grid.22937.3d0000 0000 9259 8492Comprehensive Center Pediatrics, Medical University of Vienna, Vienna, Austria
| | - B. Till
- grid.22937.3d0000 0000 9259 8492Unit Suicide Research and Mental Health Promotion, Department of Social and Preventive Medicine Center for Public Health, Medical University of Vienna, Vienna, Austria
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Abstract
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.
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Affiliation(s)
- Kumi Yoshiba
- Department of Nursing Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University , Tokyo, Japan
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9
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Ben Khelil M, Boukthir I, Hmandi O, Zhioua M, Hamdoun M. Trends of infanticides in northern Tunisia: A 40 years study (1977-2016). CHILD ABUSE & NEGLECT 2019; 95:104047. [PMID: 31288130 DOI: 10.1016/j.chiabu.2019.104047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/08/2019] [Accepted: 06/12/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Tunisian Penal Code defines infanticide as the murder committed by the mother on her child at birth or immediately after. There is a dearth of studies and official statistics on infanticide in the Arab region and North Africa. OBJECTIVE to analyze the infanticide trends in northern Tunisia between 1977 and 2016. PARTICIPANTS AND SETTING we included all cases of infanticides autopsied at the Legal Medicine Department of Charles Nicolle Hospital in Tunis, over a period of 40 years (1977-2016). METHODS A descriptive retrospective study. RESULTS We collected a total of 513 cases of infanticide over the study period. The general prevalence of infanticide was 0.42 per 100,000 live births per year. Infanticide often occurred during the week, in winter (31.5%) and in spring (30.9%). The newborn was often found on public roads (40.9%) and in urban areas (81.4%). The newborn was often full-term (73.6%), mature, without any congenital malformation, found completely naked (75.2%) and with an empty stomach (93.7%). The umbilical cord was often cut (71.5%), not ligated (82%) with an irregular edge (64%). There was often no putrefaction (54.4%). The hydrostatic test (81.8%) and histological examination (81.1%) showed that infants had breathed. Neglect was the most common cause of death (49.9%). CONCLUSION Northern Tunisia has a low prevalence of infanticide compared to most of the previous European and American studies. A better understanding of infanticide would allow us to adapt measures of prevention.
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Affiliation(s)
- Mehdi Ben Khelil
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
| | - Ilhem Boukthir
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
| | - Ons Hmandi
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mongi Zhioua
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
| | - Moncef Hamdoun
- Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia; Department of Legal Medicine, Charles Nicolle Hospital, Tunis, Tunisia
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Klier CM, Amon S, Putkonen H, Fernandez Arias P, Weizmann-Henelius G. Repeated neonaticide: differences and similarities to single neonaticide events. Arch Womens Ment Health 2019; 22:159-164. [PMID: 29796966 PMCID: PMC6373254 DOI: 10.1007/s00737-018-0850-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
Abstract
This study aims to identify differences between single and repeat perpetrators of filicide by using register-based data. The study used register-based, comprehensive, nationwide data from both Austria and Finland. The current study covers 23 perpetrators, 20 single and 3 repeat perpetrators, with a total of 28 victims. All victims had a maximum age of 24 h and all perpetrators were women. Every third victim of neonaticide was a victim of a repeat case. The repeat perpetrators were older; had a higher number of children over their lifespan, some of whom lived with them; were more likely to live within established family structures; had higher levels of education and employment; had a higher proportion of personality disorders; and were more likely to identify stress factors during pregnancy. One unexpected finding was low levels of awareness about pregnancy within the perpetrator's circle remain a risk factor, especially for repeat perpetrators. Arguably, the quality of interpersonal relationships these women have may be affected by their own mental health issues and life experience and vice versa.
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Affiliation(s)
- Claudia M. Klier
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Sabine Amon
- Department of Psychology, University of Vienna, Vienna, Austria
| | - Hanna Putkonen
- Vanha Vaasa Hospital, Vaasa, Finland ,Addiction Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Paula Fernandez Arias
- Public Policy Research Centre, Universidad Mayor, Santiago, Chile ,Monash Deakin Filicide Research Hub, Department of Social Work, Monash University, Melbourne, Australia
| | - Ghitta Weizmann-Henelius
- Vanha Vaasa Hospital, Vaasa, Finland ,Department of Psychology and Logopedics, Åbo Akademi University, Turku, Finland
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Nanjundaswamy MH, Gaddapati S, Thippeswamy H, Thampy M, Vaiphei K, Kashyap H, Kishore T, Ganjekar S, Chandra PS. Denial of Pregnancy: Psychopathology and Clinical Management. Psychopathology 2019; 52:271-274. [PMID: 31593965 DOI: 10.1159/000503151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 09/02/2019] [Indexed: 11/19/2022]
Abstract
Denial of pregnancy (DOP) is a challenging condition with poorly understood psychopathology. DOP is reported to be associated with problems such as severe psychological conflicts, obstetric complications, risks to the newborn, and difficulties in bonding with the infant. In this paper, we present and discuss the clinical manifestations of a severe form of DOP that lasted until the time of delivery with resultant multifaceted complications. Our paper highlights the severity of psychopathology and the need for coordinated management. Descriptions from different cultural backgrounds would improve the conceptual understanding of DOP.
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Affiliation(s)
- Madhuri H Nanjundaswamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Sravani Gaddapati
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Harish Thippeswamy
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India,
| | - Mareena Thampy
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Kimneihat Vaiphei
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Himani Kashyap
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Sundarnag Ganjekar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Prabha S Chandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
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Murphy-Tighe S, Lalor JG. Regaining agency and autonomy: A grounded typology of concealed pregnancy. J Adv Nurs 2018; 75:603-615. [PMID: 30307061 DOI: 10.1111/jan.13875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/23/2018] [Accepted: 09/12/2018] [Indexed: 11/27/2022]
Abstract
AIM To explore and understand the experience of concealed pregnancy and develop a framework for practitioners. BACKGROUND Numerous cases of concealed pregnancy resulting in serious outcomes including maternal and perinatal death, newborn abandonment, and neonaticide are reported internationally. Historically concealed pregnancy is associated with oppressive religious cultures where premarital pregnancy was shunned. Concealed pregnancy has traditionally been viewed through a biomedical lens and associated with mental illness but this assertion remains unsubstantiated by robust evidence. DESIGN A Glaserian grounded theory study was undertaken. DATA SOURCES Thirty women were interviewed, between 2014 - 2016, on up to three occasions (46 interviews) and 22 cases of public interest were included as data. METHODS The constant comparative method and theoretical sampling which are the analytical strategies of grounded theory were used to analyse the data and generate the typology. RESULTS Concealed pregnancy is a fearful, life-altering, and traumatic experience. Women with a history of controlling and oppressive relationships characterized by fear respond to a crisis pregnancy by keeping it secret. Many women's relationships were characterized by emotional, mental, sexual, or physical violence. Fear for one's survival is common, may render women unable to access care or support and can be so extreme that a woman may end her own life or give birth alone. CONCLUSIONS This typology of concealed pregnancy is intended to aid understanding the fear, trauma, and complexities associated with concealed pregnancy which is vital if practitioners are to provide sensitive, responsive and non-judgemental care.
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Affiliation(s)
- Sylvia Murphy-Tighe
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Joan G Lalor
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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Simmat-Durand L. Y avait-il un père ? Paternité et relations de couple dans les affaires de néonaticides. ENFANCES, FAMILLES, GÉNÉRATIONS 2018. [DOI: 10.7202/1051502ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cadre de la recherche : Les affaires de néonaticide sont essentiellement connues au travers de la procédure judiciaire qui garde une approche très traditionnelle d’un crime exclusivement féminin et qui ne met en cause que la mère.
Objectifs : Le présent article s’attache à analyser ce qui est décrit de l’attitude du partenaire de la mère vis-à-vis de la paternité, et ce faisant les relations de couple qui y sont attachées.
Méthodologie : À partir de 2306 articles de presse décrivant 357 néonaticides suspectés en France de 1993 à 2012, une analyse thématique a été réalisée, utilisant toutes les mentions au père de l’enfant.
Résultats : Trois grandes tendances ont été mises en exergue : l’homme qui a conçu cet enfant, soit n’est pas envisagé dans ce rôle de père, car il est écarté de la paternité par la mère ou par la justice, soit ne veut pas être père, soit veut être père, mais en est empêché par la mère.
Conclusions : Contrairement à la littérature sur la parentalité aujourd’hui, les affaires de néonaticide mettent en scène une vision stéréotypée où la mère est seule à répondre du désir d’enfant. Ainsi, lors des poursuites judiciaires pour néonaticide, la présence du père est déniée, refusée, que le désir paternel existe ou non.
Contribution : Cet article fait le point sur l’existence donnée au père dans le contexte des poursuites judiciaires des mères à partir d’un corpus de presse concernant 141 mères ayant été poursuivies pour nénonaticide.
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Şar V, Aydın N, van der Hart O, Steven Frankel A, Şar M, Omay O. Acute dissociative reaction to spontaneous delivery in a case of total denial of pregnancy: Diagnostic and forensic aspects. J Trauma Dissociation 2017; 18:710-719. [PMID: 27997287 DOI: 10.1080/15299732.2016.1267685] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This article presents the history of a 21-year-old female college student with total denial of pregnancy who experienced an acute dissociative reaction during the spontaneous delivery at home without medical assistance where the newborn died immediately. Psychiatric examination, self-report questionnaires, legal documents, and witness reports have been reviewed in evaluation of the case. Evidence pointed to total denial of pregnancy, that is, until delivery. The diagnoses of an acute dissociative reaction to stress (remitted) and a subsequent PTSD were established in a follow-up examination conducted 7 months after the delivery. Notwithstanding the inherently dissociative nature of total denial of pregnancy, no other evidence has been found about pre-existing psychopathology. For causing the newborn's death, the patient faced charges for "aggravated murder," which were later on reduced into "involuntary manslaughter." Given the physical incapacity to perform voluntary acts due to the loss of control over her actions during the delivery, and the presence of an acute dissociative reaction to unexpected delivery, the legal case represents an intricate overlap between "insanity" and "incapacitation" defenses. The rather broad severity spectrum of acute dissociative conditions requires evaluation of the limits and conditions of appropriate legal defenses by mental health experts and lawyers. Denial of pregnancy as a source of potential stress has attracted little interest in psychiatric literature although solid research exists which documented that it is not infrequent. Arguments are presented to introduce this condition as a diagnostic category of female reproductive psychiatry with a more neutral label: "unperceived pregnancy."
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Affiliation(s)
- Vedat Şar
- a Department of Psychiatry , Koc University School of Medicine (KUSOM) , Istanbul , Turkey
| | - Nazan Aydın
- b Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital on Mental Disorders , Istanbul , Turkey
| | - Onno van der Hart
- c Department of Psychology , Utrecht University , Utrecht , The Netherlands
| | - A Steven Frankel
- d Department of Psychology , University of Southern California , California , USA.,e California Bar Association , California , USA.,f District of Columbia Bar Association , Washington , DC , USA
| | - Meriç Şar
- g New York Bar Association, New York , New York , USA.,h Istanbul Bar Association , Istanbul , Turkey , USA
| | - Oğuz Omay
- i Perinatal Psychiatry Unit , La Teppe Medical Center , Tain l'Hermitage , France
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Karakasi MV, Markopoulou M, Tentes IK, Tsikouras PN, Vasilikos E, Pavlidis P. Prepartum Psychosis and Neonaticide: Rare Case Study and Forensic-Psychiatric Synthesis of Literature. J Forensic Sci 2017; 62:1097-1106. [DOI: 10.1111/1556-4029.13365] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/25/2016] [Accepted: 10/03/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Maria-Valeria Karakasi
- Adult Psychiatry, Psychiatric Department; G. Papanikolaou General Hospital of Thessaloniki; Exohi, Asvestoxori GR 57010 Thessaloniki Greece
| | - Maria Markopoulou
- Department of Forensic Psychiatry; Psychiatric Hospital of Thessaloniki; GR 56429 Stavroupolis, Thessaloniki Greece
| | - Ioannis K. Tentes
- Department of Biochemistry; School of Medicine; Democritus University of Thrace; GR 68100 Alexandroupolis Greece
| | - Panagiotis N. Tsikouras
- Department of Obstetrics and Gynecology; University General Hospital of Evros; School of Medicine; Democritus University of Thrace; GR 68100 Alexandroupolis Greece
| | - Epameinondas Vasilikos
- Adult Psychiatry, Psychiatric Department; G. Papanikolaou General Hospital of Thessaloniki; Exohi, Asvestoxori GR 57010 Thessaloniki Greece
| | - Pavlos Pavlidis
- Laboratory of Forensic Sciences; School of Medicine; Democritus University of Thrace; GR 68100 Alexandroupolis Greece
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Aho AL, Remahl A, Paavilainen E. Homicide in the western family and background factors of a perpetrator. Scand J Public Health 2017; 45:555-568. [PMID: 28565939 DOI: 10.1177/1403494817705587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Familicide is a multiple-victim homicide incident in which the killer's spouse and one or more children are slain. A systematic review was conducted to reveal the background factors of western homicide perpetrators. METHODS The systematic search was performed in the Arto, Medic, Cinahl, Medline, EBSCOhost Academic Search Premier and Social Services abstracts databases. The keywords were familicide, family homicide, familicide-suicide, filicide-suicide, extended suicide, child, murder, family, filicide and infanticide. The searches revealed 4139 references from the databases. The references were filtered and 32 peer-reviewed research articles revealed in years 2004-2014 were selected as data. The articles were analysed using inductive content analysis, by finding all possible background factors related to homicide. RESULTS The factors were described as percentages of the range. The background factors of familicide perpetrators were categorised as follows: perpetrators who had committed homicide of a child and intimate partner and possibly committed suicide; a father had who killed a child; a mother who had killed a child; a father who had committed a filicide-suicide; and a mother who had committed a filicide-suicide. CONCLUSIONS Psychological instability, violence and crime were found in all these categories of familicides. Perpetrators who had committed a suicide in addition to the familicide had more often been diagnosed with depression, but they sought treatment for mental health problems less often and had violence and self-destructiveness less often in their background than in other familicide categories. Social and healthcare professionals should be more sensitive to emerging family problems and be prepared for intervention.
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17
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The worldwide incidence of neonaticide: a systematic review. Arch Womens Ment Health 2017; 20:249-256. [PMID: 28013408 DOI: 10.1007/s00737-016-0703-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
Neonaticide is the killing of a neonate on the day of its birth by his/her own mother. Neonaticidal women were reported to be predominantly young, unmarried, and primiparous. The motive for murdering the newborn relates to the shame, the fear of rejection, and abandonment by significant others, and the social stigmas associated with an illegitimate birth. The goal of the present study was to conduct a systematic review of the scientific literature and identify population-based studies reporting the incidence of neonaticide in different countries. A total of 485 abstracts were screened. After applying the inclusion/exclusion criteria, 10 studies were selected. Additional searches identified two more articles. Most of these studies were from Europe, where incidence varied from 0.07 (Finland, 1980-2000 period) to 8.5 neonaticides per 100000 births (Austria, 1975-2001 period). More recent studies have indicated that a growing proportion of neonaticidal women are married, multiparous, and suffers from mental disorders. Preventive measures, such as anonymous free delivery, were shown to reduce the incidence of neonaticide, although this effect may be short-lived. Despite social and institutional changes, neonaticide persists even in the most socially advanced, liberal, and prosperous societies in the world.
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Simmat-Durand L. Les néonaticides en France : analyse de 357 cas identifiés dans la presse (1993-2012). SANTE PUBLIQUE 2017. [DOI: 10.3917/spub.173.0321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Abrahams N, Mathews S, Martin LJ, Lombard C, Nannan N, Jewkes R. Gender Differences in Homicide of Neonates, Infants, and Children under 5 y in South Africa: Results from the Cross-Sectional 2009 National Child Homicide Study. PLoS Med 2016; 13:e1002003. [PMID: 27115771 PMCID: PMC4846035 DOI: 10.1371/journal.pmed.1002003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 03/15/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Homicide of children is a global problem. The under-5-y age group is the second largest homicide age group after 15-19 y olds, but has received little research attention. Understanding age and gender patterns is important for assisting with developing prevention interventions. Here we present an age and gender analysis of homicides among children under 5 y in South Africa from a national study that included a focus on neonaticide and infanticide. METHODS AND FINDINGS A retrospective national cross-sectional study was conducted using a random sample of 38 medico-legal laboratories operating in 2009 to identify homicides of children under 5 y. Child data were abstracted from the mortuary files and autopsy reports, and both child and perpetrator data data were collected from police interviews. We erred towards applying a conservative definition of homicide and excluded sudden infant death syndrome cases. We estimated that 454 (95% CI 366, 541) children under the age of 5 y were killed in South Africa in 2009. More than half (53.2%; 95% CI 46.7%, 59.5%) were neonates (0-28 d), and 74.4% (95% CI 69.3%, 78.9%) were infants (under 1 y), giving a neonaticide rate of 19.6 per 100,000 live births and an infanticide rate of 28.4 per 100,000 live births. The majority of the neonates died in the early neonatal period (0-6 d), and abandonment accounted for 84.9% (95% CI 81.5%, 87.8%) of all the neonates killed. Distinct age and gender patterns were found, with significantly fewer boy children killed in rural settings compared to urban settings (odds ratio 0.6; 95% CI 0.4, 0.9; p = 0.015). Abuse-related killings and evidence of sexual assault were more common among older girls than in all other age and gender groups. Mothers were identified as the perpetrators in all of the neonaticides and were the most common perpetrators overall (71.0%; 95% CI 63.9%, 77.2%). Abandoned neonates were mainly term babies, with a mean gestational age of 38 wk. We did not have information on abandonment motives for all newborns and did not know if babies were abandoned with the intention that they would die or with the hope that they would be found alive. We therefore considered all abandoned babies as homicides. CONCLUSIONS Homicide of children is an extreme form or consequence of violence against children. This national study provides one of the first analyses of neonaticide and infanticide by age and gender and shows the failure of reproductive and mental health and social services to identify and help vulnerable mothers. Multi-sectoral prevention strategies are needed.
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Affiliation(s)
- Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- * E-mail:
| | - Shanaaz Mathews
- Children’s Institute, University of Cape Town, Cape Town, South Africa
| | - Lorna J. Martin
- Forensic Pathology Services, Western Cape Government, Cape Town, South Africa
- Division of Forensic Medicine and Toxicology, University of Cape Town, Cape Town, South Africa
| | - Carl Lombard
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nadine Nannan
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
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Grylli C, Brockington I, Fiala C, Huscsava M, Waldhoer T, Klier CM. Anonymous birth law saves babies--optimization, sustainability and public awareness. Arch Womens Ment Health 2016; 19:291-7. [PMID: 26267063 DOI: 10.1007/s00737-015-0567-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
The aims of this study are to assess the impact of Austria's anonymous birth law from the time relevant statistical records are available and to evaluate the use of hatches versus anonymous hospital delivery. This study is a complete census of police-reported neonaticides (1975-2012) as well as anonymous births including baby hatches in Austria during 2002-2012. The time trends of neonaticide rates, anonymous births and baby hatches were analysed by means of Poisson and logistic regression model. Predicted and observed rates were derived and compared using a Bayesian Poisson regression model. Predicted numbers of neonaticides for the period of the active awareness campaign, 2002-2004, were more than three times larger than the observed number (p = 0.0067). Of the 365 women who benefitted from this legislation, only 11.5% chose to put their babies in a baby hatch. Since the law was introduced, a significant decreasing tendency of numbers of anonymous births (p = 047) was observed, while there was significant increase of neonaticide rates (p = 0.0001). The implementation of the anonymous delivery law is associated with a decrease in the number of police-reported neonaticides. The subsequent significantly decreasing numbers of anonymous births with an accompanying increase of neonaticides represents additional evidence for the effectiveness of the measure.
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Affiliation(s)
- Chryssa Grylli
- Department of Child and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .,Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Ian Brockington
- University of Birmingham, Lower Brockington Farm, Bredenbury, Bromyard, Herefordshire, HR7 4TE, UK
| | - Christian Fiala
- GynMed, Clinic, Mariahilfer Gürtel 37, 1150, Vienna, Austria
| | - Mercedes Huscsava
- Department of Child and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Claudia M Klier
- Department of Child and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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21
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Barros AJS, Rosa RG, Telles LEDB, Taborda JGV. Attempted Serial Neonaticides: Case Report and a Brief Review of the Literature. J Forensic Sci 2016; 61:280-3. [DOI: 10.1111/1556-4029.12873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/29/2014] [Accepted: 12/11/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Alcina Juliana Soares Barros
- Instituto Psiquiátrico Forense Maurício Cardoso; Avenida Diário de Notícias n 200, Room 909, PO Box 90810080 Porto Alegre Brazil
- Universidade Federal do Rio Grande do Sul; Rua São Manoel, 963- Rio Branco, Porto Alegre - RS, 90620-110 Brazil
| | - Regis Goulart Rosa
- Instituto Psiquiátrico Forense Maurício Cardoso; Avenida Diário de Notícias n 200, Room 909, PO Box 90810080 Porto Alegre Brazil
- Universidade Federal do Rio Grande do Sul; Rua São Manoel, 963- Rio Branco, Porto Alegre - RS, 90620-110 Brazil
| | - Lisieux Elaine de Borba Telles
- Instituto Psiquiátrico Forense Maurício Cardoso; Avenida Diário de Notícias n 200, Room 909, PO Box 90810080 Porto Alegre Brazil
- Universidade Federal do Rio Grande do Sul; Rua São Manoel, 963- Rio Branco, Porto Alegre - RS, 90620-110 Brazil
| | - José Geraldo Vernet Taborda
- Instituto Psiquiátrico Forense Maurício Cardoso; Avenida Diário de Notícias n 200, Room 909, PO Box 90810080 Porto Alegre Brazil
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22
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Murphy Tighe S, Lalor JG. Concealed pregnancy: a concept analysis. J Adv Nurs 2015; 72:50-61. [PMID: 26370358 DOI: 10.1111/jan.12769] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 11/29/2022]
Abstract
AIM/DESIGN A concept analysis of concealed pregnancy was undertaken using Walker and Avant's framework to examine the attributes, characteristics and uses of the concept in maternity care. BACKGROUND Understanding the concept of concealed pregnancy is critical as failing to do so adds the risk of maternal and neonatal morbidity and mortality. Reviewing the literature and selected empirical referents indicated that concealed pregnancy has been predominantly viewed through a biomedical lens. Confusion exists around the definitions of denied and concealed pregnancy. DATA SOURCES A systematic search of five bibliographic databases using keywords from the years 1960-2014. METHODS Walker and Avant's framework was used to guide the concept analysis. A thematic analysis of reviewed papers identified the main characteristics of concealed pregnancy. RESULTS Concealed pregnancy was conceptualized as a process and the critical attributes are secrecy, hiding, daytime story, staying away and avoidance. This process involves avoidance and if this includes failing to access healthcare can lead to catastrophic outcomes such as maternal and neonatal death. Antecedents, attributes and consequences of concealed pregnancy are also identified. CONCLUSIONS Understanding the concept of concealed pregnancy and its antecedents, attributes and consequences may assist in risk identification of women who conceal a pregnancy. This concept analysis has identified a need for further exploration of the coping styles and psychosocial processes involved in women concealing and revealing a pregnancy.
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Affiliation(s)
| | - Joan G Lalor
- School of Nursing & Midwifery, Trinity College Dublin, Ireland
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23
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Krüger P. Prevalence and phenomenology of neonaticide in Switzerland 1980-2010: a retrospective study. VIOLENCE AND VICTIMS 2015; 30:194-207. [PMID: 25929137 DOI: 10.1891/0886-6708.vv-d-13-00083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
For a child, the likelihood of being murdered is highest during the first year of life, and many such cases are neonaticides. Although several recent studies have examined neonaticide in different countries and cultures, there has been no in-depth analysis of Swiss cases, even though this country has special neonaticide legislation and four "baby hatches" have been opened to prevent such killings. The primary objective of this retrospective study was to analyze the prevalence and phenomenon of neonaticide in Switzerland. Using data from judicial files, 11 cases were identified in 15 German-speaking cantons between 1980 and 2010. The sample included two uncommon cases of nonmaternal neonaticide. The discussion addresses possible prevention strategies.
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Klier CM, Grylli C, Amon S, Fiala C, Weizmann-Henelius G, Putkonen H. Is the introduction of anonymous delivery associated with a reduction of high neonaticide rates in Austria? BJOG 2013; 120:1028-9. [DOI: 10.1111/1471-0528.12261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- CM Klier
- Medical University of Vienna; Vienna; Austria
| | - C Grylli
- Medical University of Vienna; Vienna; Austria
| | - S Amon
- Medical University of Vienna; Vienna; Austria
| | - C Fiala
- Gynmed Ambulatorium; Vienna; Austria
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Klier CM, Grylli C, Amon S, Fiala C, Weizmann-Henelius G, Pruitt SL, Putkonen H. Is the introduction of anonymous delivery associated with a reduction of high neonaticide rates in Austria? A retrospective study. BJOG 2012; 120:428-34. [PMID: 23210536 DOI: 10.1111/1471-0528.12099] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess rates of neonaticide after the implementation of a preventative 'anonymous delivery' law in mid-2001 in Austria. Women are allowed to access antenatal care and give birth in a hospital anonymously, without showing any ID and free of charge. DESIGN Retrospective study. SETTING A complete census of police-reported neonaticides was obtained from the police statistics of Austria, Sweden and Finland. POPULATION All neonaticides reported to the police, 1991-2009. MAIN OUTCOME MEASURES Neonaticide rates before (1991-2001) and after (2002-2009) the introduction of anonymous delivery legislation per 100 000 births. METHODS The Mann-Whitney U-test for two independent samples was used to compare neonaticide rates in the period before the new law was introduced with the rates observed after the implementation of the new law for each country. RESULTS On average the rate of police-reported neonaticides was 7.2 per 100 000 births (SD 3.5, median 7.1) in Austria prior to the new law being passed, and 3.1 per 100 000 births (SD 2.1, median 2.6) after the law was passed. A significant decrease in neonaticide was observed in Austria after the implementation of anonymous delivery (Mann-Whitney U-test P = 0.017). Whereas the Finnish and Swedish rates were lower than the Austrian rates before and after the implementation of the Austrian law, they remained unchanged over the study period. CONCLUSIONS Our data demonstrate a significant decrease in the number of police-reported neonaticides in Austria after the implementation of anonymous delivery. Even though underlying factors associated with neonaticide are complex, the findings could indicate an effect of anonymous delivery in the prevention of this crime.
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Affiliation(s)
- C M Klier
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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