Monstrous Mothering: Understanding the Causes of and Responses to Infanticide

The deliberate killing of a child by its mother is abhorrent and is associated in the minds of many with mental illness and in particular with postnatal depression. However, at least 50% of perpetrators are neither "mad" nor "bad", and mothers who kill children are not "unhinged" by pregnancy or childbirth. We propose a different explanation: "blind rage" or "overwhelmed syndrome", whereby parents, stressed to breaking point by sleep deprivation or incessant baby crying, respond by lethally harming their child contrary to previous behaviour. The roots of this blind rage may be found in psychosocial disturbances, including the mother's own unsatisfactory experience of parenting which has caused attachment disorders. The legal framework guiding decisions to prosecute and structuring sentencing decision-making following conviction should acknowledge the exceptional stress experienced by such mothers postnatally. Health professionals including midwives and obstetricians should increase their vigilance and arrange referrals for mothers at risk of causing harm or committing infanticide.

[The invisible pregnancy: Clinical characteristics and perspectives about denial of pregnancy]

Denial of pregnancy is a public health problem due to maternal, fetal, and neonatal morbidity, affecting both physical and mental health. It generally involves an absence of the physical signals associated with pregnancy such as abdominal swelling, amenorrhea, weight gain, or even perception of fetal movements. Despite the potential consequences for mother and child, there is still little data on its clinical features and the neurocognitive mechanisms involved. In this paper, we provide an update on the clinical, socio-demographic, and psychopathological characteristics of pregnancy denial based on contemporary scientific literature. We first define denial of pregnancy by referring to the history of the concept, previous definitions, and nosographic classifications. We then detail the clinic of denial by distinguishing the physical and psychological symptoms of this disorder, then the socio-demographic, gynecological, and psychiatric characteristics. We describe the consequences of denial on the mother, infant, and the dyad, referring to situations of cryptic neonaticide. Finally, we show the importance of perinatal neuroscience research on maternal interoception to understand the mechanisms involved in denial of pregnancy, and improve their medical management in clinical practice.

The first COVID-19 infanticide-suicide case: Financial crisis and fear of COVID-19 infection are the causative factors

BACKGROUND

The global suicide occurrences have been aggravated because of COVID-19 crisis-related issues such as fear of infection, the financial crisis, being infected with COVID-19, loneliness, social boycott, etc. Although two studies reported about the seven dyadic suicidality cases (i.e., suicide pacts), child homicide-suicide has not been studied.

CASE PRESENTATION

On 14 May, two dead bodies (i.e., a 30-years old Indian woman and her six-month-old baby) were found in a Riyadh apartment complex. The perpetrator (a person who kills the others and later commits suicide) - a trained nurse, was in search of a job. The woman's husband was recently retrenched from his technician job at a company in Madinah Airport. Her husband was admitted to a hospital with symptoms related to the COVID-19 infection four days before the suicide incidence. The 70-year-old mother-in-law alerted the neighbors after finding that the apartment is locked from inside and there was no response on knocking the doors. After this, the neighbors gathered and called the police. Police found two dead-bodies after opening the flat and suspected that the child was killed before the woman committed suicide.

CONCLUSIONS

Based on the present findings, further child filicide-suicide possibilities in families with economically distressed and/or positive COVID-19 status are expected. Hence, proper financial supports, providing authentic information (COVID-19), and mental health promotional strategies are suggested for decreasing incidences of COVID-19 related infanticide-suicide cases.

[Regulatory evolution of the crime of infanticide]

The objective of the present study consists of the juridic-anthropological analysis of the infanticide, a phenomenon that nowadays is highly existent within the context of crime-settings. Particular consideration has been given to the legal developments of the infanticide act, which occurred simultaneously with the mutation of the socio-cultural contexts. Because the legislative process of the infanticide act has not evolved since 1981, it was possible to underline the criticisms and the inadequacy of such norm. Indeed, the legal norm has not always been able to provide an exhaustive answer concerning cases of infanticide. The process of humanisation of the law led to the introduction of a legal system, which describes the infanticide act as a condition of material and moral abandonment. This has become uncertain and ambiguous to interpret, risking to relegate the legislative matters of infanticide only to exceptional cases. The current study aims to highlight the criticisms and hypothesised different reform perspectives.

Nepal - exploited by older married man - young unmarried mother accused of infanticide

In Nepal, it is considered sinful for a woman to have sexual intercourse before marriage while the male is exonerated. The female will be branded a loose character outcast by family and society. Only a small percentage of women who feel the other way and stand mentally strong or who have family support come out to seek justice. Despite the stringent law, the loopholes in the justice mechanism re-victimise female victims. We report a case where a young unmarried pregnant woman who gave birth alone was charged with infanticide.

Maternal Infanticide and Filicide in a Psychiatric Custodial Institution in Hong Kong

OBJECTIVE

The aim of this study was to review the history, legislation, and psychiatric perspective of filicide, to compare the characteristics of mothers who committed neonaticide versus infanticide, and to discuss the infanticide law in Hong Kong.

METHODS

Data of mothers remanded to the Siu Lam Psychiatric Centre from 2008 to 2016 for filicide were reviewed, as were data of filicide from the Child Fatality Review Reports published by the Social Welfare Department.

RESULTS

From 2008 to 2016, eight mothers were remanded to Siu Lam Psychiatric Centre for filicide. Four were convicted of infanticide; the other four were convicted of manslaughter. Those convicted of infanticide were single and aged <18 years. They had concealed their pregnancies and received no antenatal care. They delivered at home and then either smothered or abandoned the newborn. They reported no suicidal attempts after the index offence and had no record of mental illness. They were given supervision orders instead of prison sentences. In contrast, those convicted of manslaughter were in their 30s and married. They were documented to have killed the victims by charcoal burning, strangulation, mutilation, or defenestration. They all attempted suicide immediately after the killing and had histories of mental illness: paranoid schizophrenia (n = 2), severe depressive disorder with psychotic symptoms (n = 1), and recurrent depressive disorder (n = 1). They were sentenced to Hospital Orders for unspecified periods.

CONCLUSIONS

In Hong Kong, the incidence of maternal filicide is low. However, the infanticide provision grants leniency to mothers, including those who show no evidence of mental illness.

Obsessions of child murder: underrecognized manifestations of obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a common illness that remains underdiagnosed and undertreated. Distressing obsessions of violence are a frequent manifestation of OCD, related to overattribution of meaning to passing thoughts, a sense of overresponsibility, and concurrent confessing rituals to decrease related anxiety. These intrusive thoughts can include infanticidal or filicidal obsessions in new parents. There is little to no evidence to suggest that these thoughts pose a significant risk of harm, which is reflected in related professional treatment guidelines. In this study, we sought to examine the recognition and risk management preferences among psychiatry professionals and trainees regarding a case example description of filicide obsessions as a manifestation of OCD. A questionnaire regarding a case marked by filicide obsessions was emailed to psychiatrists and psychiatry residents. Respondents provided their preferred and differential diagnoses, reporting their perceptions of risk and optimal case management. Of the 43 respondents, only 62 percent considered OCD in the differential diagnosis. Those considering OCD in the differential diagnosis assessed risk of harm as being lower than did those who did not consider it (3.7 versus 6.6; F(1,36) = 12.18; p < .005). Despite this result, the majority of respondents included involuntary admission (60%) and reports to child welfare authorities (68%) among their preferred management strategies. This survey supports our contention that greater awareness of OCD and understanding of management strategies is needed among psychiatrists and trainees. As well, a greater awareness of the low risk of violence associated with this population is necessary to avoid penalizing individuals with OCD-related aggressive and infanticidal obsessions.

A case series of twenty one maternal filicides in the UK

OBJECTIVE

This study reports a case-series study of 21 women from the United Kingdom convicted of the murder or manslaughter of their child (maternal filicide: MF). These cases were reviewed using data provided from police forces and from publicly available resources.

METHODS

Content and thematic analysis and multidimensional scaling techniques were used to analyse the relationships between the variables present in the commission of the crimes.

RESULTS

Mothers who killed their children could be categorised as emotionally driven and in despair at their situation, or rejecting their children due to perceiving them as a threat. Mothers who killed their babies (neonaticides) appeared to form two distinct subgroups: reluctant and detached neonaticidal offenders.

CONCLUSION

These findings offer an insight into the factors that may be of relevance in understanding how a mother may come to commit MF, and are interpreted in terms of disturbed attachment processes.

Can denial of pregnancy be a denial of fertility? A case discussion

BACKGROUND

For many years, several cases of neonaticide resulting from a denial of pregnancy were reported in the press. Recently, a case of neonaticide made headlines in Belgium: a woman realised that she was pregnant during childbirth. A few minutes after the delivery, the baby was asphyxiated to death. In the obstetric history of the patient, we note six pregnancies, of which three births were given to anonymous adoption. Mrs D. was not able to explain why she was not using any method of contraception despite all of her pregnancies. Many questions need to be asked in order to further understand denial of pregnancy. Do these women understand the link between sexual intercourse and the potential of pregnancy? Which women are more at risk of denying their pregnancy? Is there a certain personality profile at risk?

METHODS

In the following article, we report the case of Mrs D. who presented to the consultation of the clinic of CHU Mont-Godinne (Belgium). We will also discuss the literature available on the online databases (PubMed, PsycArticles, PsycInfo and Cairn.info) using the following keywords: denial of pregnancy, neonaticide, contraception.

RESULTS

In the results of retrospective studies, we notice that indeed most women who have had a denial of pregnancy were not using any method of contraception. This observation suggests the hypothesis of a denial of fertility in these women. In addition, it appears that a specific personality profile is very difficult to establish, due to the lack of sufficient data and due to the discrepancy of the results concerning these women, especially in the matters of age and socio-economic status. However we can note that some psychological characteristics are similar.

CONCLUSIONS

The denial of pregnancy is a complex mechanism, which still raises many questions in the clinical setting and in matters of etiopathogenesis. In these patients, we note that denial is a defense mechanism regularly used, even in other aspects of their lives. Moreover, the frequent non-use of contraceptive method might therefore be more in favor of a denial of fertility than of a denial of pregnancy.

[Infanticide or murder in a forensic psychiatric assessment. A case study 5-fold infanticide--the search of psychopathology]

OBJECTIVE

The difficulties to distinguish between infanticide and murder of the woman own child, experienced by both experts and the court, have been discussed on the example of the psychopathological description of the perpetrator killing five of her children, and data from the literature.

CASE

This paper describes an extremely rare case of the woman who has killed five of her children immediately after their birth over several years.

COMMENT

It is very difficult to decide whether the seemingly rational motivation to kill her own child shortly after their birth can be a proof of specific psychopathological state which is a consequence of childbirth or an assassination planned in cold blood. The act of killing a child by their own mother is so contrary to nature that it seems easy to find the ground for psychosis or a state of emergency. However, when neither of them has been proven the experts are left with the conviction of both diagnostic deficiency and inexplicability of human behaviour.

[Major psychiatric disorders and filicide: a descriptive analysis of filicides perpetrated by women with psychotic mental illness]

INTRODUCTION

This study aims to reflect on the connection between maternal filicide and major psychiatric disorders based on international literature, and analysis of filicides perpetrated by women and ending with compulsory medical treatment based on a not guilty by reason of insanity verdict.

METHOD

For the purpose of the analysis we collected cases back to 1993 from the archives of the Forensic Observation and Psychiatric Institution (IMEI), when a female perpetrator committed homicide against her blood-related offspring, after which she spent her compulsory medical treatment in the Institution. We had 14 cases which were only descriptively analysed due to the low number of cases. We collected data through overview of the documentation of the patients. We focused on several factors: demographic characteristics of the victims, characteristics of the homicidal act, demographic and psychiatric characteristics of the perpetrators.

RESULTS

Most importantly, our results show interesting findings in the field of gender distribution of the victims. In relation to suicide risk, our results concur with previous findings pointing out its strong connection with filicide. Furthermore, our findings point out the relevance of schizoaffective disorder, as it was the most frequent diagnosis in our cases.

CONCLUSION

We make our conclusions primarily in regard of prevention, we emphasise the strongest risk factors according to the results, which can draw the clinical practitioner's attention to the danger of filicide.

No worries, mate: a forensic psychiatry sabbatical in New Zealand

Sabbaticals were initially intended to take place one year of every seven and to provide an opportunity for study or travel. Psychiatrists rarely take sabbaticals, but they can be of tremendous value in widening professional and personal horizons. It is not merely the psychiatrist taking the sabbatical who reaps the benefits, but also the home institution and patients. Sabbatical-takers have an opportunity to learn across cultures, to experience a new system of medical care, and to develop a less provincial view of their work and indeed their place in the world. A sabbatical can be a time of substantial accomplishments, such as writing or reorganizing programs. In this article, the benefits of a forensic psychiatry sabbatical experience in New Zealand are described.

"Asia's missing women" as a problem in applied evolutionary psychology?

In many parts of Asia, the Middle East and North Africa, women and children are so undervalued, neglected, abused, and so often killed, that sex ratios are now strongly male biased. In recent decades, sex-biased abortion has exacerbated the problem. In this article I highlight several important insights from evolutionary biology into both the origin and the severe societal consequences of "Asia's missing women", paying particular attention to interactions between evolution, economics and culture. Son preferences and associated cultural practices like patrilineal inheritance, patrilocality and the Indian Hindu dowry system arise among the wealthy and powerful elites for reasons consistent with models of sex-biased parental investment. Those practices then spread via imitation as technology gets cheaper and economic development allows the middle class to grow rapidly. I will consider evidence from India, China and elsewhere that grossly male-biased sex ratios lead to increased crime, violence, local warfare, political instability, drug abuse, prostitution and trafficking of women. The problem of Asia's missing women presents a challenge for applied evolutionary psychology to help us understand and ameliorate sex ratio biases and their most severe consequences.

[Suicidal and infanticidal risks in puerperal psychosis of an early onset]

OBJECTIVE

A sample of patients with a puerperal psychosis of an early manifestation is investigated in respect of special risks of suicide and infanticide.

METHODS

During a 20-year period 96 patients who had been fallen ill with a puerperal psychosis within four weeks after delivery were admitted to a psychiatric university hospital. Patients with an acute exacerbation of a known schizophrenic disorder were excluded. In a subgroup of 37 patients states of a previous (affective, bipolar affective) psychotic illness were recorded already before the puerperal index episode, in a subgroup of 59 patients puerperal psychosis was the first manifestation of a psychotic illness. Suicide- and infanticide-relevant psychopathological symptoms were analysed (suicidal ideas/behaviour before/during inpatient treatment, general disorganized aggression, psychotic anxieties related to baby, infanticidal obsessions, aggressive ideas/behaviour towards baby, neglect, infanticidal impulses).

RESULTS

Puerperal psychoses were distributed to the diagnostic categories of psychotic depressive disorder, bipolar affective disorder, and schizoaffective disorder. Six patients died due to suicide, tragically already some few days till weeks after discharge from psychiatric hospital, despite a pronounced or even complete remission of puerperal psychotic symptoms at the time of discharge. Three patients committed an extended suicide attempt that resulted in two infanticides. All isolated and extended suicides were committed in a state of depressive mood and presumably synthymic delusion.

CONCLUSIONS

Suicidal ideas and behaviour play a major role in patients with puerperal psychosis before and during inpatient treatment. An increased risk for mothers and babies may persist, however, even after a seemingly good symptomatic remission. Besides the clinical challenge of general prevention of puerperal psychosis the request of adequate models of inpatient treatment, carefully prepared discharge, close afterdischarge follow up, and continuous outpatient care have to be stressed.

Filicide, medical empathy, directives of the Supreme Court and reduced punishment

The role of empathy in the preparation of legal-psychiatric assessments is a controversial issue which has been discussed in the professional literature and in the practice in Court. The focus of the controversy is the question of objectivity versus subjectivity in the examiner and the worries about empathy leading to over-identification with the examinee. In this paper the authors will discuss relevant literature. They will also, for explanatory reasons, analyze a landmark decision of the Israel Supreme Court dealing with a case of filicide--a decision which may be understood as giving an increased role to the empathic perceptions of the evaluating psychiatric expert".

Analysis of the relationship between neonaticide and denial of pregnancy using data from judicial files

OBJECTIVES

Using judicial files on neonaticides, (1) to examine the frequency of the association between neonaticide and denial of pregnancy; (2) to assess the accuracy of the concept of denial of pregnancy; (3) to examine its usefulness in programs to prevent neonaticides.

METHODS

Quantitative and qualitative analyses of data collected from judicial files during a population-based study carried out in 26 courts in 3 regions of France over a 5-year period.

RESULTS

There were 32 cases of neonaticides identified; 24, perpetrated by 22 mothers, were solved by police investigation. Aged 26 years on average, the mothers had occupations that resembled those of the general population and 17 had jobs, 13 were multiparous and 11 lived in a couple relationship. No effective contraception was used by women in 20 cases. Psychopathology was rare but mothers shared a personality profile marked by immaturity, dependency, weak self esteem, absence of affective support, psychological isolation and poor communication with partners. No pregnancy was registered nor prenatal care followed. Two (perhaps 3) pregnancies were undiscovered until delivery. No typical denial of pregnancy was observed in the other cases. Pregnancies were experienced in secrecy, with conflicting feelings of desire and rejection of the infant and an inability to ask for help. Those around the mothers, often aware of the pregnancy, offered none. In the absence of parallel clinical data, it is not possible to calculate the frequency of the association between neonaticide and denial of pregnancy.

CONCLUSIONS

The term 'denial of pregnancy' cannot fully reflect the complexity of emotions and feelings felt by all perpetrators of neonaticide and is used differently by different professionals. The term itself and its excessive generalization contribute to pathologizing women while absolving those around them and has little operational value in preventing neonaticides. The authors suggest rethinking the terms presently used to describe the phenomenon of pregnancy denial.

Mothers who kill their offspring: testing evolutionary hypothesis in a 110-case Italian sample

OBJECTIVES

This research aimed to identify incidents of mothers in Italy killing their own children and to test an adaptive evolutionary hypothesis to explain their occurrence.

METHODS

110 cases of mothers killing 123 of their own offspring from 1976 to 2010 were analyzed. Each case was classified using 13 dichotomic variables. Descriptive statistics and hierarchical cluster analysis were performed both for cases and variables, and significant differences between clusters were analyzed.

RESULTS

The Italian sample of neonaticides (killings of children within the first day of life) was found to satisfy all evolutionary predictions for an evolved behavioral, emotional and motivational pattern to increase fitness, showing a consistent profile for offending mothers. Relatively young, poor women with no partner kill their offspring non-violently, either directly or through abandonment, and they attempt to conceal the body. These women have no psychopathologies and never attempt suicide after killing their children. All neonaticide cases fall in a single cluster that is distinct from all other offspring killings by mothers. Infanticide (killing of children within the first year of life) and filicide (killing of children after the first year of life) do not significantly differ according to any of the variables measured. The common profile of mothers who have committed infanticide or filicide includes psychopathology, suicide or attempted suicide after killing their children, violent killing of their victims, and no attempt to conceal the victims' bodies. These results suggest that maternal infanticide and filicide represent an improper functioning of adaptation, and their profile are much more variable than those of neonaticide offenders.

CONCLUSION

Our study confirms that only neonaticide is an adaptive reproductive disinvestment, possibly evolved in the remote past, to increase the biological fitness of the mother by eliminating an unwanted newborn and saving resources for future offspring born in better conditions. Neonaticide is shown to be clearly distinct from infanticide and filicide and therefore should be approached, prevented, and judged differently.

"They have already thrown away their chicken": barriers affecting participation by HIV-infected women in care and treatment programs for their infants in Blantyre, Malawi

HIV-infected infants and young children are at high risk of serious illness and death. Morbidity and mortality can be greatly reduced through early infant diagnosis (EID) of HIV and timely initiation of antiretroviral therapy (ART). Despite global efforts to scale-up of EID and infant ART, uptake of these services in resource poor, high HIV burden countries remain low. We conducted a qualitative study of 59 HIV-infected women to identify and explore barriers women face in accessing HIV testing and care for their infants. To capture different perspectives, we included mothers whose infants were known positive (n=9) or known negative (n=14), mothers of infants with unknown HIV status (n=13), and pregnant HIV-infected women (n=20). Five important themes emerged: lack of knowledge regarding EID and infant ART, the perception of health care workers as authority figures, fear of disclosure of own and/or child's HIV status, lack of psychosocial support, and intent to shorten the life of the child. A complex array of cultural, economic, and psychosocial factors creates barriers for HIV-infected women to participate in early infant HIV testing and care programs. For optimal impact of EID and infant ART, reasons for poor uptake should be better understood and addressed in a culturally sensitive manner.

Postpartum psychosis and the courts

Although mental state defenses frequently are raised in cases of infanticide, legal criteria for these defenses vary across jurisdictions. We reviewed outcomes of such cases in states using M'Naughten or model penal code (MPC) standards for insanity, and the factors considered by the courts in reaching these decisions. LexisNexis and Westlaw searches were conducted of case law, legal precedent, and law review articles related to infanticide. Google and other Internet search engines were used to identify unpublished cases. Despite the differing legal standards for insanity among states, the outcomes of infanticide cases do not appear to be dependent solely on which standard is used. The presence of psychosis was important in the successful mental state defenses. This case series suggests that states that use the stricter M'Naughten standard have not been less likely than states with an MPC standard to adjudicate women who have committed infanticide as not guilty by reason of insanity.

Maternal neonaticide following traumatic childbirth: a case study

Recent work has documented the relatively high incidence of Posttraumatic Stress Disorder (PTSD) symptoms in women during the birth delivery process and afterwards, even in uncomplicated births. This phenomenon, however, has yet to be linked with cases of neonaticide (child homicide in the first 24 hr of life) or infanticide (child homicide within the 1st year of life). Women are more likely to experience mental disorder after childbirth than at any other time in their lives, and the intentional killing of an offspring by a mentally ill mother is likely underreported. The immediate postpartum period is a time of heightened vigilance by health providers and, when the tragic death of an infant occurs, forensic professionals should specifically assess for PTSD. As an illustration, the authors present a case of maternal neonaticide that was directly linked to PTSD without any other concomitant mental disorder. PTSD is a viable mitigating factor to be examined in legal defenses of infanticide either in isolation or in conjunction with other factors.

How does one do the history of disability in antiquity? One thousand years of case studies

Exploring literary sources from the first century BCE up to the eleventh century CE, this article demonstrates how the history of disabilities in antiquity can go further than just collecting 'interesting case histories'. Using a model developed by Michel Vovelle, the sources are interpreted on different levels, taking into account both the cultural context in which the text arose and the intentions of the author.

The experience of pregnancy and childbirth for unmarried mothers in London, 1760-1866

This article explores the experience of pregnancy and childbirth for unmarried mothers in the metropolis in the eighteenth and nineteenth centuries. It draws upon, in particular, the infanticide cases heard at the Old Bailey between 1760 and 1866. Many of the women in these records found themselves alone and afraid as they coped with the pregnancy and birth of their first child. A great deal is revealed about the birthing body: the ambiguity surrounding the identification of and signs of pregnancy, labour and delivery, the place of birth and the degree of privacy, and the nature of, and dangers associated with, solitary childbirth.

Dead infants, cruel mothers, and heroic popes: the visual rhetoric of foundling care at the hospital of Santo Spirito, Rome

The fresco cycle painted at the behest of Pope Sixtus IV in the late 1470s in the main ward of the hospital of Santo Spirito in rome comprises an extended pictorial biography of Sixtus, prefaced by scenes representing the legendary foundation of the hospital by his predecessor Innocent III. The legend, which tells how Innocent established Santo Spirito as a foundling hospital in response to the discovery of victims of infanticide in the Tiber River, positions the pope as the savior of the city's unwanted children. This article elucidates how the construction and renovation of the hospital is presented in the cycle as a generative product of papal will, with the care of foundlings situated as an integral part of the image of the pope as both Father of the Church and restorer of past glory to the city of Rome. While the frescoes engage with both widespread conventions for representing infanticide and commonplace notions of the social value of caring for abandoned children, I demonstrate that the ideologically potent visual rhetoric of foundling care was also flexible, and could be adapted to meet the specific needs of a particular institutional and patronal context.

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

Public opinion about neonaticide (the killing of a newborn within the first 24 hours of life) has varied across time and cultures. Some nations have passed legislation on behalf of maternal offenders with the assumption that childbirth, a time of unique biological change, may lead to mental disturbance. The United States, however, makes no such distinction; offenders are prosecuted under general homicide laws. Nevertheless, U.S. courts often consider a mother's emotional and physical condition prior to and during delivery. This study includes 44 female offenders and 45 infant deaths and highlights society's ambivalence toward neonaticide offenders. The authors suggest that this ambivalence may be attributed to: (1) the perception that an offender's emotional and physical turmoil during the birth and homicide reduces her culpability; (2) the sentiment that neonaticide offenders are more "redeemable" than other offenders; and (3) the uncertainty about the personhood of a fetus or newborn.

Infanticide and neonaticide: a review of 40 years of research literature on incidence and causes

The prevailing public view on women who kill their babies is that they are either monsters or psychotic, or both. The psychiatric and legal communities recognize that the issue is not as simply dichotomous as this. Evidence suggests that there are important distinctions to be drawn between different types of baby deaths and that this may have implications for identification, punishment, and/or treatment of potential and actual perpetrators. This article reviews and summarizes research, incidence statistics, and judicial and clinical outcomes ranging over four decades of work and sets out various ways forward in the study and prevention of infant murder.

Chasing spirits: Clarifying the spirit child phenomenon and infanticide in Northern Ghana

In the Kassena-Nankana District of Ghana, researchers and health interventionists describe a phenomenon wherein some children are subject to infanticide because they are regarded as spirit children sent "from the bush" to cause misfortune and destroy the family. This phenomenon remains largely misunderstood and misrepresented. Based upon both ethnographic research and verbal autopsy data from 2006 to 2007 and 2009, this paper clarifies the characteristics of and circumstances surrounding the spirit child phenomenon, the role it plays within community understandings of childhood illness and mortality, and the variations present within the discourse and practice. The spirit child is a complex explanatory model closely connected to the Nankani sociocultural world and understandings surrounding causes of illness, disability, and misfortune, and is best understood within the context of the larger economic, social, and health concerns within the region. The identification of a child as a spirit child does not necessarily indicate that the child was a victim of infanticide. The spirit child best describes why a child died, rather than how the death occurred. In addition to shaping maternal and child health interventions, these findings have implications for verbal autopsy assessments and the accuracy of demographic data concerning the causes of child mortality.

"Killed by its mother": infanticide in Providence County, Rhode Island, 1870 to 1938

This article analyzes infanticide based on the Coroners' Records for Providence County, Rhode Island, from the 1870s to 1938 to determine doctors' and coroners' attitudes toward mothers who killed. The nineteenth century witnessed a medical discourse on the possibility of postpartum insanity as a cause of infanticide. While some women claimed temporary insanity, and some doctors and coroners legitimated this defense, its application to mothers who killed was arbitrary. They determined who deserved this diagnosis based on the woman's character, her forthrightness, and extenuating circumstances. Infanticide divided the profession nationally and at the local level and prevented doctors or coroners from speaking in a united voice on the issue. This article does not attempt to follow cases of infanticide through to jury verdicts. Instead, it provides an opportunity to analyze the circumstances women faced that led them to kill their newborns, and to analyze the responses of doctors and coroners to these mothers who killed. Unlike the findings of other studies, neither physicians nor coroners in Rhode Island were united in a claim of ignorance to save these women from guilty verdicts.

Socio-cultural aspects of the high masculinity ratio in India

The paper aims to explicate those factors accountable for the continuing imbalance in the sex ratio and its further masculinization over the whole of the 20th century. Here it is contended that the traditional practice of female infanticide and the current practice of female foeticide in the contemporary period, especially in the north-west and Hindi-speaking states, have significantly contributed to the high masculinity ratio in India. In addition, increasingly higher survival ratios of male children, particularly from the 1951 census onward, have been the prime reason for a declining proportion of females in the Indian population. As the Indian value system has been imbued with a relatively higher preference for sons, improvements in health facilities have benefited males more than females, giving rise to a highly imbalanced sex ratio in the country. This scenario, however, has steadily tended to alter in favour of greater balance in sex ratio.

Maternal and paternal filicides: a retrospective review of filicides in Finland

The purpose of this retrospective study was to illustrate the differences in maternal and paternal filicides in Finland during a 25-year period. In the sample of 200 filicides [neonaticides (n = 56), filicide-suicides (n = 75), other filicides (n = 69)], the incidence was 5.09 deaths per 100,000 live births: 59 percent of filicides were committed by mothers, 39 percent by fathers, and 2 percent by stepfathers. The mean age of the maternal victims (1.6 y) was significantly lower than that of the paternal victims (5.6 y), but no correlation between the sex of the victim and the sex of the perpetrator was found, and the number of female and male victims was equal. The sample of other filicides (n = 65) was studied more closely by forensic psychiatric examination and review of collateral files. Filicidal mothers showed mental distress and often had psychosocial stressors of marital discord and lack of support. They often killed for altruistic reasons and in association with suicide. Maternal perpetrators also dominated in filicide cases in which death was caused by a single episode or recurrent episodes of battering. Psychosis and psychotic depression were diagnosed in 51 percent of the maternal perpetrators, and 76 percent of the mothers were deemed not responsible for their actions by reason of insanity. Paternal perpetrators, on the other hand, were jealous of their mates, had a personality disorder (67%), abused alcohol (45%), or were violent toward their mates. In 18 percent of the cases, they were not held responsible for their actions by reason of insanity. During childhood, most of the perpetrators had endured emotional abuse from their parents or guardians, some of whom also engaged in alcohol abuse and domestic violence. The purpose of this study was to examine the differences between maternal and paternal filicides in a sample of 200 cases in Finland. This report also provides a psychosocial profile of the perpetrator and victim in 65 filicides and a discussion of the influence of diagnoses on decisions regarding criminal responsibility.

Neonaticide: Phenomenology and considerations for prevention

This article explores the phenomenon of neonaticide, the murder of an infant during the first day of life. Characteristics of maternal neonaticide offenders in industrialized countries were identified based on a systematic literature review. Neonaticides were most often committed by poor, relatively young, single women who lacked prenatal care. Efforts to better prevent these tragedies should include improved sex education and contraceptive access. Two legal responses to the problem of neonaticide, Safe Haven laws utilized in the United States, and anonymous birth options in Europe are discussed.

Judgments of culpability in a filicide scenario

Previous research has indicated that potential jurors are likely to use personal biases, such as those based on gender and ethnicity, in their judgments of culpability of criminal defendants in addition to, or instead of, the facts of the crime. The present paper seeks to extend this literature to the crime of filicide; to examine whether male defendants are judged more harshly than female defendants, as is the case for domestic violence and sexual abuse. 214 participants were provided with a scenario of filicide in which the gender of the perpetrator, the gender of the child, and the family's social class were randomly assigned. Participants were asked to rate the culpability of the defendant in the case. Results indicated that, unlike for other violent crimes, participants did not use gender or social class biases in their judgments of criminal culpability.

[Filicide; psychiatric disorders in parents who murder their children--a literature review]

BACKGROUND

In the Netherlands between 1992 and 2001 there were 70 reported cases of child murder by parents, the total number of victims being 86. The crime of filicide is rare but has enormous impact on society. It is not known whether there is a relation between filicide and psychiatric disorders.

AIM

To gain insight into the proportion and type of psychiatric disorders in perpetrators of filicide. method Literature search by means of PubMed, Embase Psychiatry and PsychInfo on the basis of the search terms filicide, neonaticide, infanticide, gender, psychiatric disorder. results Perpetrators of filicide were found to have many types of psychiatric disorders. The most frequent types of diagnostic categories were affective disorders with or without psychotic features. The second most frequent type was schizophrenia. There was a considerable overlap between these disorders, personality disorders and symptoms of drug-dependence. Often perpetrators were also found to have lower-than-average intelligence.

CONCLUSION

A psychiatric disorder in one or both parents constitutes a major risk factor for child murder by parents. The identification of other risk factors and their possible interrelatedness is important for our understanding of these criminal acts, for the detection of warning signs and for the development of preventive strategies.

The civil liability for damages of the criminally insane

As a rule, mentally ill patients are held to be responsible for their acts just like everyone else. Notwithstanding, the law in Israel contains special rules which distinguish individuals with mental illness from other people. The instructions laid out in article 34h of the Israeli Penal Law empower the court to release a defendant from criminal responsibility. To do this the following criteria must be met: (a) the defendant was mentally ill, (b) he/she was in a psychotic state at the time he/she performed the felony, (c) his/her mental illness deprived him/her of his/her abilities in at least one of the two following areas: 1] he/she could not understand what he/she was doing, or the forbidden nature of the act; 2] he/she was incapable of preventing him/herself from carrying it out. In the case presented, a mentally ill individual was charged with the murder of his child and with an attempt to murder another child. The court ruled him to be legally insane and therefore non-punishable. He was later sued by the other child's parents for damages on the grounds of the assault tort. The issue in question was how does the fact that the defendant was ruled legally insane while committing the wrong doing affect the legal ruling of the defendant's liability especially regarding the tort of assault? The Magistrate's Court ruled that the Israeli Tort Law did not determine exemption from responsibility for the mentally ill. Liability for damages will be imposed upon an individual whenever the prerequisites to define a tort are met, even if the mental requisite is an outcome of one's mentally ill state. The District Court determined that an individual who intended to inflict harm is guilty of assault, even though the intent was an outcome of his mental state. Lack of volition due to one's inability to refrain from action does not constitute a defense for assault. In this case liability for damages was imposed on the defendant. The Court related to the issue of justice according to which an innocent person's damages should not remain uncompensated, and the assailant was required to pay damages to the victim.

Maternal filicide theoretical framework

The maternal filicide theoretical framework (MFTF) was developed to enrich the understanding of how traumatic experiences during formative years can affect a woman's relationship with her own child. Exposure to a known set of vulnerabilities can foster triggers that predispose a woman to respond impulsively and violently toward her child. Comprehensive assessment of vulnerable families is essential for the prevention of fatal and nonfatal abuse. The MFTF may be applied to both crimes.

Murder, mercury, mental illness: infanticide in nineteenth-century Ireland

BACKGROUND

Infanticide has been described in almost every human society.

AIMS

To present a case of infanticide from nineteenth-century Ireland and explore related diagnostic, therapeutic and judicial issues.

METHODS

This paper uses original archival material from the Central Mental Hospital, Dublin to present a case of infanticide and inform an exploration of related issues.

RESULTS

In 1892, 'Dora', a thirty-four year old servant from Dublin, was found guilty of the murder of her eight-month old child and sentenced to indefinite detention at the Central Mental Hospital, Ireland's only inpatient forensic psychiatry facility. The subsequent experiences of Dora ("a case of melancholia") illustrate many of the diagnostic, therapeutic and judicial issues surrounding infanticide in nineteenth-century Ireland.

CONCLUSIONS

There were strong links between social circumstances and infanticide in nineteenth-century Ireland, compounded by myriad diagnostic and therapeutic challenges associated with forensic psychiatric committal and lengthy detention in poorly-therapeutic facilities .

Legal outcomes of all suspected neonaticides in Finland 1980-2000

This nationwide study examined legal outcomes and possible psychiatric diagnoses of suspected cases of neonaticide. Neonaticide is commonly defined as the killing of a newborn on the day of its birth, and is considered to have not only a low prevalence but also a high level of concealed criminality. This hidden nature guided us to find out what the final legal outcomes of suspected neonaticide were. It was a comprehensive, retrospective, register-based study of all 44 cases of suspected neonaticide that occurred 1980-2000 as recorded by Statistics Finland. The 44 cases were ascribed to 40 suspects, three of whom died themselves during the offence. Twelve cases (27%) were eventually prosecuted and the accused convicted of neonaticide. Their mean sentence was 617 days (SD 216, range 300-1095 days). Fourteen offenders (35% of offenders) underwent a forensic psychiatric examination, out of which four (29%) were diagnosed with a psychotic disorder and 10 (71%) with a personality disorder. Six of the 14 women were not sentenced as criminally irresponsible and three of them were committed to involuntary hospital care. Nine cases (20% of cases) were still unsolved, and in eight (18%) cases the offence title had changed into something other than neonaticide. We concluded that since only 41% of suspected neonaticides completed the court process as neonaticides, the previous results from studies on neonaticide may present a subgroup of offenders, not the whole picture. Therefore, further discussion and research is needed to elucidate this perplexing, sad, and utterly redundant offence in modern society, to prevent it, and develop treatment programs for the offenders.

Motives for maternal filicide: results from a study with female forensic patients

The objective of this study was to examine different motivational factors, leading mothers to commit neonaticidal, infanticidal or filicidal acts. This study was based on data gathered through a retrospective chart review of all filicidal women admitted to the Mid-Hudson Forensic Psychiatric Hospital in New York State (MHFPC) between 1976 and 2000 (n=57). Because our sample was drawn from MHFPC records it excludes filicidal mothers who went directly to prison. Our women were either found not competent to stand trial, or found not guilty by reason of insanity, or were convicted offenders who were seriously mentally ill and were not sent to prison. Fourteen percent committed neonaticide, meaning that they killed their child within the first day of its life; 21% killed the child after the first day but before it reached its first birthday (infanticide); and 65% committed filicide by murdering a child older than one. Two groups of women could be identified as having different motivational profiles: The neonaticidal mothers were mostly troubled by psychosis and social problems while the filicidal women were defined as severely depressed, with a history of self-directed violence and a high rate of suicide attempts following the filicidal offense.

Infantizid als Folge einer postpartalen Bindungsstörung

Parental killing of their own children in the 1st year constitutes a rare phenomenon. Studies on infanticide show that mothers who kill their children are frequently psychiatrically disturbed. Depression is the most common postpartum disorder and may represent a vital danger for both mother and child. The association between depression and infanticide can usually be explained by maternal psychopathologic symptoms. The importance of a mother's bonding to her infant has not often been examined in respect to infanticide. The present case report underlines the importance of postpartum bonding disorder and its relation to a higher risk of infanticide.

Neonaticides may be more preventable and heterogeneous than previously thought - neonaticides in Finland 1980-2000

Neonaticide is a sad and infrequent crime with possibly a high level of underreporting. The aim of this study was to examine the circumstances of neonaticide, and whether there are subtypes of offenders, or suggestions for prevention. The study was retrospective and register-based using comprehensive nation-wide material of all cases of suspected neonaticide during 1980-2000 in Finland. Out of the 50 suspected cases, 32 women were included in the final analyses as neonaticide offenders. Most women (91%) had concealed their pregnancy, which was not the first for 66%. Most (66%) were not quite sure why they had offended, and the most frequent (63%) method of operation was neglect. Four women were diagnosed psychotic and formed a specific group. We concluded that there might be specific subgroups of offenders - even though our small population limited conclusions. Furthermore, prevention might be heightened. We call for international joint projects for enlarged material to enable grouping, as well as education and discussion among the public and the professionals to prevent neonaticide, unify its jurisprudence and improve the treatment of the offenders.