Is a Postpartum Depression Defense a Cop-Out?


A few of you who read my blog regularly and follow me on Twitter may remember a conversation I held with a woman who asked at her blog if Postpartum Depression is a cop-out defense when it comes to infanticide. This post is my response. It’s taken me some time to write due to research and the intense emotional aspect of this issue. The post below is lengthy. It is triggering. There are graphic descriptions beginning in the first paragraph. If you are easily triggered, go watch this video instead. Oh, and if you go watch the video? I’m not responsible for the ensuing addiction. (I’ve been listening to it almost non-stop for the past 36 hours.)

Humankind cannot bear too much reality.

T.S. Eliot

Since the dawn of time, humanity has grappled with parental induced deaths of infants and children. In Paleolithic and Neolithic ages, infanticide was an acceptable practice, one meant to preserve the balance of man and his immediately available resources. Later, in some cultures, infanticide grew to be gender-based with girls specifically sacrificed due to the cost of dowry required at marriage. Ritual sacrifice, unwanted birth, illegitimate birth, gender disappointment (including financial reasons such as dowry), birth defects or deformities, preservation of ecological balance, and a number of additional reasons peppered several cultures as legitimate reasons for the practice of infanticide.

Common early methods of infanticide included but were not limited to: exposure, suffocation or asphyxia, ritual sacrifice, brute force, blunt force trauma, and others. The most common method was exposure as this freed the parents from any direct involvement in their infant’s actual death according to societal belief. In fact, Romans often abandoned their infants with the hopes they would be raised by others, in which case they were referred to as “foundlings.”

Infanticide, the murder of a child older than 24 hours yet younger than 12 months, is carried out in our modern ages primarily by the mother and typically does not involve brute force or violent methods. The child is instead smothered, drowned, poisoned, or asphyxiated. Some cases do involve more force and more heinous methods.

Most mothers who commit infanticide are in a lower financial class and lack support from family and community. It’s also important to note many victims of infanticide are not first born but instead second or later born children.

Interestingly enough, not many fathers were cited in the research in regard to infanticide. In fact, only four known cases of infanticide with fathers at fault are present in current literature spanning the subject of infanticide. Fathers are far more prevalent in filicide cases which are cases involving children over 12 months of age. In these cases, the father is more likely to also harm the mother and himself in addition to any children involved.

In many infanticide cases involving mothers, a mental health disorder is cited as part of the defense or reason for the crime. Occasionally this directly relates to a Postpartum Mood Disorder, specifically Postpartum Psychosis. But for the mothers who use a Mental Health defense, is it a worthwhile defense or is it a cop out?

Postpartum Mood Disorders have been mentioned in literature since Hippocrates. Within the past several years, research and community awareness has exposed these conditions as real and palpable. While the true cause is not yet known or fully understood, researchers are working to expose the root cause and improve treatment for those affected. To date, we understand some physical roots but experts are still teasing out the specifics of these causes. Increasing social support surrounding mothers has proven time and again to be key to preventing and shortening the Postpartum Mood Disorder experience. Creating awareness and understanding of a less than Utopian postpartum experience lends a helping hand as well. Improving access to knowledgeable professional resources such as psychiatrists, therapists, and the like, also increases the potential for recovery success in families struggling with Postpartum Mood Disorders.

In many infanticide cases, the mothers and their families did not have adequate access to knowledgeable and compassionate personal, community, or professional help. If they did realize help was needed, they were either discouraged from reaching out for it via societal stigma (ie, the husband didn’t want his wife on medication, they were told to get “over it,” or there were religious beliefs preventing the necessary help) or there simply was not adequate sympathetic and knowledgeable care within physical or financial reach. That said, every infanticide case, as with every Postpartum Mood Disorder case, is different from the next. There are important basic factors from each which carry over into the next but the idiosyncrasies differ which make each case nearly impossible to successfully compare in entirety to the next.

From a legal perspective, choosing a Mental Health Defense is more of a crap shoot or a game of roulette. Postpartum Psychosis and Depression, while a real and experienced phenomenon, is not a guaranteed defense against the crime or action of infanticide. It is a transient defense at best, one wholly dependent upon the current legal status of mental health defense within the state and/or country in which the accused mother resides.

The legal definition of Postpartum Psychosis is not congruent with the medical definition. Both are based, at this time, officially on speculation. The DSM IV eliminated Postpartum Psychosis as a classification. The DSM III listed Postpartum Psychosis in the index but not as a separate illness. According to the DSM III, Postpartum Psychosis was thought to fall under: schizophreniform disorder, brief reactive psychosis, atypical psychosis, major affective disorder, and organic brain syndrome. Postpartum Psychosis occurs in 1 to 2 births out of every 1,000, or at a .1% rate. Postpartum Psychosis is considered a medical emergency with immediate treatment necessary. Onset is sudden and occurs within the first 4 weeks after birth, most often within the first 2-3 days. Postpartum Psychosis is the deadliest of the Postpartum Mood Disorders with a 5% rate of infanticide.

The legal definition of Postpartum Psychosis is no different than that of any other Mental Health Disorder as far as fault-finding and therefore subject to the same rigorous testing of any other Mental Health defense. In the United States, this is dependent on the state of residence. Some states abide by the M’Naughten rule while others abide by the A.L.I. test. In three states, Montana, Idaho, and Utah, the Insanity Defense has been abolished even though these states still admit evidence of mental status in cases.

Even with access to a state by state chart of current Mental Health Defense guidelines, it’s confusing at best to determine what your outcome would be in a court of law. In the United States, there is argument against setting a legal specification for Infanticide  as England did in 1922. The current argument against this specification cites lack of a true medical definition for Psychosis along with the potential for a growth of sympathy for mothers who kill and would then invoke the status.

If a mother who commits infanticide invokes a Mental Health Defense, she is not guaranteed freedom if not convicted of murder in the criminal sense but is instead found Not Guilty By Reason of Insanity (a conviction, by the way, not available in ALL states and very dependent upon which test your state uses to determine sanity at time of criminal action). She instead opens herself up to be remanded to a State Mental Institute more than likely with high security. This is not like going home after trial or heading off to a luxurious Club Med vacation. This is dark, gloomy, filled with meds, psychiatrists, therapy, and communing with a population who is equally if not more disturbed than the remanded mother. She is cut off from family, from friends, and from her life, just as if she were sentenced directly to jail. Also, she is continually judged by society, regardless of her convicted status as a psychiatric inmate versus a mainstream high security or possibly death row inmate.

Once remanded to a Mental Institution, the sentenced mother is at the hands of whatever governing body is responsible for releasing psychiatric inmates. This also differs from state to state. More often than not, it is the Court but a few states hand this responsibility to various agencies within their purview. She may also be sentenced to spend a specified amount of years at the Mental Institution despite therapeutic or rehabilitation status, thereby subjecting her to additional exposure to a less than preferable environment for years after conviction just as if she were a mainstream inmate.

The legal and medical diagnosis and defense of Postpartum Psychosis are at best subjective to the diagnostic technologies, sound judgment, and ethics of the medical and legal professionals privy to each individual case of infanticide, thereby further complicating the transient nature of this defense. Therefore a conclusion claiming Postpartum Depression/Psychosis defense as a “cop-out” is erroneous at best as this defense rarely guarantees the defendant the freedom to which she had access prior to her accusation and subsequent proceedings regardless of any legal outcome.

As David G. Myers stated in Social Psychology, “There is an objective reality out there, but we view it through the spectacles of our beliefs, attitudes, and values.” Infanticide has an objective reality in the courtroom. It is a crime. The precise charges depend upon the circumstances of the commission of the actual crime. The defense relies upon the knowledge of the psychological and criminal experts examining the accused. The prosecution relies upon them as well but relies heavier upon the requirements set forth by the law and the justice system to which they are bound. Society at large, meanwhile, is set free to judge, convict, and develop opinions not bound by the court. Our convictions of the accused mothers may be harsher, intrinsically darkened with our own emotions and experiences.

In the end, far more than one life is lost in every case of infanticide. Yes, one life moves on to eternity, but the lives of those surrounding the one lost will never recover. Infanticide is therefore not an incident captured in a vacuum but a ripple vacillating through families and communities like a tornado. Conversations must be held, action must be taken, and the stigma of asking for help signifying failure at motherhood must dissipate if we are to begin to battle the further destruction and loss of mothers, families, and infants to this crime.


Media Sensationalism, AOL, and Postpartum Mood Disorders


1, 2, 3, 4, 5, 6, 7, 8, 9, 10.

Oh, hey.

You’re here. Excellent.

1,2,3,4,5,6,7,8,9,10.

Why am I counting? You’ll find out in a bit. For now, just go with it.

1,2,3,4,5,6,7,8,9,10.

In the United States, from October 2008 through October 2009, 4,148,000 live babies were born.

The statistical rate of Postpartum Mood Disorder is up to 20% of all new mothers. And by new, I mean just gave birth, not first time mom. Postpartum Mood Disorder is one of those fabulous non-discriminating kinda things which will walk up to anyone and cold cock them for no reason at all. Regardless of how well prepared said person may be. It’s kinda like getting mugged. Repeatedly.

This means that from October 2008 – October 2009, approximately 829,600 new mothers more than likely struggled with a Postpartum Mood Disorder at some level. This means 2 out of every 10 moms struggled with a Postpartum Mood Disorder (hence, the counting).

There is no data which tells us how many of those 829,600 mothers sought help.

1,2,3,4,5,6,7,8,9,10.

I have been in the trenches with Postpartum Mood Disorders since 2004. You see, I had a very horrible episode of Postpartum OCD after the birth of my first daughter. After her birth, vicious thoughts swirled about in my head. Visions too. Instead of enjoying my brand new baby’s time here, I was swallowed whole with anxiety, shoved into fight mode to protect her from myself, and left thinking the whole world was out to get me because they knew how much I sucked at this whole motherhood thing.

1,2,3,4,5,6,7,8,9,10.

For the record? I did the right thing. I called my doctor and made an appointment. I had to take my daughter with me because my husband was unable to get off work. So off we went, into the wild blue yonder where this thing called Help lived. We arrived, waltzed through the front door and signed my name with a flourish because dammit, we were there to do the right thing.

Only my doctor was not there to do the right thing.

He was there to judge me. To inform me that all my hormones had slid magically back into their little slots at 4 weeks postpartum and there was nothing wrong with me.

Whaaaa????

Wait a second.

I JUST handed you a scale. On which I answered YES to having thoughts of harming myself AND my child. And YOU, a trained medical professional, are dismissing this? Did I miss something here? I am no professional but.. uh… um…. really?

THEN… oh then… the icing:

“How important is breastfeeding to you?” he asked, quite seriously as he peered at me from behind his large and imposing wooden desk as my daughter screamed her head off to be nursed beside me.

I should have gotten her out of her car seat and started to nurse right then and there. But I didn’t. Shock slacked my jaw and curled my mouth into a grin. This “professional” clearly did not have the capacity to help me. I smiled my way right out of the appointment and drove home with tears sliding down my face. You see, the Internet had told me just what to do – to go seek help. To make an appointment with my doctor. The Internet had said nothing about what to do when you are shot down by your doctor.

So there I was……driving baby, me, and my shattered heart all the way home. Alone. Isolated. Abandoned. Scared as hell.

Never before in my life had I experienced a hell quite like the one in which I now found myself mired. Never before had I, a perfectly normal person prior to giving birth to my daughter, given any thought to harming another person. NEVER. And the day on which I discovered my pregnancy? There was no way I would have ever thought that less than three months after giving birth I would want to go back in time so I would never get pregnant. I wanted to run, hide, make this new me go away.

In what state did all of this take place?

South.Frigging.Carolina.

Just a couple of hours away from Orangeburg and less than 45 minutes away from where Susan Smith, well, you know.

Let me tell you a bit about rural South Carolina.

There is nothing in rural South Carolina. Small towns there are devoid of much of anything. Residents in these towns are intent on keeping outsiders out and insiders in. We barely made any friends while there. The town in which we lived seemed to have some sort of an addiction problem as most wandered around mindlessly. The poverty level? Wow. We were on the high end of the scale for living because we: Rented a HOUSE instead of a trailer and owned TWO cars instead of one or none at all. The house we rented was tiny. But that didn’t matter. We were considered to be upper class in the town despite the fact that we were just squeaking by on my husband’s salary as a restaurant manager.

In this town, there lived a family everyone knew to avoid. They didn’t have running water so they never bathed which made them reek to high heaven. If you were fortunate enough to be at the local Wal-mart or Bi-Lo when they were, you learned to walk to the other side of the store if you saw them coming.

High School graduates were also hard to come by as well. Many young people had to go to work early to help support the family. They worked at whatever they could find – sometimes driving long distances for good jobs. Even then it was hard to get good work because the jobs in the city were very picky if you lived too far away. Understandable concern but it really does put a crimp on improving your life when you are living in the middle of nowhere and cannot afford a move into the city until you get a better job which of course, you can’t get because you live too far away. It is a very vicious cycle.

Oh, and the Klan had a central PUBLIC meeting location.

And yes, you read that right.

Bottom line here – South Carolina has problems. A lot of problems. Many states do but never before in my life had I witnessed a perfect storm – poverty, ignorance, and a lack of support for its residents.

Since I have left, there has been the development of a Postpartum Coalition there. I’ve been asked to speak at their annual conference in October 2011. I am really looking forward to coming full circle with my experience and helping to educate providers and citizens alike in a state which so desperately needs raised awareness of Postpartum Mood Disorders.

Why did I just walk you through all of that history?

Earlier this week, a mother in South Carolina was arrested for the deaths of her two toddler sons. According to news articles, she was unemployed, frustrated, and had some heated words with her mother the night before the incident. This mother has since confessed to her actions and is now in jail facing court and charges.

For some reason, various members of the media have dragged the idea of this mother having Postpartum Depression into the Speculation surrounding her case. Now, Dr. Arlene Huysman, author of The Postpartum Effect, an excellent book which examines why mothers kill, postulates that Susan Smith and others may struggle with something called Progressive Postpartum Depression.

Here’s how she describes it on page 43 (empasis mine):

“The mother with progressive postpartum depression (PPPD), however, does NOT recover without treatment. She merely experiences a hiatus until her next episode. Subsequent episodes are very often triggered by rejections, separations, and losses, and recur throughout the woman’s life. Usually the next episode is worse than the last. If this pattern goes unchecked, the mother will spiral into a cycle of illness that can destroy her life and her family.

When a mother is in the grip of this disease in its most serious form, she passes beyond reason. In the place of the capable woman is one full of dread, rage, and confusion. She feels unloved and unlovable and loses her ability to distinguish right from wrong. She may hear voices in her head and be listening to them rather than the voices of her family. This is not a symptom of schizophrenia, but rather a reflection of her own obsessive thinking. Death may become a preoccupation. She is in the throes of what feels like an unending despair.”

Yesterday, (Please do not click on the following link if you are still struggling as it may be triggering.) AOL News contributor, David Lohr, published an article about this South Carolina mother at AOL News. In the original version, he included a quote from criminal profiler Pat Brown. Ms. Brown, based out of Washington DC, has been featured in many outlets including CNN, Court TV, and various other sources. Makes perfect sense to get a quote from a criminal profiler for a case involving well, crime.

But David Lohr and AOL news made an egregious error in their publication of the quote by Ms. Brown. AOL news has since removed the quote from the story and appended the story with an editor’s note to this effect. Ms. Brown has gone on the defensive in regards to a very public and viral outburst by many of the women I am proud to blog and tweet with on a daily basis.

The offensive quote:

“Most women who suffer depression after their children are born are suffering from post-how-did-I-get-stuck-with-this-kid, this body, this life? They may be depressed, but it is their situation and their psychopathic personality that brings them to kill their children, and not some chemical malfunction.”

If most women were truly suffering from “post-how-did-I-get-stuck-with-this-kid, this body, this life” then all we would need is a personal trainer or plastic surgeon, a nanny, and a million dollars to effectively change our stars. Oh wait – speaking of stars, don’t celebs have this too? Bryce Dallas Howard had it. Miranda Kerr, Gwyneth Paltrow, Brooke Shields, Marie Osmond, and many others. Granted, they did not kill their children but they still struggled (even severely) with Postpartum Mood Disorders. And they had access to all the help in the world.

Postpartum Mood Disorders do not just strike poor down on their luck moms.

Postpartum Mood Disorders are NOT the only possible explanation for filicide.

Postpartum Mood Disorders may not be definitively caused by a hormonal or “chemical malfunction” but study after study shows there are differing rates of various hormones of women struggling with PMD’s. Researchers have not yet defined what this means yet but I suspect that with sustained research we will get closer to answers each and every day.

The ignorance of Ms. Pat Brown in making such a sweeping statement in regards to an entire population of struggling moms is highly irresponsible. With her reach and popularity as a commentator for several national shows including the Today Show, the CBS Early Show, Larry King, Inside Edition, Nancy Grace, Issues with Jane Velez-Mitchell, Joy Behar, and America’s Most Wanted as well as featured on the Court TV show I, Detective, it frightens me to hear her make such a grandiose and untrue statement. The possibility that a hurting mother somewhere may have read her statement and then dismissed her own issues scares the hell out of me.

We, mothers who have struggled with Postpartum Mood Disorders, have issue enough with gathering strength to make that first call for help. We become convinced we are bad mothers. That we have failed and will never get better. We talk ourselves down even further the rabbit hole into which we tripped after we gave birth to children we love more than life itself.

Moms with Postpartum Depression are NOT:

Bad Mothers

Mourning the loss of our previous supermodel body

Tragically sad because now we have a little person stuck with us

Moms with Postpartum Depression ARE:

Madly in love with their children

Good moms who want to heal

Desperate to find reliable help

I can’t even begin to fathom the damage this statement has made. I have had more mothers tell me they are a bad mom because they are sad. It’s not supposed to be like this. I’m supposed to be happy. I don’t love my son, daughter, husband, etc. What is wrong with me? The confusion, angst, sorrow, frustration, guilt, all adds to their journey with a Postpartum Mood Disorder. Then if they are unable to find the help they need (like me), they are left to their own devices for recovery. Unfortunately, some of us never find the right help and are not surrounded by empowering people who can lift them up and guide them toward recovery.

If you are struggling with a Postpartum Mood Disorder or hurting, sad, upset, and thinking of harming yourself or others, PLEASE reach out for help. If it’s after the birth of a child, you can call Postpartum Support International at 1-800-944-4PPD. Volunteers check the messages on a daily basis (I’m one of them and these ladies are DEDICATED. We will get you in touch with someone in your area who can help you). If you need urgent help, please go to the nearest ER. If you’re feeling suicidal, you can call 1-800-273-TALK anytime of the day, even at 2am on a Sunday.

I remember that sense of isolation. The need to reach out and talk with someone who has been there and done that was overpowering. The desperation I felt in my incapacity to locate professional help. I tried for four days before I broke down to call my doctor. I hung up as soon as the automation came on the line. Have you ever tried to admit to someone that things are NOT okay when you are supposed to be at your happiest, especially according to Johnson & Johnson? It is one of the hardest things in the world to do. Hands down.

Fittingly, Jennifer Lopez’s Let’s Get Loud just came on Pandora as I’m wrapping this up.

I thank everyone out there who got LOUD yesterday to let AOL, Pat Brown, and David Lohr know how wrong they were.

AOL, you need to apologize. The quote should never have been published to begin with.

Pat? I challenge you to read Dr. Huysman’s book, The Postpartum Effect if you have not already. It’s available at Amazon. Hell, I might just mail you a copy. Anyone else want to flood her office with copies? It’s about $15 or so. If that wouldn’t get her attention…..

And David Lohr, the next time you need a quote about something related to Postpartum Depression? Try Postpartum Support International. I believe they know a thing or two about Postpartum Mood Disorders.