Infanticide: contrasting views.

BACKGROUND: The subject of infanticide is met with complex reactions. Paradoxically, the very same society that practices gender selection may also prosecute a mother for killing an infant. The author reviews historical, cultural, and political views on infanticide. OBJECTIVE: Using the case of Andrea Yates, the author illustrates the outcome of an infanticide case in American Judicial System in which a floridly psychotic mother serves a life in prison. This work explores contemporary worldwide experiences of infanticide and investigates culture specific attitudes towards causes, facilitation, and punishment of this tragic cause of infant mortality. The work illustrates the intricate relationship between a society's construction of parenthood and mothering, and its experience of infanticide. RESULTS: Infanticide is deeply embedded in, and responsive to the societies in which it occurs. Causes vary from poverty to stigma, dowry and insanity. The worldwide experience of infant murder reaches from facilitation of gender determination in China and Asia to lethal execution of mothers as perpetrators in the United States. CONCLUSION: Infanticide must be viewed against the political, cultural, social and legal backgrounds of societies that treat women with disregard. It is a reflection of social and cultural norms governing motherhood, a constant that links these seemingly disparate acts. The overall association of infanticide with crime, postpartum illness, population and sex selection speaks to unjust discrimination against women and children. We as a world society can do a far better job of protecting motherhood.

A systematic investigation of 16 cases of neonaticide.

OBJECTIVE: Neonaticide, or infant murder on the day of birth, is often preceded by denial of pregnancy. The preponderance of case reports of neonaticide describes a pattern of pregnancy denial, dissociation, and ego disorganization. The author systematically investigated the clinical characteristics of 16 women charged with homicide in the United States after alleged neonaticides. METHOD: The women received a psychiatric evaluation and were administered the Dissociative Experiences SCALE: RESULTS: Nearly all of the women reported similar precipitants and symptoms, including depersonalization, dissociative hallucinations, and intermittent amnesia at delivery. CONCLUSIONS: The characteristics of the women in the study were similar to those reported in the literature on neonaticide. The existence of this common pattern suggests that treatment strategies can be designed for women at risk for neonaticide.

Antepartum and postpartum depression.

Psychiatric mood disorders can and do occur in pregnant women. Women with antepartum depression have a risk of poor nutrition, substance abuse, and prenatal noncompliance. Careful assessment of risk and benefits to the pregnant woman and to the unborn child must be made before pharmacologic therapy is initiated. The three postpartum mood disorders--postpartum "blues," postpartum depression, and postpartum psychosis--are common, and education is an important instrument in the treatment of these disorders.

Interpersonal psychotherapy for depressed antepartum women: a pilot study.

OBJECTIVE: Antenatal depression, a substantial risk factor for postpartum depression, occurs in 10% of pregnant women, but no clinical treatment trials of antenatal depression exist. In an effort to establish treatment guidelines for depression during pregnancy, the author reports on a treatment program using interpersonal psychotherapy for antepartum depression. METHOD: A 16-week open pilot trial conducted with 13 pregnant women who met DSM-III-R criteria for major depression. RESULTS: The women's mean depression ratings decreased significantly from week 0 to week 16 of the treatment program. CONCLUSIONS: Interpersonal psychotherapy for antepartum depression appears to be an effective alternative to pharmacotherapy in pregnancy. This study served as a pilot for an ongoing controlled clinical treatment trial.