Maternal Infanticide: Murder or Mental Illness?

On June 20, 2001, Andrea Yates drowned her five children in the family bathtub. On May 11, 2003, Deanna Laney stoned two of her three children to death. The third survived but had permanent brain damage and blindness. Andrea was convicted of murder and sentenced to life in prison. However, Deanna was found not guilty by reason of insanity and is currently being treated at a maximum security psychiatric hospital. These cases were remarkably similar: both women were charged with murder, both plead insanity due to Postpartum Psychosis, both women gave birth just months before the killings, both home schooled their children, both were devoutly religious and the same forensic psychiatrist, Dr. Park Dietz, testified for the prosecution against the women . So how could the verdicts be so different? These women were suffering from a postpartum mental illness, and are not a threat to society. Neither deserves a prison sentence, but should be hospitalized and treated for their illness. Similar situations may have more consistent outcomes by implementing alternative solutions nationwide. One solution is for the United States to follow in the footsteps of Great Britain and many other countries by passing an Infanticide Act into law. Another option is to implement a modernized insanity test to make it easier for women suffering from postpartum mental illness to be treated in a psychiatric facility instead of serving jail-time.

Many would argue that mothers who kill their children should be treated like any other murderer, and they deserve to spend their lives in prison or even the death penalty. However, these women often suffer from Postpartum Psychosis (PPP), a very rare disorder following childbirth, which only affects about 0.5% of women. PPP typically arises in the first two weeks following childbirth, and requires hospitalization and aggressive medical treatment. Mothers with PPP experience paranoid delusions, auditory command hallucinations, severe depression, homicidal ideations toward their children, and/or believed that their children were possessed or dangerous. They are also more likely to have a history of psychiatric hospitalization, and suicide attempts .

The first solution to explore is for the United States to pass an infanticide act into law. Maternal infanticide is defined as a mother killing her child that is less than 12 months old . For example, in Great Britain, a woman who has killed her infant under age one can be indicted for infanticide. This legislation, passed in 1922, reads:

Where a woman by any willful act or omission causes the death of her child - aged less than a year - but at the time the balance of her mind was disturbed by reason of her not having fully recovered from the effect of giving birth to the child... the offense, which would have amounted to murder, is deemed infanticide and is dealt with and punished as if it were manslaughter .

Psychiatric treatment and probation are mandatory, and many countries have followed suit. In Sweden, these cases go before a panel of doctors, and never enter the criminal justice system at all . Countries that have enacted infanticide acts have recognized that childbirth can have an effect on a woman's mental state, and realize that these women need treatment, not punishment. If the United States had an infanticide act in force at the time of the Yates killings, Andrea would have only qualified under the act for one of the killings, because four of her five children were over the age of one. There would need to be a provision in a US infanticide act to include all women who have given birth in the past twelve months before the killings, no matter the ages of the children who were killed.

Another solution may be to implement a modernized insanity test in place that would redefine the term "not guilty by reason of insanity." The current test that is used in most states, including Texas, is the M'Naughten test. The M'Naughten test was established in England 1843 after the trial of Daniel M'Naughten, who was the first to be officially found "not guilty by reason of insanity." During the trial, M'Naughton's psychiatrist testified that his patient was suffering from paranoid delusions when he killed his victim . According to the M'Naughten test, a defendant is judged insane only if she can prove that, because of mental disability, she either did not know right from wrong at the time she committed the ultimately criminal act or did not understand the nature and quality of that act . Several problems arise when using this test for insanity. First of all, it was created more than 150 years ago. Since then we have made many new scientific discoveries on the nature of mental illness, especially postpartum mental illness. A Second problem, that needs to be addressed, is that mothers who kill their children may believe that what they are doing is right, and in the child's best interest. For example, according to Walker, Andrea Yates killed her children to save them from Hell. She knew that killing them was legally wrong, but she believed she was morally doing the right thing. Therefore, the jury believed that since she was lucid enough to make that distinction, she was found guilty and sentenced to life in Prison at her first trial. Contrastingly, Deanna Laney, who said that God told her to kill her children, was found not guilty by reason of insanity using the same M'Naughten test .

The psychiatrist who testified at both the trials on behalf of the prosecution was later asked why the verdicts were so blatantly different. He reasoned that, "Yates knew her actions were wrong and would be considered wrong by others and God, while Laney was struggling to carry out God's will. Yates knew her actions were wrong because the devil told her to kill her children, while Laney did not know what she was doing was wrong because God told her to do it" . No matter who or what told these women to kill their children, the fact that they were hearing voices at the time of the killings raises a red flag that they are suffering from some sort of mental disturbance. In addition, both women have a history of mental illness, and had given birth within the last twelve months. This is why the insanity test itself should be changed to include PPP in the definition of "insanity."

Some psychiatrists have proposed the following as a test especially for PPP:

Affirmative Defense: The defendant can raise the affirmative defense of insanity based on postpartum psychosis if:

1.The killing of the defendant's child occurred within one year of the mother giving birth to that child or another child, and

2.An expert psychiatrist appointed by the court determines that there is a reasonable doubt as to the defendant's sanity.

Elements: The defendant must prove, to the extent determined by the law, that:

1.She was suffering from postpartum psychosis, and

2.There was a casual connection between the psychosis and the killing, and

3.She did not know right from wrong, or, if she did know right from wrong, then she must prove that because of the psychosis, she had lost the ability to choose between right and wrong.

This test has advantages over the M'Naughten test because it recognizes the effects PPP has on women and their actions, and being diagnosed, she can be recommended for treatment instead of being sent to prison.

The nature of maternal infanticide creates specific problems that can land outside the strict boundaries of the insanity defense. Consequently, women who kill their children end up serving life sentences in prison or on Death Row, and receive no psychiatric treatment whatsoever. These women fall through the cracks of an outdated legal system, which bases it decisions on strict insanity tests created over 100 years ago. To implement an infanticide act in the US, a bill would have to be introduced into congress, and congress would have to see the need for the legislation in order to pass it into law. As for a new insanity test, that would have to be handled on the state level. Each state legislature determines what tools they use for criminal prosecution. In order to accomplish any or all of these tasks, actions need to take place on a grassroots level to organize reform. Who will step up to take action?

Lewis, Catherine F., MD and Scott C., PhD Bunce. "Filicidal Mothers and the Impact of Psychosis on Maternal Filicide." The Journal of the American Academy of Psychiatry and the Law 31 (Nov 2003): 459-70.

Manchester, Jessie. "Beyond Accomodation: Reconstructing the Insanity Defense to Provide an Accurate Remedy for Pospartum Psychotic Women." Journal of Criminal Law and Criminology 93.2 (Winter/Spring 2003): 713-52.

March, Cristie L. "The Conflicted Treatment of Postpartum Psychosis Under Criminal Law." William Mitchell Law Review 32.1 (Mar 2005): 243-63.

Spinelli, Margaret G, MD. "Maternal Infanticide Associated with Mental Illness: Prevention and the Promise of Saved Lives." American Journal of Psychiatry 161.9 (Sep 2004): 1548-57.

Walker, April J. "Application of the Insanity Defense to Postpartum Disorder-Driven Infanticide in the United States: A Look Toward the Enactment of an Infanticide Act." University of Maryland Law Journal of Race, Religion, Gender, & Class 6.1 (Mar 2006): 197-221.