Postpartum Depression and the Death Penalty

Claims of Policy: Postpartum mothers who kill their newborns should be tried for involuntary manslaughter despite clinical diagnosis of postpartum depression or postpartum psychosis.

Even the words depression and mental illness strike a since of fear in many Americans.  In fact a 1996 study by the Indiana Health Consortium found that ” preference for social distance in most social settings between the public and those with mental health problems remains distressingly high” (Pescosolido, Martin, Link, Kikuzawa, Burgos, Swindle & Phelan, 1996).  As a general public we do not understand the issues therefore we have distanced ourselves from the individuals.  As such, mental illness has always been a difficult subject for many people to discuss. As it refers to postpartum women there are often social stigmas and mores that prevent many people from openly discussing post partum depression (PPD) and postpartum psychosis (PP) despite the fact that PPD and PP affect about 15% of all postpartum women collectively (Doucet et al, 2009).  Societal stigmas often prevent these women from seeking the help they need or admitting that there is a problem.  A mother was recently tried for the murder of her 9 month old baby over 56 years ago, last year in Florida a mother drowned and killed her one year old baby, she was diagnosed with postpartum depression.  These cases are rampant and it seems that new stories of mothers killing their young babies hit the newspapers almost monthly.    The question is should these mothers be tried for murder or manslaughter or should a mental health disorder entirely preclude them from the effects of their disease? Firstly, the discussion regarding whether or not they should be charged at all is a lengthy discussion of its own for another time.  I believe that they should be tried and at this time I will contend that any parent who slaughters their child should be tried for man slaughter rather than murder regardless of mental health conditions or any other external factor.

 

There is evidence to support that these women should be tried for manslaughter in such an instance.  Daniel Jensen a lawyer in San Jose, California describes the difference between manslaughter and murder as such; ” the primary distinction is that murder entails deliberately ending another person’s life, while manslaughter is generally an accident”.   In essence manslaughter indicates that a life was taken without previous planning whether voluntary or involuntary, while murder is classified in three degrees.  These degrees are as follows and reference for these degrees comes from Daniel Jensens website:

  • First degree – crimes of exceptional premeditation and/or cruelty
  • Second degree – killing with malice and no respect for the law, but with no prior deliberation
  • Felony murder – an accidental death that occurs during the commission of a felony

 

Manslaughter on the other hand is classified as either voluntary or involuntary with the distinction being (from Daniel Jensens website):

 

  • Voluntary – close to murder in that there was intent to kill, but there was also provocation (crime in the heat of passion)
  • Involuntary – death of another due to someone’s lack of care, which can occur during the commission of a non-felony crime or a legal but dangerous act

 

 

According to the website “Life Love and Bipolar” , a support website for individuals suffering from bipolar:

“The law considers bipolar disorder as an EXCUSE, not the reason for the crimes committed by bipolar offenders. The only consideration offered by the legal system in case of this disorder, is a leniency in the charges and the punishment meted out. That means if a bipolar individual commits murder, he may be charged with manslaughter, which is a comparatively lesser charge.”

 

In their research Doucet et al discovered that PP “represents a variant of bipolar disorder triggered by childbirth” (Doucet et al, 2009).  Bipolar is often triggered by traumatic life event and in the case of PP the onset is often sudden within the first 48 hours to 2 weeks following childbirth.  Issues like family history of mental illness, little social support, low income, advanced birth age, and delivery complications tend to contribute to the incidence of PP and PPD.  I feel that within the medical community we have an in depth understanding of what contributes to the onset of PPD and PP as well as a strong grasp of treatments for the disorders.  With this understanding I believe that if a mother suffering from PPD of PP murders their child they should be tried for manslaughter as would any individual suffering from a mental illness.  We cannot excuse wrongful death of a child and I feel that trying these people to the full extent of the law is the appropriate course of action.  Given the circumstances of the mental health condition which we must assume as a real disease at the time of the act these women should be treated with additional leniency as discussed above while still feeling the weight of their crimes.  The distinction between murder and manslaughter should be made given that PPD and PP are in fact real mental health issues that can create a bipolar state within the sufferer.

Health care providers working with postpartum women have a responsibility to assess these women at birth and within 4 weeks after birth to diagnosis any potential depressive disorders.  They must also educate mothers that it is not abnormal to feel depressed and that help is available.  Prevention is the best solution and first line health care providers are in a position to provide the prevention.  Quick screenings are inappropriate and will not provide the answers needed to appropriatly diagnosis and prevent PPD and PP related infant harm.   Proper education can be given prior to birth during the weeks leading up to the birth of the child as the woman is at or near normal cognitive functioning state.  Postpartum women are often found to have “severe ruminations of delusional thoughts about the infant” according to Varcolis and Halter.   In women with a family history of bipolar it has been found that prophylactic lithium treatments has reduced the incidence of PP (Doucet et al, 2009).  Many expecting parents, including myself, participate in birthing classes that teach relaxation and breathing techniques to aid in the birthing process.  These sorts of classes should incorporate discussions of similar techniques to implement in the post partum time to prevent or combat PPD and PP.       Nurses should question mothers and fathers about possible risk factors for PPD and PP and intervene by teaching relaxation techniques, referring to mental health professionals, or providing brief counseling sessions while the mothers are still in the hospital.  Many people have never experienced severe depression and are not sure where to go for help.  They need to be made aware of resources and tested to insure they understand that mental health problems do not make you “crazy” and proper help can improve overall health.

Postpartum depression and postpartum psychosis are in fact real mental disorders brought on by the birth of a child.  Previously normal functioning women may find themselves with delusions and inappropriate thoughts about their child with fleeting thoughts of bringing harm to themselves or the child.  Postpartum depression has clinical diagnosing codes within medical diagnosis books as a subset of depression and just as the loss of a job can lead a man into a depressive state that eventually could lead to suicidal attempts, postpartum depression leads mothers to abnormal mental functioning levels that can lead them to extreme irrational behaviors possibly resulting in taking their own life or the life of the baby.  Appropriate legal action calls for corrective action to be taken with the mother and she should not be considered “safe” within society during that time.  A sentence of involuntary manslaughter can lead to an average of approximately 5.5 years in corrective facilities while murder would lead to potential life sentence.  Women who kill their infants while under the influence of PPD or PP are extreme cases of severe mental health disorders brought on by extenuating circumstances, with proper conditioning and reformation offered during their prison time they can be provided with coping skills, medication, and understanding of depressive disorders which will allow them to improve their level of functioning and act as healthy members of society.  Trying these women for murder does not improve the current social stigmas surrounding mental health within our country and only acts as a detriment in the progression of our society as a tolerant and understanding community with regards to mental health.  A murder charge also criminalizes and destroys the life of a women who in most in need of help and assistance.  PPD and PP are enemies within her mind and psyche which pushed her to actions which months earlier would have been considered heinous in her mind.  Providing for these women to undergo reformation, treatment, and education under the supervision of both medical and law enforcement authorities via a sentence of involuntary manslaughter will allow for them to come to grasp with their crime, understand their disorder, and get their lives back on track to become fully functioning and healthy members of society.

 

Pescosolido, B. A., Martin, J., Link, B., Kikuzawa, S., Burgos, G., Swindle, R., & Phelan, J. (1996). Americans’ views of mental health and illness at century’s end: Continuity and change. The Indiana Consortium of Mental Health Services Research, Indiana University, Retrieved from http://www.indiana.edu/~icmhsr/docs/Americans

 

Bipolar disorder – relation to criminal offenses. (2009). Retrieved from http://www.lifeloveandbipolar.com/bipolar-crime.html

Lowdermilk, D., & Perry, S. (2006). Maternity nursing. Philadelphia: Elsevier.

Doucet, J., Dennis, C., Letourneau, N., & Blackmore, E. (2009). Differentiation and clinical implications of postpartum depression and postpartum psychosis.JOGNN38, 269-279.

http://www.danieljensenlaw.com/articles/murder-vs-manslaughter/