The Sorry State of Mental Health Care for New Mothers in the US

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postpartum depressionThere are hundreds of thousands of women suffering at this very moment from mental illnesses related to pregnancy and childbirth like postpartum depression. This very minute.  Only 15% of them are getting the professional mental health care they need and deserve.

I’m not kidding.  Only a small minority are getting help. The rest are left to fend for themselves.

Maybe they don’t know they need help.  The amount of education and awareness offered is usually brief, if offered at all.  Almost dismal, really.  So many childbirth educators and OBs don’t want to upset or offend pregnant moms by getting into the dirty details of postpartum depression.

And the mamas fend for themselves.

We don’t have time to screen for postpartum depression, the providers say.  We don’t have time to take social histories.  We aren’t reimbursed.  There’s no mandate to do it in most states.  Besides, who should do it? The pediatrician? The OB? Someone else? Who’s paying for this? When should we do it? Where do I send her if she’s sick? Which tool do I use?

And the mamas continue to fend for themselves.

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Mother Charged With Murder Had Been Treated for Postpartum Depression

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This post may be upsetting if you are currently suffering from a perinatal mood or anxiety disorder.

A baby has died and a mother is charged with murder.

I hate writing about these things.  I’d almost rather pretend they haven’t happened.  Sonia Hermosillo, a mother of three who had apparently been treated for postpartum depression, threw her seven-month-old son off of a four-story parking garage.  Sadly, he passed away from his injuries yesterday.

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Dying at the Hands of Postpartum Depression: Infanticide In the Media

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Two media stories have been sitting in my inbox for several days, both about the killing of young children by their mothers. I let them sit there because I always have a hard time finding the words to talk about such things. At the same time, there is plenty of speculation in the media about why the mothers in these two stories harmed their children, and whether it had anything to do with postpartum depression.

Maybe. Maybe not.

As outlined in this pretty balanced story on, there are several situations in which mothers kill their children:

  • ignored pregnancy
  • abuse-related
  • neglect-related
  • assisted or coerced filicide (such as when a partner forces the killing); and
  • purposeful filicide with the mother acting alone

The cases I've seen involving postpartum psychosis or severe postpartum depression with psychotic features have generally fallen into that last category. The MSNBC story doesn't say which percentage of all murders of children fall under purposeful filicide, nor does it say what percentage of all purposeful filicides involve infanticide, which is the murder of a baby younger than 1 year of age, so it's hard for us to know how often, among all murders of children, a murder is committed because the mom has a perinatal mood or anxiety disorder. Once is often enough, of course, but still it would be nice to have hard data to show moms with postpartum depression so they know that their fellow sufferers aren't murdering their children all over the place. (They AREN'T, by the way.)

It seems fairly certain that one of the mothers involved in the news last week, Janet Thies-Kogh, had a perinatal mood disorder of some sort. Thies-Kogh has been charged with suffocating her 8-month-old, andThe Chicago Tribune reports that she is being treated now, according to her lawyer, for postpartum psychosis. As is always the case, I wonder what the advance signs were and whether anyone was aware that she needed serious help.

It will be more difficult to find out what happened in the case of LaShanda Armstrong, because she drove her van into a river, killing herself and four of her children. She cannot be tested by psychiatrists. Those who know her say she was depressed after finding out the father of three of her children was having an affair, according to the New York Daily News, so it may be that she didn't have postpartum depression per se.

No matter what, such tragedies often bring discussions of postpartum depression to the media forefront. I suppose I could be grateful that perinatal mood and anxiety disorders are being discussed at all. I just wish the media was equally as likely to discuss PPD in other circumstances — positive circumstances — as it is in the cases of infanticide. What about the stories of recovery? What about the stories of moms helping moms? What about the fact that the vast majority of women with postpartum depression never harm even a hair on any child's head for any reason?

Maybe then we'd reduce stigma and more women would get the help they need. Maybe then more women would recognize when they are suffering, and more doctors would be looking out for them, and more family members would be there for support, and women who sought help would get it from people who know what they are doing.

Maybe then we could eliminate stories of tragedy altogether.

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Canadian Ruling Upholds Infanticide Defense

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You may not have been aware of this, but recently the country of Canada was considering whether to eliminate its infanticide law.

As reported in the Montreal Gazette, Ontario's top court ruled that "a woman who kills her newborn baby can continue to use infanticide resulting from postpartum depression as a defense against the charge of murder."

Whereas a murder charge could lead to a life sentence, a conviction of infanticide in Canada carries a maximum 5-year sentence. It would apply to any mother who, "… through a 'willful act or omission' causes the death of a newborn under 12 months because 'her mind was disturbed. following childbirth or lactation."

The Gazette story stated that the Crown asked the court to revisit the infanticide defense "… last September after a 29-year-old woman was found guilty by a trial judge of infanticide for killing two of her babies. She ended up spending one year in prison after being given credit for pre-trial custody." The government felt the infanticide law was outdated and no longer reflected the views of society, as apparently neither the prosectors nor the public was happy with the amount of this woman's prison time.

The US doesn't have such laws, but I believe they are common in Europe. Texas was attempting to be the first state to enact an infanticide law, but I don't believe that has happened.

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