Mothers who kill Mothers do not deliberately kill their children without warning, says a psychology professor and author.
show signs of distress
An author argues that neighbors
and family members have a
duty to step in and helpDay 1: Bond of Sorrow
By Treena Shapiro
tshapiro@starbulletin.comAndrea Pia Yates, who drowned her five children in a bathtub last month in Houston, is no exception, said Cheryl Meyer, an associate professor of psychology at Wright State University in Ohio and co-author of the book "Mothers Who Kill Their Children: Understanding the Acts of Moms from Susan Smith to the 'Prom Mom.'"
Drawing from media reports, Meyer said that Yates gave out many signals, including two suicide attempts following the births of her fourth and fifth children. Yates' brother has said that she stopped laughing and started communicating in monosyllables. Her husband, Russell Yates, who said his wife had been suffering from postpartum depression, has described her as "robotic" and "withdrawn."
"She gave a lot of signs. She told health professionals. She told friends. She told family. People knew," Meyer said.
And those who know a mother is in distress bear a responsibility to make sure she has adequate support, she said. "I think they all share in that responsibility -- we all do -- even that neighbor who's isolated and across the street."
Providing support goes beyond simply asking a mother if she needs help, Meyer said. "The last person that's going to say they want to go into counseling is the person who needs it."
Meyer and her co-author, Michelle Oberman, turned up more than 2,000 instances where mothers killed their children in the 1990s and researched more than 200 U.S. cases for their book.
But despite the frequency of these cases, the authors found little scholarly literature on what would prompt a mother to take her child's life.
Major statistical manuals used to diagnose health and psychological disorders have only recently acknowledged mood and behavioral disorders related to childbirth.
Entries did not appear until the latest editions of the "Diagnostic and Statistical Manual of Mental Disorders" and the "International Statistical Classification of Diseases and Related Health Conditions."
With the illness lacking validation in the medical and psychological community, researchers say it is difficult to find funding to study postpartum disorders, Meyer said.
Despite the lack of extensive research, postpartum mood disorders are generally believed to be associated with the hormonal and lifestyle changes that a mother experiences after giving birth.
James Young, whose late wife's story bears a striking resemblance to Andrea Yates', hopes that more awareness of postpartum depression in the wake of the Houston case will lead to better screening for expectant and new mothers.
"Why not train obstetricians to screen mothers-to-be for their potential to suffer from (postpartum mood disorders)? How about a simple interview?" he asked, in an e-mail interview with the Star-Bulletin.
On Nov. 22, 1965, Maggie Young drowned the couple's five children, ages 8 months to 8 years, in the bathtub of their Aiea home. James Young, a retired Air Force pilot who now lives in California, believes future tragedies can be prevented.
Pregnant women who already have children could be asked how they felt after previous births, he suggested. Interviewing fathers, particularly in cases where mothers are predisposed to postpartum mood disorders, could also be helpful.
"The father could be asked about the mother's reaction to the birth," Young wrote. "Is she happy? Does she show signs of being tired all the time? Does she appear lazy? Takes to the bed during the day? Often goes to bed in her clothes?"
To this day, Young wonders why he did not recognize these signs in his own wife.
"They come on so insidiously, so slowly that they do not appear to be an illness. They come on as a behavior change," he said.
His wife's behavior complicated their marriage and led the couple into counseling, with no positive result, he said. Eventually she exhibited other psychotic symptoms and was hospitalized. But doctors released her to recover at home, and a few weeks later she killed the children.
"There must be better awareness of the seriousness of this illness," Young wrote. "It must be recognized earlier -- if not predicted -- and the patient must be treated more effectively."
But Laurence Kruckman, a medical anthropologist and president-elect of Postpartum Support International, also worries that the heightened awareness Yates' case has brought to postpartum mood disorders could have a negative effect on women who need treatment.
"My greatest fear in all of this is that women in the U.S. and around the world (suffering from postpartum mood disorders) will not come forward," he said.
It is common for a woman with postpartum depression to have fantasies or fears about hurting her children, but very few act on the impulse, he said. "Almost all these cases are depression." But in light of the Yates case, "they will fear being labeled as such."
And Dr. Suzanne Steinberg, a specialist in the clinical treatment of postpartum women at McGill University Health Center in Quebec, warns against blaming postpartum depression or psychosis for the deaths of the Yates children.
Less than 1 percent of women experience postpartum psychosis, she said. Of those women, only 4 percent murder their children. "That's why people have been looking for different (explanations)," she said.
One reason to question the role a postpartum mood disorder may have played in Yates' case is the ages of her children: 6 months to 7 years.
"She doesn't exactly fit into the scenario," Steinberg said. "The children are too old to be a simple postpartum event."
Without interviewing Yates, Steinberg was unable to speculate what may have gone wrong, but said that there is often an underlying cause when mothers kill their children. In some cases, women had a psychological condition before giving birth, perhaps a character affectation.
Steinberg said that a 1990 study by P.T. d'Orban on "battering mothers" could point to another reason why mothers would murder their children.
"He said basically a small number of mothers who kill their babies are psychotic," Steinberg explained. "People are more likely to kill in a sudden impulsive act involving loss of temper with the infant."
Women who fall into this category generally have a history of childhood or spousal abuse, financial and housing problems, come from large families, have a family and personal history of crime, and may be pregnant or ill at the time of the offense. Generally the children killed by these women are older than 1 year, Steinberg said.
While uncommon, mothers murdering their children is not as rare as it seems. Though slightly less likely than fathers to kill their children, mothers murdered an average of 170 children under 5 years old each year between 1976 and 1999 in the United States, according to Department of Justice statistics.
Meyer and Oberman have developed five typologies to fit these mothers:
>> Mothers who kill an infant before it is 24 hours old (often so far in denial that they do not believe they have given birth)
>> Mothers who are assisted or coerced into killing by a partner
>> Mothers who kill through neglect
>> Mothers who kill through abuse
>> Mothers who kill purposely
Andrea Yates and Maggie Young fit into the final category, Meyer said.
Mothers who killed purposely tend to be older and married and were overwhelmingly described as "devoted mothers," Meyer said.
Often these mothers killed their children after the loss of a relationship, usually the husband, although in Yates' case the precipitating factor could have been her father's recent death.
Meyer said the last category is the only one in which more than one child was killed indicating that in some cases, the number of children could have been a factor.
"As soon as you start to multiply your children, you're multiplying all the needs that need to be met; you're multiplying the demands on your time," she said.
In many of the cases Meyer looked at, mothers suffered from postpartum depression or psychosis after more than one pregnancy.
She added, however, that many women who experienced postpartum depression after their first child did not experience it again, perhaps because the major life changes experienced after the first birth are eased with the next child.
But given that every pregnancy is different, when Yates attempted suicide after the birth of her fourth son, doctors should have advised her that postpartum depression could be more severe following another birth, Meyer said.
Yates, who confessed, has been charged with murder and may face the death penalty. But if she does escape conviction, she will need extensive therapy, even if she is suffering from passing postpartum psychosis, Meyer added.
When she recovers, "she's going to realize what happened. I can only imagine that she's going to be incredibly suicidal and depressed," Meyer said.
Meyer said about 50 percent of the mothers who purposely killed their children attempted suicide.
Maggie Young committed suicide on the grounds of the Hawaii State Hospital in Kaneohe less than a year after the murders. James Young said she took her life after she started to recover and realized what she had done.
If Yates is released, she is not likely to pose a threat to society, Meyer said. "I can't think of a case that these women were a threat to anyone other than these children."