Interview: When Mothers Kill Their Kids

What drives a mother to kill her own children? Gabriel Estrada did not leave any real clues about why she hanged her four young daughters before taking her own life in their Texas trailer home on Tuesday. (Three of the girls, aged 5, 3 and 21 months died; her 8-month-old baby survived.) Estrada, 25, brought to eight the number of Texas women who have murdered their children since the 2001 tragedy in which Andrea Yates drowned her five children in the bathtub.  But while gruesome multiple murders like these make the headlines, government statistics show that hundreds of children around the nation die from abuse or neglect every year—often at the hands of a caregiver like a parent, foster parent or nanny.  NEWSWEEK's Alexandra Gekas spoke with Dr. Margaret G. Spinelli, an infanticide specialist at the Columbia University College of Physicians and Surgeons, about whether any lessons can be learned from the Estrada case. Excerpts:

NEWSWEEK: What was your first impression when you heard about Gabriel Estrada?
Margaret G. Spinelli:
Even eight months after the birth of her last daughter, we would consider it postpartum depression. So in infanticide or filicide like this, the woman is either psychotic, hearing voices [or] delusional. When she’s really depressed or suicidal it’s called altruistic infanticide or filicide—when the mother kills herself but kills her children too, because she can’t leave them behind.

How common is postpartum depression?
About 20 percent of women experience postpartum depression. It’s a major problem that we don’t screen for in the U.S., [where] one in 1,000 [women] experiences postpartum psychosis where they hear voices or they hear that the child is the devil. In the case of Andrea Yates, her delusion was that Satan gave her the message that she must kill the children or else they would burn in hell. But without imposing my own diagnosis, the act is so severe that it seems like it would likely be from somebody who is psychotic.

What could cause a woman to go to such an extreme as to kill her own children?
Sometimes it is a kind of altruistic infanticide, or sometimes when a woman herself is being abused or battered by the husband, she may comply with an infanticide. Sometimes it is neglect or abuse that has gone awry, like the mom who is so overwhelmed she has the baby in the bath and she leaves it to go check on another child and the baby drowns. But I think many of these things are moms who are depressed. … In the Andrea Yates case there was some blatant psychiatric illness and she was missed on many levels. She was catatonic; she made several suicide attempts; she had been in and out of the hospital from which she was discharged because of insurance [problems]. People saw her crawling around the floor like a caged animal and she was talking about Satan. But if you’re strictly religious and the word Satan is used in your everyday life, although in her case it was more in the realm of psychosis, people can normalize that. And so I think there were many levels where things were missed.

Are women who experience postpartum psychosis predisposed to it before their pregnancies?
Just to clarify the hormonal changes, about 80 percent of women will go through a period of moodiness, ups and downs after labor, which usually resolve in about two weeks. If a woman is going to have a psychiatric episode in her lifetime it is more likely to be in the first three postpartum months. When brain chemicals go awry they cause psychiatric symptoms. Hormones of pregnancy interact with brain chemicals. Over the 40 weeks of pregnancy the woman's hormones become extremely high, then abruptly fall within the first 24 to 48 hours of childbirth. If a woman has a personal or family history of mood disorder, she will be more vulnerable to the whole psychological process. If the hormones interrupt the brain chemicals, psychiatric symptoms are likely to occur in a woman who has a predisposition to psychiatric illness. These are the women who have postpartum depression or postpartum psychosis.

Are women more prone to committing infanticide than men?
Women are more prone to committing infanticide if they have a postpartum psychosis. It’s actually about half and half men and women who commit infanticide, but the picture is different. Often men might attack the family, not necessarily just the children, and often there’s alcohol use involved. But for women, much of the time it is either due to postpartum psychosis or neonaticide, where women deliver in the bathroom and put the baby in the trash, which is a different type of infant murder.

What are doctors and lawyers doing to prevent this from happening?
Maybe because of Andrea Yates we’ve come a longer way, but not far enough in terms of people identifying and wanting to know about postpartum illness. You see many more attempts in the education of health-care professionals, but again, we’re very far behind. In some countries there is usually a psychiatrist in the labor clinics. The United Kingdom and many other European countries also have infanticide laws, where if a woman is thought to have killed her child in the first year of life, she is charged with infanticide, which means usually she is put on a long probation and psychiatric treatment. But here there is no treatment, we put them away and usually they come out with the same [psychosis] with which they went in.

How are cases of infanticide usually tried? Are the killers more often found guilty or not guilty by reason of insanity?
They will definitely be charged with murder. But a lot of women are serving life sentences and it didn’t matter if they were psychiatrically ill when they committed the crime. Sometimes it can even be the same crime in different states and have different outcomes, but frequently they will take a plea to manslaughter. It depends on the state, and the state’s insanity law. It’s unusual to have a successful insanity defense.

How do you think the cases should be tried?
I think that ideally we should have an infanticide law where the woman sees psychiatrists and is not placed immediately in the legal system where she’s in the midst of a psychosis and being questioned by the police. Although I appreciate she has to be questioned, I think her vulnerability has to be taken into consideration and I think the psychiatric symptoms have to be taken into consideration, but unfortunately they are often not. I think these women should definitely receive mandatory psychiatric care because that is going to be the thing that keeps them from doing this again.

What about the argument that women will use an infanticide law to their advantage, to get away with murder?
I think if you have a good psychiatric evaluation, it’s not as if someone is going to place them in one box or the other. Obviously there are respectful and educated people who are going to evaluate her. If you evaluate somebody like Andrea Yates and see how severely psychotic she was, that is different from a woman who is just bad.  And let me just say, there are women who are just bad.