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58) Amer. J. Psychiat. 126: 10. April 1970

Murder of the Newborn: A Psychiatric

Review of Neonaticide

Ifl l’IIILLIP J. RFSNICK. I.l).

The author believe.s that the killing of anewborn hab’ is a separate entitt’ Iron? otherfilicides, differing in regard to the diagnosis.mall yes, and legal dispo.sitioiz ott/ic murder-er. Wherea.s most fthcide.s are conzmitted for‘altruistic’’ reasons. m?io.sl izeonaticides arecarried out .swzplv because the child is notwanted. The author notes the different psy-chological charact eri.ctic.v 01 mother.s whocom;i milit these two crinze.s. L egal con.cidera-tion.s and the present .slalu.c o/ neonaticide arealso th.s’cu.s.v ed.

A simple child.That lightly draws its breath.And feels its life in every limb.What should it know of death’?

\ oRDSWoRTH(5O)

T HERE IS NO CRIME more difficult to com-prehend than the murder of a child by his

own parents. Nevertheless, the killing of’chil-dren goes back as Far as recorded history.Reasons have included population control,illegitimacy. inability of the mother to caref’or the child, greed f’or power or money,superstition, congenital defects, and ritualsacrifice(40). The practice of’ stabilizing build-ings by enclosing children in their foundationsis still symbolically represented by our f’oun-dation stones(47).

There was an ancient concept that thosewho create may destroy that which they havecreated. Roman law formalized this conceptunder patria potestas. which recognized afather’s right to murder his children. AmongMohave Indians, half-breeds were killed at

Read at the 125th anniversary meeting of the Ameri-can Psychiatric Association, Miami Beach, Fla., May5-9. 1969.

At the time this paper was written Dr. Resnick was aresident in psychiatry, University Hospitals ofCleveland,Ohio. He is currently an instructor in psychiatry. CaseWestern Reserve University School of Medicine, 2040Ahington Rd., Cleveland, Ohio 44106.

birth(9). A merciless environment f’orced Es-kimos to kill infants with congenital anom-alies as well as one of niost sets of twins( 12).The killing of’ female infants was common inmany cultures. In China this practice waswidespread as late as the 1800s. Daughterswere sacrificed because they were unable totransmit the family name and imposed theburden on their parents of paying their mar-riage portion(29, 41). It is claimed that thewidespread murder of children in ancienttimes was first stemmed by the influence of’the Christian religion(43).

In the literature, all child murders by par-ents are usually lumped together under theterm “infanticide.” In the author’s opinion,there are two distinct types of child murder.“Neonaticide” is defined as the killing ofa neonate on the day of its birth. “Filicide”is operationally defined as the murder of ason or daughter older than 24 hdurs. Thedata for this paper were obtained by review-ing the world literature on child murder from1751 to 1968: relevant articles were found in13 languages. From these papers and threecases treated by the author, 168 case reportswere collected. A previous publication de-scribed the 131 cases that f’ell into the filicidecategory(42). This paper will discuss the 37neonaticides(2, 3, II, 20, 21, 23-30, 32, 33,36. 44, 45. 48). The cases are reported invarying detail from mental hospitals, psy-chiatrists in practice, prison psychiatrists,and a coroner’s office.

Since neonaticide is usually viewed in asociologic context, it has received little at-tention in the psychiatric literature. The pur-pose of’ this paper is to draw together ourpsychiatric knowledge about this crime.Neonaticide will be shown to be a separateentity. differing from filicide in the diag-noses, motives, and disposition of the mur-derer. Legal considerations and the presentstatus of neonaticide will be discussed.

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Methods of eonaticide

The methods of’ neonaticide listed inorder of’ greatest frequency are suffocation,strangulation. head trauma, drowning. ex-posure, and stabbing(6, 7, 13, 17, 35). Lesscotii mon methods include dismemberment,burning, acid, lye, throwing to pigs, andburying alive. The need to stifle the baby’sfirst cry makes suffocation the method of’choice f’or mothers attempting to avoiddeteetion(38). The drownings are most of’tenaccomplished in toilets. Case reports of upto 48 stab wounds or decapitation may re-flect the bitterness of’ the abandoned girl,who sees the child in her lover’s image(34,44). Some mothers use extreme clevernessto avoid discovery of their deed. In Indiathese methods have included drowning inmilk and poisoning by rubbing opium onthe mother’s nipples(3l). Some midwiveskilled newborns by thrusting a needle underthe eyelid or into the anterior fontanel(16,22). A needle f’rom one such unsuccessfulattempt was f’ound at autopsy in the brainof a 70-year-old man(22).

I)escript ion of the Murderers

The 37 neonaticides were committed by34 mothers, two fathers, and in one case,both parents. In order to simplify the data,only the mothers who committed neonati-cide will be compared to the mothers whocommitted fllicide(42). The mothers in theneonaticide group (range 16 to 38 years)were significantly younger than the mothersin the fIlicide group (range 20 to 50 years).Whereas most (89 percent) of the neonati-cide group were under 25 years old, the ma-jority (77 percent) of’ the filicide group wereover 25. While 88 percent of the filicidegroup were married, only 19 percent of theneonaticide group enjoyed that status.

Comparison of the diagnoses of the twogroups suggests that neonaticide and fIlicideare committed by two different psychiatricpopulations. Only 17 percent of the womenin the neonaticide group were psychotic, butpsychosis was evident in two-thirds of thefIlicide group. A serious element of depres-sion was f’ound in only three of the neonati-cide cases, compared to 71 percent of thefilicide group. Finally, suicide attempts ac-companied one-third of the filicides, but

none occurred among the neonaticide cases.

Motives

In order to provide a framework for view-ing child murder, the killings are divided intofive categories by apparent motive (table 1).This classification is based on the explana-tion given by the murderer and is indepen-dent of diagnoses. The “unwanted child”murders are committed because the victimwas not desired or is no longer wanted byhis mother. The “acutely psychotic” mur-ders are committed by mothers under theinfluence of hallucinations, epilepsy, or de-lirium. The “altruistic” murders are carriedout to relieve the victim of real or imaginedsuffering, or in association with suicide.“Accidental” murders, lacking in homicidalintent, are often the result of a batteredchild syndrome. The “spouse revenge”murders result from deliberate attempts tomake the spouse suffer.

It is apparent from table 1 that the mo-tives that cause a mother to kill her newbornare considerably different from those thatdrive a mother to murder an older offspring.Whereas the majority of filicides are under-taken for an “altruistic” motive, the greatbulk of neonaticides are committed simplybecause the child is not wanted.

The most common reason for neonaticideamong married women is extramarital pa-ternity. One example(32) is a woman whobecame impregnated by her brother-in-lawwhile her husband was in prison. After cooldeliberation, she murdered her infant atbirth to avoid suspicion of her affair. It iscommonplace for fathers to show somejealousy of their newborn children. The onecase(26) in which both the husband andwife were known to consciously plan the

TABLE 1Classification of Child Murder by Apparent Motive

CATEGORYMATERNAL

NEONATICIDENUMBER PERCENT

MATERNALFILICIDE

NUMBER PERCENT

Unwanted childmurder 2983 10 11

Acutely psychoticmurder 4 11 21 24

“Altruistic” murder 1 3 49 56Accidental” murder 1 3 6 7Spouse revengemurder 0 2 2

Total 35 100 88 100

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(601 Amer. J. Psychiat. 126: 10. April 1970

murder of their expected infant is an ex-treme example of this. The 28-year-oldfather and 17-year-old mother made nopreparations for the birth of their baby ex-cept to dig a grave in the cellar. Both parentshad physical deformities and feelings ofinferiority. They were deeply in love andcould not bear the thought of a third partyinterfering in their relationship. The hus-band initially proposed the crime againstthe “annoying animal” that deformed his“beloved wife’s virginal figure.” He assistedin the delivery at home, strangled the infant,and buried it.

The stigma of having an illegitimate childis the primary reason for neonaticide inunmarried women today, as it has beenthrough the centuries. In 1826 Scott wrote:

A delicate female, knowing the value of achaste reputation, and the infamy and disgraceattendant upon the loss of that indispensablecharacter, and aware of the proverbial unchari-tableness of her own sex, resolves in her distrac-tion, rather than encounter the indifference ofthe world, and banishment from society, to sac-rifice what on more fortunate occasions, itwould have been her pride to cherish(46).

Hirsch mann and Sch mitz(23) dividedwomen who killed their illegitimate infantsinto two major groups. The women in thefirst group are said to have “a primaryweakness of the characterological super-structure.” In the second group are womenwith strong instinctual drives and little ethi-cal restraint. All but a small minority of our35 cases fall into the former group. Thesewomen are usually young, immature primi-paras. They submit to sexual relations ratherthan initiate them. They have no previouscriminal record and rarely attempt abortion.

Gummersbach(19) points out that passiv-ity is the single personality factor that mostclearly separates women who commit neo-naticide from those who obtain abortions.Women who seek abortions are activistswho recognize reality early and promptlyattack the danger. In contrast, women whocommit neonaticide often deny that theyare pregnant or assume that the child willbe stillborn. No advance preparations aremade either for the care or the killing of theinfant. When reality is thrust upon them bythe infant’s first cry, they respond by per-manently silencing the intruder.

The women in the second group-thosewith strong instinctual drives and little ethi-cal restraint-are more callous, egoistic,and intelligent. They tend to be older,strong-willed, and often promiscuous. Theircrime is usually premeditated and not out ofkeeping with their previous life style.

A prominent feature in several of theneonaticides was the inability of the unwedgirl to reveal her pregnancy to her mother.This may be due to the girl’s shame or to fearthat her mother’s response would be anger,punishment, or rejection. In addition, un-resolved oedipal feelings may cause some ofthese girls to have the unconscious fantasythat their pregnancy is proof of incest. Onecase treated by the author will be presentedas an example of this speculation.

Case Report

Mrs. C., a 36-year-old married, childless secre-tary. committed neonaticide at age 17. However,she did not have her first psychiatric contactuntil she made a suicide attempt almost two dec-ades later.

Four months before her suicide attempt, Mrs.C. found a letter indicating that her husband hadbeen unfaithful. As with each previous adversityshe had encountered, she felt that this was retri-bution for her killing. She became anorecticand lost 22 pounds over a four-month period.She developed insomnia, indecisiveness, and in-ability to concentrate on her work. She beganto feel that others could read her mind and in-fluence her through voodoo. She had frighteningdreams and fantasies in which both she and herhusband were beaten, murdered, and crucified.When she looked in the mirror she saw herselfas a devil. She became totally preoccupied withhow “evil” she was, especially because of herneonaticide. Feeling that she deserved to die,she drank a glass of corrosive liquid that causedesophageal stricture, eventually necessitating acolon-esophageal transplant.

The patient was the third of four sisters. Mrs.C. described her father as a jolly, outgoing, talk-ative laborer who brought home his paycheckweekly, but who was more like a roomer than ahusband. He “ran around,” and the patient hadoften heard her mother speak of the “otherwoman.” Her mother was described as a strong-willed, decisive, brusque woman who often hurtthe patient’s feelings. Even the tone of her voicecould make the patient feel as if she were beinghit. Mrs. C. was constantly seeking her mother’sapproval but never felt that she received it. Herfirst memory occurred at age three. Her father

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had taken her out in a new dress and showed heroff to some men. They kidded him by sayingthat she was too cute to be his. The patient hada recurrent dream from age eight to 11 in whicha terrifying monster came at her from behindbut never quite reached her. As far back as Mrs.C. could remember, her parents had slept inseparate bedrooms. When she was 15 her par-ents separated permanently. However, her fa-ther would come back and have the patientlaunder his shirts.

The patient dated the boy who impregnatedher only a few times. She passively submitted tosexual relations to avoid his disapproval. Shedid not know what to do about her pregnancy,but she was quite certain she could never let hermother know. She corsetted herself and success-fully concealed the pregnancy from her family.Fortuitously alone at home when she beganlabor, she gave birth in the bathroom to amale child. She strangled the infant with herhands and then hung it on a towel rack with ahanger until she had cleaned up. She wrappedthe body in old clothes and put it in a dresserdrawer overnight. The next day she put it in therubbish, and her crime was never discovered.She was amazed at her own coolness. She claimsshe had no feeling of guilt at the time. “It wasjust something that had to be done.”

However, since the killing she has tried to dogood “to even things up.” She felt it would beappropriate for her to die in childbirth as afinal balancing of the scales. She had an extendedaffair with a narcotics addict that ended after hehad served a prison sentence. She felt it was her“lot in life” to put up with this man even thoughhe treated her badly. The man who subsequentlybecame her husband was married when she methim. During their affair she was very consciousof being the “other woman” of whom she hadso often heard her mother speak.

The final diagnosis was psychotic depression.The patient’s psychotic thinking cleared earlyin her three-month hospital stay. After her dis-charge she was seen weekly for one year as anoutpatient.

Whereas some neonaticides result frompsychosis. this case may be looked upon asa psychosis resulting in part from a neonati-cide. When Mrs. C. learned of her husband’sinfidelity she developed murderous impulsestoward him. In view of her past murder inreality, it was difficult for her to experiencethese wishes at a conscious level. Insteadthey took the f’orm of fears in her psychosisthat both she and her husband would bemurdered. It is noteworthy that as Mrs. C.’sneonaticide injured her infant’s throat, so

her method of suicide damaged her ownthroat.

Various elements in the patient’s historysuggest that unresolved oedipal feelingsmay have been instrumental in this neona-ticide. Her first memory questions her bloodrelationship to her father. Throughout herchildhood the patient was unable to feelclose to her mother. During psychologicaltesting her response to Rorschach Card IVwas of particular interest. She appearedterrified, threw down the card, and criedfor a long time. She said it was dreadful, likethe monster in her repetitive dream. Severalmonths later she admitted that her firstthought upon seeing the card had been thatof her mother in a fur coat. After her par-ents’ separation Mrs. C. took over the ratherintimate chore of doing her father’s laundry.In spite of protesting, she proceeded to be-come the “other woman” in relation to herhusband. The sum of these factors suggeststhat Mrs. C. may have failed to reveal herpregnancy to her mother because of theunconscious idea that it would be viewed asproof of incest.

Although there are no previous reports ofneonaticide attributed to an oedipal issue,this phenomenon has been observed inother pathological mother-child interac-tions. There is one report in which a marriedwoman had an abortion because she un-consciously felt that she was carrying herfather’s child(49). Zilboorg(5l) recounts acase of de vression in a mother in which thecentral theme was a wish to destroy herchild because she viewed it as living testi-mony of her unconscious incestuous attitudetoward her father.

Paternal Neonaticide

Although it is not uncommon for fathersto murder older children, it is rare for afather to kill a newborn infant. Fathershave neither the motive nor the opportunityof mothers. Only two case reports werefound in which the father was the sole killer.One mentally deficient 32-year-old man poi-soned his newborn child because he felt thathis own poor health might result in hisdeath, leaving no one to provide for his wifeand child(20). The other father was a bright26-year-old man who was forced into thar-riage by his wife’s pregnancy(36). He saw

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(621 Amer. J. Psychiat. 126.’ 10, April /970

the coming child as a bar to his ambition.On one occasion he put poison in his wife’ssoup in an attempt to cause the infant to bestillborn. I-Ic strangled the infant while de-livering it himself’. Although free of overtpsychosis at the time, he developed a full-blown picture of schizophrenia three yearslater. Both fathers were sentenced to tenyears in prison. Fathers appear to receivemore severe sentences than mothers forneonaticide and for filicide(42).

Disposition

Mothers who commit neonaticide aremore likely to be sentenced to prison orprobation, whereas mothers who commitfilicide are more likely to be hospitalized.This difference is in keeping with the lessernumber of psychoses in the neonaticidegroup. Victoroff(48) notes that there is someappreciation that a mother who destroysher own child constructs enough guilt in thisact to punish her sufficiently for the crime.Juries often find that the woman accused ofneonaticide does not correspond to theirimagination of a murderess. For no othercrime is there such a lack of convictions(19).Even those who are convicted often receiveonly probation or minimal prison sentences.

The likelihood of a woman’s killing asecond newborn child after standing trialfor neonaticide is very slim. There are a fewreports in which a mother did kill two(10,11) or three(5, 14) successive newborns.However, in all but one case the previousneonaticides had been undiscovered andunpunished. There is a greater chance ofrecidivism if’ the crime is consistent with thelife style of the mother.

Legal Considerations

To understand the current legal status ofinfant murder, it is instructive to review theEnglish law regarding this crime. In thereign of James I, the law presumed an illegit-imate newborn found dead to have beenmurdered by its mother unless she couldprove by at least one witness that the childhad been born dead(48). In 1803 the samerules of evidence and presumption becamerequired as in other murders(15). Deathsentences for this crime were almost invari-ably commuted(29). Juries hesitated to find

a verdict of guilty and send the accused tothe gallows. Abse states, “Those juries knewthat at or about the time of birth, dogs, cats,and sows.. sometimes killed their ownyoung. They were not prepared to extendless compassion and concern to a mentallysick woman than they would to an excitablebitch”( 1).

A desire to make the punishment moresuitable to the crime led to the InfanticideAct of 1922. This act reduced the penaltiesto those of manslaughter for a woman whokilled her newborn child while the “balanceof her mind was disturbed from the effectof giving birth”(29). Critics of this law sug-gest that if a woman were insane at the timeof the crime she should not be held respon-sible, rather than be convicted of a lessercri me(4).

Several European countries provide lesserpenalties for neonaticide than for adultmurder. These universally apply only to themother: if a father kills a newborn child heis charged with murder(21, 38). In theUnited States there is no legal distinctionbetween the murder of adults and the mur-der of newborn infants. Although it is acommon occurrence to find dead newborninfants in sewers, alleys, and incineratorsin any metropolitan community. convictionsare rare because of’ the difficulty in provingthe guilt of those responsible(2). Severalstates have passed laws against the moreeasily prosecuted offense of concealment ofbirth.

In order to convict an individual of neo-naticide it must be proven that he killed theinfant by a specific act of commission oromission(8). It must also be proven thatthe infant breathed and had a viable sepa-rate existence from the mother after beingfully extruded from the birth canal. Provinglive birth was made easier by Swammer-dam’s discovery in 1667 that fetal lungswould float on water if respiration had oc-curred(40). However, this test was found tobe not infallible, and even careful micro-scopic examination of neonatal lungs todaydoes not always reveal a definitive an-swer(2). The other vexing forensic problemis proving that the child was wholly born.It is theoretically possible for a woman tocut the throat of her half-born infant, report

the incident to the authorities, and there-

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fore escape prosecution for either murder orconcealment. Such cases have been re-ported(7).

Present Status of Neonaticide

It is extremely difficult to get accurate fig-ures on the incidence of neonaticide becauseso many cases are never discovered. Pub-lished figures do suggest a decline in the lastcentury(7, 13, 17, 18, 37, 39). Several f’actorsmay have contributed to this. Effective birthcontrol measures are now widely available.Since the advent of antibiotics, abortionsare rarely life threatening. Homes forunwed mothers have become available as ashelter from the “scoff and scorn of a taunt-ing world,” and placement of unwantedchildren can often be arranged. Finally,welfare payments today have reduced a wo-man’s prospect of being destitute. Yet inspite of these advances, hundreds andpossibly thousands of neonaticides still oc-cur in this country each year.

Psychiatric intervention to prevent neo-nati#{231}ide is extremely difficult. Unlike fili-cide, in which 40 percent of murderingmothers seek medical or psychiatric consul-tation shortly before their crime, it is rarefor women who commit neonaticide to seekany type of prenatal care. One way to fur-ther reduce the incidence of neonaticidewould be a liberalization of abortion laws.Although this approach is far from ideal, itwould provide women a less cruel alterna-tive than killing their newborn infant. Eachneonaticide is tragic-not only for the infantbut also for the continuing effect that thecrime has on the life of the mother.

Summary

This paper has attempted to show thatthe killing of a newborn infant is a separateentity f’rom other filicides. Hence a newword, “neonaticide,” is proposed for thisphenomenon. When mothers who commitneonaticide are compared with motherswho kill older children, they are found tobe younger, more often unmarried, and lessfrequently psychotic. Whereas the majorityof filicides are committed for “altruistic”reasons, most neonaticides are carried outsimply because the child is not wanted.Reasons for neonaticide include extramari-tal paternity, rape, and seeing the child as

an obstacle to parental ambition. However,illegitimacy, with its social stigma, is themost common motive.

The unmarried murderesses fall into twogroups. In the first group are young, imma-ture, passive women who submit to, ratherthan initiate, sexual relations, They oftendeny their pregnancy, and premeditationis rare. The women in the second group havestrong instinctual drives and little ethicalrestraint. They tend to be older, more cal-lous, and are often promiscuous.

It is speculated that unresolved oedipalfeelings may contribute to some neonati-cides that have previously been attributedto entirely sociologic f’actors.

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Let thy discontents be thy secrets; if the world knows them, ‘twill despise thee andincrease them.

-BENJAMIN FRANKLIN