A startling pattern of trauma and pregnancy denial incites young women to do the unthinkable. Are we criminalizing women with a rare dissociative disorder?
At 24, Courtney Addington repeatedly denied being pregnant before she gave birth alone and tucked the baby into a garbage bag under her bed. Even after being examined in the ER, she claimed there was no baby—she had irritable bowel syndrome. Before the judge charged her with first-degree murder, she referred to Addington lamentably as a “sweet girl.” Addington is currently serving a sentence of 25 years to life in Central California Women’s Facility, and is still waiting to be evaluated by a psychiatrist.
A year ago, 18-year-old Angelena Hamilton of Clovis, California, was arrested when a witness saw a trail of blood that led to a trash can in her driveway only to discover a dead newborn inside. No one in her household knew she was pregnant. Law enforcement believes she gave birth outside in the middle of the night. No charges are filed in her case as of yet, but she is under investigation pending a coroner’s report.
In July 2018, high-school cheerleader and overachiever Brooke Skylar Richardson, also 18, was arrested after the burned and buried remains of a baby were discovered in her backyard in Carlisle, Ohio. Despite having a conversation with her doctor, Richardson never acknowledged the pregnancy to anyone. She had struggled with an eating disorder, her family told the press, and so they were happy that she had gained a little weight. She pled not guilty to aggravated murder charges and maintains that the baby was stillborn. Her trial is set for September 2019.
Addington was already a homeowner, working 60 hours a week and wearing a promise ring from her boyfriend. Both Hamilton and Richardson had just started college and did not have steady boyfriends. All three of these newborn death cases are “neonaticides”—an infant killed or abandoned in the first 24 hours of life. None of these women acknowledged their pregnancies, and each woman gave birth unassisted and disposed of the baby.
Understandably, their families and communities are shocked: “She was such a sweet girl,” eerily echoes through these stories. The media fuels the drama with headlines like: “Teen Mother Arrested After Newborn Found Dead in Garbage Can”; “Mom Killed Newborn, Tossed Infant Onto Neighbor’s Deck”. There’s even a reality show exploiting the tragic news: I Didn’t Know I Was Pregnant.
But where the law sees a gory, unthinkable murder, psychologists and legal advocates see a constellation of biological, social, and psychological conditions that descend upon these young women with catastrophic consequences.
The Neonaticide Profile
Forensic psychologist and professor at University Hospitals Cleveland Medical Center Dr. Philip Resnik first categorized neonaticide in 1970. After conducting a sweeping 100-year review of the legal and scientific literature in infant deaths all over the world, Resnik’s research reveals that there are many distinctions between neonaticide and infanticide, though both are almost universally committed by mothers. Neonaticide usually presents with no previous mental illness, is committed without a weapon (strangulation, suffocation, or drowning), and is always characterized by denial of pregnancy, with very few exceptions. Infanticide, by contrast, is almost always accompanied by mental illness and is more often premeditated.
An examination of newborns killed or abandoned in North Carolina from 1985 to 2000 revealed 34 cases, meaning that out of 100,000 live births, 2.1 were neonaticides. There are approximately 150 to 300 of these cases every year in the U.S., but these numbers are unreliable, experts warn, since many go undiscovered. In 1999 in Texas alone, 33 babies were discovered in dumpsters. Where homicides in general in the U.S. are trending down, the data shows a rise in homicides of children.
Types of Denial
Dr. Diana Lynn Barnes, a psychotherapist who specializes in maternal mental health, describes the different types of denial and provides a framework for understanding these cases. Affective denial is when the new mother knows intellectually that she is pregnant, “but the heightened sensitivity around a pregnancy that we might expect is absent.” They don’t nest, and don’t talk about it. This is often overlooked or chalked up to difficulty adjusting. But with affective denial, the new mother relates to the baby not as a joyous event but “as a traumatic reminder.” These women will often come around to accept the baby when they see the sonogram or start to show physical signs of pregnancy.
But pervasive denial is when the knowledge of the baby either disappears, or never comes into the woman’s consciousness. Denial is a coping mechanism that gives us some distance from a shocking piece of information before it “sinks in,” but these women never awaken to the pregnancy, even when they are asked directly. It’s simply too terrifying to face the consequences. “I consider it a dissociative disorder,” says Dr. Barnes, “and what’s fascinating is that all the symptoms of the pregnancy are either absent or misattributed.”
An Invisible Pregnancy
For anyone who has experienced the radical physical transformation of pregnancy and birth, this is a hard sell. But obstetrics studies confirm that these women often don’t present the same physical symptoms of birth. These young pregnant women won’t gain much weight or experience other telltale signs like morning sickness. Brooke Skylar Richardson gained a little weight, her family said, but she was swimming with friends wearing a bikini all summer right before she gave birth. Forty-eight percent of these women even continue their menstrual cycle throughout gestation, according to Dr. Resnick. In some rare cases, they go to the doctor for something unrelated and even their physicians fail to detect the baby, often because the young woman is misattributing her pregnancy symptoms, as was the case with Courtney Addington blaming IBS.
Michelle Oberman, professor of Law at Santa Clara University, and a scholar on the topic of maternal filicide, says that fear of abandonment sets the stage for pervasive denial. “The uncertainty and isolation they feel leads these young women to dissociate from their changing bodies, living day to day, making no plans for the inevitable labor and delivery of their baby.” Women in denial won’t seek family planning or an abortion and they won’t premeditate murder because as far as their conscious mind is concerned, that baby doesn’t exist.
Dr. Barnes has worked on more than 60 cases of neonaticide as an expert witness in the U.S., and she also sees a clear clinical profile. Six different studies on neonaticide reported the mean age of these women to be under 24, and in the U.S., the mean is 19. Single, no criminal record, no substance abuse or severe mental illness in their histories, they are often dependent on their families and thought of as “good girls,” just as the judge said of Courtney Addington.
But the most obvious link, according to Dr. Barnes, is a history of complex trauma, most often sexual abuse. Multiple studies confirm that one in five girls, or 20 percent, in the U.S. experiences sexual abuse, and that a cascade of risks follow those girls throughout their lifetimes. Substance abuse, obesity, suicidal depression, even diabetes and heart disease all spike when trauma is in the background.
Trauma and Dissociation
When we are exposed to violence for prolonged periods of time, thoughts and associations become unglued in order to protect the consciousness. This is what’s happening when we have no memory of a horrific accident, or go numb when we have an injury. Any feeling of danger is that “traumatic reminder” Dr. Barnes discussed, and it triggers the dissociative state.
Psychologists theorize that these women have dissociated during their pregnancies, and go into labor thinking they are having gastric discomfort. Many give birth quietly with their families or roommates in the next room. The body goes into full-blown shock, they can’t talk, experience tunnel vision, and their hearing grows muffled. “Even when these women have given birth, they do not realize they’ve given birth,” Dr. Barnes explains. They experience the baby as an unwanted part of themselves that needs expelling, like a blood clot. In depositions and interviews, many described feeling very little pain, or they simply blacked out.
When a body goes into shock, the blood vacates the decision-making part of the brain, leaving the brainstem that governs basic body functions to do the heavy lifting. This primitive, reptilian brain is all reflex and no reason. The kind of brain that would not detect a heartbeat or hear crying. The kind of brain that would instinctively “clean up the mess,” or just get to safety.
Data suggests that non-psychotic, pervasive pregnancy denial resulting in neonaticide is a geometry of factors. Terror of rejection from family and community forces the pregnancy “underground.” The predisposition to disassociate from the body during gestation couples with the unimaginable panic of giving birth. Some of them don’t make it and both the woman and the baby die.
Historical and International Perspective
Other countries view these types of “crimes” as event-onset disassociative disorders directly related to the biological vulnerability of pregnancy, birth, and motherhood. As far back as 1922, the U.K. passed a law called the Infanticide Act. If a woman takes her own infant’s life, the court acknowledges that she was of a “disturbed mind” and that treatment and probation were more commensurate, rather than prison time. In 1938, the law extended to the first year of life. The impetus for this law was to relieve punitive measures against young, unwed, low-income women who were clearly snapping under the pressure of unwanted motherhood.
Now in 2018, most industrialized nations have separate statutes for neonaticide, often reducing the crime to manslaughter and assuring that the women receive psychiatric care. Canada, Ireland, Australia, New Zealand, Brazil, Denmark, and Sweden all have laws that recognize pregnancy, birth, and lactation as standout biological events that predispose mothers to mental illness in filicide and endangerment cases. They also implement effective support measures to draw down mortality rates.
Neonaticide in the U.S.
Nearly every review, study, and book on the subject of neonaticide calls for more widespread study and better tracking. The U.S. Department of Health and Human Services doesn’t even distinguish between infanticide and neonaticide, despite all the evidence that they require a separate investigation. Evidence-based demands go largely unheard in our justice system. Because of this, introducing the neonaticide psychological profile is inadmissible in U.S. courts.
No federal criteria means legal outcomes vary widely: murder in the first, second, or third degree, manslaughter, gross abuse of a corpse, child abuse, and concealment of death, with sentences ranging from ten years to life in prison. Bizarrely, some charges are dropped altogether. Of those 60-plus cases for which Dr. Barnes has offered expert testimony, she says very few women were remanded to mental health facilities.
Still, dedicated forensic psychologists and legal advocates appear to be nudging policymakers in certain states. In November 2017, Illinois passed HB 1764 and became the first state to recognize postpartum depression and psychosis as mitigating factors in sentencing women who commit crimes against their children.
In California, then-Governor Jerry Brown signed a bill on his way out of office that institutes maternal mental health screening and care for women under prenatal and postnatal care. This piece of legislation could potentially inform a similar prevention process that would step up screening and pregnancy testing to support sexually active young women.
The global psychiatric community is trying to develop international classification systems for pregnancy denial and neonaticide, but federal laws are unlikely to change in the U.S. given the polarized climate around reproductive rights and our prosecution-hungry legal system.
However, it’s a mistake to jump to the conclusion that pregnancy denial and resulting neonaticide happens purely as a result of cultural failure; it’s not simply America’s refusal to destigmatize sex, contraception, and abortion that lead to these tragedies. Neonaticide manifests differently in different cultures, even cultures like France where abortion and sex education are accessible and accepted. Scientists believe we are possibly looking, not just at a psychological and social issue, but that physiological directives are at play too. It’s probably more accurate to say that a deadly confluence of sexual trauma, social pressures, personality, and biological directives conspire against these women.
The critical difference is that other countries know enough to understand that it’s not murder, and write their laws accordingly.
Courtney Addington’s only hope at this stage is that she might be eligible for California’s young offender statute that might push her parole hearing up so that new evidence could be submitted. Angelena Hamilton could still be brought up on charges if the coroner’s report determines that the infant was born alive. Brooke Skylar Richardson is facing multiple counts including aggravated murder and gross abuse of a corpse. The Ohio Supreme Court is currently determining Richardson’s right to doctor-patient confidentiality so that her doctor can testify against her. Maternal rights advocacy groups and anti-abortion activists are mobilized.
Given that none of these women has a criminal past, there is a chance that their respective juries will feel some compassion for them. Regardless of the length of the sentences they serve, these young women’s futures are permanently derailed.
There is no question that denial of sex education and access to reproductive care are our first lines of defense, and the lack of these basics provide fertile ground for the phenomenon to occur. These deaths are gruesome and become feeding frenzies for anti-abortion idealogues, an accute irony in that these same groups vehemently oppose the social programs that could reduce the number of dead infants they are supposedly fighting for.
But overhauling women’s reproductive health would be an incremental first step, not the solution. Just as with so many of our crisis-level issues in our culture, violence is the common denominator. And as with so many of our inherently misogynist problems, we tend only to talk in terms of women as both the problem and the solution.
We are only addressing half the issue when over 90 percent of sex abuse perpetrators are men. And overwhelmingly, these perpetrators were once victims themselves. These women don’t get pregnant by themselves, but on a micro and macro scale in our culture, men deny the risks and realities of contraception and we don’t refer to them as mentally ill or delusional. So with neonaticide, women are exclusively culpable in the deaths of these newborns and the extenuating circumstances and accomplices go ignored.
Any reforms we set out to achieve will be superficial if we don’t heal the deep wounds that continue to re-inflict generation after generation. It’s inarguable that these newborns never had a chance. But what kind of chance did these traumatized children have when they reached reproductive age with a fundamental rift between mind and body? And when it is not a choice, should the outcome constitute a crime?
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