Neonaticide is the killing of a neborn within the first 24 hours of life. Although relatively uncommon, numerous cases of maternal neonaticide have been reported. To date, only two cases of paternal neonaticide have appeared in the literature. The authors review neonaticide and present two new case reports of paternal neonaticide. A psychodynamic explanation of paternal neonaticide is formulated. A new definition for neonaticide, more consistent with biological and psychological determinents is suggested.

Introduction:

No act arouses emotions more than the death of an infant. Even harder to explain, or even comprehend, is the death of a newborn at the hands of a parent. Resnick (1), coined the term neonaticide to describe the killing of a child less than 24 hours old. Although this tragedy is not uncommon amongst mothers, it is an exceptionally rare event amongst fathers.

This article will review the history of neonaticide and the two cases of paternal neonaticide reported to date (2,3). It will also present two new case reports, one of which is based on extensive interviews conducted by two of the authors (N.K. and N.B.). Finally, an early hypothesis will be postulated to explain this behavior.

History:

The earliest reference to filicide (the killing of a child by a parent) is the Biblical story of the near slaying of Issac by his father Abraham (4). Later, in greek mythology, it is reported that Medea killed her two sons after Jason abandoned her for the daughter of the King of Corinth (5) giving us what has been termed the Medea Complex (6). Under the Roman Law, patria potestas, the right of a father to kill his own children was protected (7,8).

It was not until the 300's that Christianity, influenced heavily by Judaic law, began to regard filicide as a crime. Still, mothers who killed their infants or newborns received lesser sentences under both the laws of the church and the state (9-12). The church consistently dealt more leniently with those mothers whose children died by "overlying," an accidental death by smothering when a sleeping parent rolled over on the infant. The opinions of the church in these deaths reflects an awareness of one of society's first attempts to understand the severe problem of overpopulation and overcrowding (9-12).

England has traditionally viewed infanticide as a "special crime" passing its first Infanticide Act in 1623 under the Stuarts and more recently in the Infanticide Acts of 1922 and 1938 (13,14). Most recently England passed the Infanticide Act of 1978 which allows a lesser sentence for attempted infanticide (15).

Unlike England and other European countries, the United States has not adopted special statutes to deal with infanticide or neonaticide. Nonetheless, juries and judges, as reflected in their verdicts and sentences, have consistently considered the difficulties and stresses of a mother during the post-partum period.

Cross Cultural Aspects:

It is important to recognize that other cultures have developed different attitudes and mores regarding the killing of infants. The Chinese, as late as the 1800's, sacrificed newborn daughters because they were unable to transmit the family name. Additionally, daughters were viewed as weaker and not as useful in time of war or for agricultural work. In the past, Eskimos killed infants with known congenital anomalies and often one of a set of twins (16). Similarly, Mohave Indians had killed all half breeds at birth (17).

In their 1981 paper, Sakuta and Saito (18) reviewed infanticide in Japan and describe the two distinct types of infanticide commonly seen. The Mabiki type corresponds to the ancient means of "thinning out" or population control; the Anomie type, a product of modern society, corresponds to the "unwanted child."

The United States ranks first in child homicide under the age of four years. Forty-five percent (45%) of all child murders occur in the first 24 hours of life and thus can be classified as neonaticide (19,20). For the period 1982-1987, approximately 1.1% of all homicides have been of children under one year of age. Eight to nine percent (8%-9%) of all murders are of persons under eighteen years of age. Of these, almost twice as many sons as compared to daughters are victims (20).

In half of the cases death occurs literally "at the hands of" the parent. Weapons are almost never used in neonaticide. Drowning, strangulation, head trauma, suffocation, and exposure are all common methods (20).

Maternal Neonaticide:

Neonaticidal mothers are generally between sixteen and 38 years of age with almost 90% being 25 years of age or younger. Less than twenty percent are married. Less than 30% are seen as psychotic or depressed (1,13,21,22). The majority of neonaticidal mothers are unwed, poor, and have denied and/or concealed the pregnancy since conception. They frequently give birth alone and dispose of the baby as an abortion that occurs "too late."

Paternal Neonaticide:

Unlike maternal neonaticide, there are very few cases of paternal neonaticide in the literature. Thus, any statement of the demographics of paternal neonaticide would be both meaningless and misleading, based on too small a caseload to reach statistically significant conclusions. In preparing for his 1970 paper on neonaticide, Resnick (23) reviewed the world literature from 1751 to 1968 and reported only two cases. The authors updated the literature review, contacted twenty metropolitan medical examiner's offices and found the two additional cases (3 and 4) reported below. As the original two cases (1 and 2) are rather brief they will be reproduced for the sake of a thorough review.

Case Reports:

Case 1:

" J.S., born 1879, with positive heredity of mental deficiency, on July 15, 1911, poisoned his new-born child because he felt that his own poor health might result in his death leaving no one to provide for his wife and child. Psychiatric examination revealed no evidence of mental disease, but the presence of mental deficiency. He was considered responsible for the deed and later sentenced to ten years in the penitentiary. On May 1, 1915, having served three years two months, he was released on probation. At no time during his penitentiary residence nor subsequently has he shown any symptoms of schizophrenia (2)."

Case 2:

"A bright 26 year old man was forced into marriage by his wife's pregnancy. He saw the coming child as a bar to his ambition. On one occasion he put poison in his wife's soup hoping that the infant would spontaneously abort or be stillborn. He strangled the infant while delivering it himself. Although free of overt psychosis at the time, he developed a clinical picture of full blown schizophrenia three years later. He too was sentenced to ten years in prison (3)."

Case 3:

H. was 35 years old when he killed his 5 hour old son in front of the baby's mother (his girlfriend) and a nurse, in a hospital room, by stabbing him repeatedly with a hunting knife. H. had planned this and went to the hospital expressly for the purpose of disposing of this unwanted infant.

H. was born in 1946 to a rural wealthy family from the Northeast. His parents were divorced when he was 26 and his father died when he was 29. His birth was reported as being normal and atraumatic. There are no materials to suggest any difficulties in early life or as a youngster. His mother admits that she never wanted children and did so only to please her husband.

After attending three different private high schools he graduated and moved to New York City where he studied drafting at an architecture school. He claims to be an excellent draftsman and in fact has designed and built two houses when he was eighteen to twenty years of age. He reports that his favorite employment involved the freedom and independence of being a taxi-cab driver for about ten years.

However, during this period of his life he was not very socially involved and was drinking heavily alone to "shut out the rest of the world." He claims that in his early twenties his drinking ceased to be a problem and he cut down significantly. At age twenty -two he impregnated a woman who underwent an elective abortion. He was well supported financially by his family and a trust fund was established after his father's death.

Psychiatric History

H. was seen by a psychiatrist once as a young adolescent at the request of his father for behavioral problems. Also, while living alone in New York City he sought private psychiatric care but the duration and nature of treatment are unknown.

His first inpatient treatment was in 1979 when he was 33 years old. H. was touring the country at the time gathering information on railway systems in preparation for a book he was intending to write. In September of 1979 he was arrested at a motel in the Midwest for recklessly firing a .22 caliber Colt semi-automatic pistol in his room and in the lobby area where two women were working. When questioned why he had been shooting in the lobby he stated "It was my mood at the time." When asked why he was shooting in his room he replied "Because the person upstairs was playing music too loudly." As a result of his behavior in jail (breaking a television and evidencing "erratic behavior") he was admitted for psychiatric assessment, found not fit to proceed and the charges were dismissed.

Although he was not cooperative for full psychological testing the record reflects a history of homicidal threats, assaults on other patients and an interest in literature pertaining to weapons. The treating psychiatrists felt he was in need of further care and civilly committed him to a psychiatric center nearer to his home. He was transferred in May of 1980 at age 34 with a diagnosis of Schizophrenia, Paranoid.

Psychological testing done at that time revealed a Verbal I.Q. of 108; Performance I.Q. of 98; Full Scale I.Q. of 104 (WAIS). An MMPI is reported to show a "4-2" pattern and was read as valid. The psychopathic tendencies were felt to be chronic and perhaps related to his alcoholic history. The depression was felt to be of a reactive nature and short lived. The TAT revealed short answers and a sense of defensiveness and guardedness. He was never felt to be psychotic while at the psychiatric center and was discharged in September, 1980.

While a patient at the psychiatric center H. met L. another patient. The had planned on marrying after both were discharged. They lived together off and on but when she became pregnant her mother insisted that she live only with H. The marriage never took place because L. was re-hospitalized, partially as a result of the stress of her mother's rejection. At first H. was happy about the pregnancy but when L. was re-hospitalized he urged her to get an abortion. He only visited her once while she was pregnant at the psychiatric center because he "felt uncomfortable around the crazies." He also felt that her hospitalization might "reflect badly" on his family as they were "influential" and L. had a mental problem.

When initially questioned about why he killed the newborn H. explained that he had been an advocate of infanticide for about fifteen years. H. has written a 24 page typed document entitled "The Evils of Overpopulation." His feelings about the incident can be shown by quoting from the document (with his permission).

"Considering the circumstances under which the child was born-L. was in a mental institution- she had no plans to return and raise the child with me it becomes obvious that her pregnancy was not only a great source of embarrassment to me, but it was also a very difficult thing for L.. For as far back as I can remember, I have always felt a profound contempt for those irresponsible individuals who bring children into the world when they are unfit to do so. With each passing day of the pregnancy, I was aware of a terrible guilt closing in on me; I could not bear the thought that I should become the

object of rational hate. And I knew the consequent social stigma that would attach to me would critically impair my ability to function in society. By destroying the child, I cleared my name and that of my relations, and I relieved L. of a responsibility that she was in no way prepared to handle. Had I allowed the child to live, he might have been raised at L's mother's house as her mother had suggested; if so, there never would have been an end to this miserable affair. The child might have been taken by adoptive parents, but adoptive parents are, in general, inferior to natural parents. Furthermore, L. is mentally retarded to a moderate degree. I destroyed our child because I thought he would have inferior racial characteristics."

"Good children come from good parents; bad children come from bad parents. Bad parents are not necessarily bad people. L. and I are good people, but we would have been bad parents; we would have been unable to take care of our child properly. It follows that I destroyed a creature of negative potential. My son was an evil child; it was my responsibility as a parent to destroy him."

In other chapters of his writing H. explains that since L. wanted a girl and had said that a boy would be "too hard to raise too messy" that both of them were in agreement. He states that had it been a girl he would not have killed the child. It was upon receiving a call from his sister informing him that L. had given birth to a baby boy that H. went to the hospital expressly to kill the baby.

Furthermore, H. cites the historical basis of the infanticide argument. He explains how man as well how other species use and have used infanticide as a means of population control and even comments on the relationship between abortion and infanticide. Lastly, he notes how many prominent philosophers and even some famous leaders have advocated infanticide.

H. underwent a two month inpatient psychiatric evaluation after he killed his son. His interaction on the ward was limited and he spent most of his time working on his case. His mental status examination at that time was remarkable for flattened affect, social withdrawal, emotional detachment, and no remorse for his action. Specifically, there was no evidence of hallucinations, delusions, or inappropriate thought processes. H. received no medications while in the hospital.

H. was found guilty of second degree Murder and received the maximum sentence of 25 years to life. He did not raise an insanity defense. He feels "cheated" in that he was not allowed to enter a defense of justifiable homicide and therefore present to the court his view of infanticide. He is serving his sentence in a maximum security prison and is on no medication. He carries a diagnosis of Schizophrenia, Chronic, Paranoid, in remission.

Follow Up:
Since the trial H. has been admitted to the State Forensic Hospital on two occasions. Both of these admissions have been for disruptive behavior in the prison associated with psychosis and auditory hallucinations. On each occassion he has stabilized without the use of medication.

Case 4:
In 1983, X was a 36 year old professional residing in the midwest with his pregnant wife and six year old daughter. This pregnancy had been marked by acute polyhydramnios but was not considered to be a "high risk" pregnancy nor particularly difficult. A few days prior to the term delivery amniocentesis was performed to test for maturity of the infants lungs.

Upon delivery, with the father in attendance, it became immediately obvious that the baby was not entirely normal. The infant was cyanotic and not breathing. It took about seven minutes of resuscitative intervention before the baby "pinked up." The baby boy was obviously deformed with a cleft lip and palate, low set ears, short arms and webbed hands (24,25).

After the baby was stablized and in an incubator the obstetrician turned to repair the episiotomy on the mother. The father picked up his newborn son, bent down, and smashed its head on the floor, killing it instantly. The autopsy revealed that the baby had at least five valvular heart defects and that the presentation was consistent with a diagnosis of Trisomy 13, a genetic abnormality that is essentially incompatible with sustained life (24,25).

X was charged with Murder and a defense of temporary insanity was presented. The case has been tried twice and both times the juries have been unable to reach a verdict. Recently, a judge has ruled that X will not stand trial again, however, the District Attorney has appealed and the case is still pending (24,25).

X has great remorse and sorrow for his actions. He feels that he was "unprepared for anything out of the ordinary" for anything but a "normal birth and delivery." "To be left in a room for 30 minutes and seeing the problems the baby had was a terrible thing to go through as a father." " I'm sorry this happened. Given a second chance, it would not happen again (24,25)."

Discussion:

Although numerous authors have reported cases of maternal neonaticide, few have gone so far as to suggest a psychodynamic explanation for this behavior. No one has attempted to explain the psychodynamics related to the limited number of cases of paternal neonaticide. In categorizing maternal neonaticide, Resnick (1) delineated five types including: altruistic (with suicide or to relieve suffering); acutely psychotic; unwanted child; accidental; and spouse revenge.

Although statistics pertaining to maternal neonaticidal deaths are incomplete, it seems reasonably clear that the "unwanted child" is the most common type. These women use denial as the predominant defense mechanism, a fact which can no longer be avoided when birth occurs. This sudden dissolution of the major defense causes overwhelming fear, particularly fear of abandonment by the mother, from whom the pregnancy was hidden all along. This acute breakdown of defenses serves to produce disorganized thinking, impaired judgement and possibly even psychosis.

Using Resnick's classifications (1) the authors would catagorize the four cases of paternal neonaticide as follows: Case 1- altruistic; Case 2- unwanted (but later became schizophrenic); Case 3- psychotic, not acute; Case 4- psychotic, acute.

By comparing these four cases with the most common dynamic formulation in maternal neonaticide it appears that the issues of impulsivity and premeditation are significant distinguishing factors. In only case four was the patient's behavior considered "impulsive." In the other three cases some degree of "premeditation" was involved. Further tracking and clarification of this trend will be important as additional cases are reported.

The issue of premeditation is also given consideration by the criminal justice system. This may be one of the reasons that fathers who kill their children are far more likely to be sentenced and to serve time in prison as compared with the mothers who are found guilty of the same or a similar crime (20).

After reviewing and analyzing the four cases of paternal neonaticide the authors are suggesting further refinement of Resnick's definition. The first subtype would include those killings which occur "at birth." This is seen almost exclusively in maternal cases as men rarely have accessibility to the newborn. The "neonatal" period should be expanded to be consistent with biological and psychological determinents. The

American Pediatric Association and The American College of Obstetrics and Gynecology both consider the neonatal period to be longer than the first 24 hours of life. Some of these definitions include at least the first three months of life (26,27,28). In psychiatry, we recognize that post partum depression and psychosis may develop many weeks after birth and may in fact be related to weaning, an event which is quite distant from the time of birth (29). The final category would be those cases which occur after the neonatal period and should be termed infanticide.

In conclusion, the authors propose that infanticide should be divided into three subtypes as follows: A- at birth; B- birth to six months of age; C- six months to one year of age.

References:

1. Resnick, P.: Child Murder by Parents: A Psychiatric Review of Filicide. Amer. J. Psychiat 1969; 126: 325-334.

2. Hackfield, A.: Crimes of Unintelligible Motivation as Representing an Initial Symptom of an Insidiously Developing Scizophrenia; Study of Comparative Effects of Hospital Regime on such Cases. Amer. J. Psychiat. 1934; 91: 639-668.

3. Pfiester-Ammende, M.: Zwei Falle von Kindstotung in Psychiatrischev, Beurteilung, Schweiz. Arch. Neurol. Psychiat. 1937; 39: 373-387.

4. Genesis Chapter 22.

5. Hamilton, E.: Mythology. New York, Mentor Book, 1942.

6. Wittels, F.: Psychoanalysis and literature, in Lorand, S. (ed): Psychoanalysis Today, Albanay, N.Y., Boyd Printing Co., 1944.

7. Black's Law Dictionary, Fifth Edition: St. Paul, Minnesota, West Publishing Company, 1979.

8. 142 N.Y.S.2d 163

9. Victoroff, V.: A case of Infanticide Related to Psychomotor Automitism: Psychodynamic, Physiological, Forensic and Sociological Considerations. J. Clin. Exper. Psychopath; 1955; 16: 191-220. 10. Langer, W.: Infanticide: A Historical Survey. History of Childhood Quarterly; 1974; 1: 354-365.

11. Kellum, B.: Infanticide in England in the Later Middle Ages. History of Childhood Quarterly; 1974; 1: 367-388.

12. Hale, M.: The History of the Pleas of the Crown. London, E.R. Nutt and R. Gosling, 1736.

13. Infanticide Act of 1938, 1 and 2 Geo. 6, c36, sec. 1 (1).

14. Jeudwine, J.: Observations on English Criminal Law and Procedure. London, D.S. King, 1968.

15. Wilkins, A.: Attempted Infanticide. British Journal of Psychiatry. 1985; 146: 206-208.

16. Garber, C.: Eskimo Infanticide. Scient. Month. 1947; 64: 98- 102.

17. Devereux, G.: Mohave Indidan Infanticide. Psychoanal. Rev. 1948; 35: 126-139.

18. Sakuta, T. and Saito, S.: A Socio-Medical Study on 71 Cases of Infanticide in Japan. Keio J. Med. 1981; 30: 155-168.

19. d'Orban, P.: Women who kill their Children. Brit. J. Psychiat 1979; 134: 560-571.

20. Uniform Crime Reports (1982-1987). U.S. Government Printing Office.

21. Harder, T.: The Psychopathology of Infanticide. Acta. Psychiat. Scand 1967; 43: 196-245.

22. Turnbull, H.R.: Incidence of Infanticide in America: Public and Professional Attitudes. Issues in Law & Medicine 1986; 1: 363-389.

23. Resnick, P.: Murder of the Newborn: A Psychiatric Review of Neonaticide. Amer. J. Psychiat. 1970; 126: 58-64.

24. Associated Press Column in Albany Times Union Newspaper. January, 1988. 

25. Personal Communication with District Attorney.

26. Vaughan, V.: Nelson Textbook of Pediatrics, Eleventh Edition, Philadelphia, W.B. Saunders, 1979.

27. Pritchard, J. A, and Mac Donald, P.C.: Williams Obstetrics, 17th Edition, New York, Appelton-Century-Crofts, 1985.

28. Beischer, N. A. and Mackay, E. V.: Obstetrics and the Newborn, Second Edition, Philadelphia, W. B. Saunders, 1986.

29. Susman, V. and Katz, L.: Weaning and Depression: Another Postpartum Complication. Amer. J. Psychiat. 1988; 145: 498-501.