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Characteristics of Perpetrators of Neonaticide
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Authors: Klier CM, Amon S, Fernandez Arias P
Introduction
Denial of pregnancy the most important risk factor for neonaticide and is a frequent pregnancy associated disorders. It occurs more often than placenta previa or uterus rupture. Wessel found that 1 in 475 women deny pregnancy, but a new study by Simermann even found a higher prevalence of 1:300.
We studied how women face their reproductive potential before the denied pregnancy occurs. Moreover pregnancy variables in this group were compared to Austrian population data.
Methods
In total, there were 69 neonaticide victims between 1995 and 2017. We analysed 55 neonaticide cases, committed by 48 perpetrators, whereas 4 of them were repeated perpetrator and responsible for 11 cases. We also included three cases of suspected neonaticides, whereas later the coroner identified a natural cause of death. The datasheet contains 553 variables, all cases were code by one rater SA.
Specifically we looked at the following variables: method of contraception, partner’s interest in contraception, abortion, evidence of pregnancy, motives of pregnancy negation, pregnancy symptoms, prenatal care, awareness of environment, living situation during pregnancy and at birth, immediate reaction to birth
Results
We found a high percentage of women who did not use contraception (53%), specifically when compared to the percentages of the Austrian population data from a recent survey (26%). When the contraceptive methods were looked at, women in the neonaticide group did practically not use any method with a pearl index of <4, in comparison to 20% in the general population. A high adolescent birth rate (47%) could be shown in comparison to the population (3%).
Conclusions
It needs further research to find out how denial of pregnancy and reproductive potential are connected and if the reasons for denial of pregnancy are the precursors of the reproductive denial also.
When Parents have a Severe Mental Illness : Can we Prevent Family Separation and Adverse Effects after Childbirth ?
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This presentation will review the current state of knowledge about severe maternal perinatal mental illness. Severe disorders are associated with a higher prevalence of somatic difficulties during pregnancy, poorer quality of pregnancy follow-up and potential impairment of infant care. These children are therefore very vulnerable and require specific care. We will present how graduated care coordinated and above all integrated between psychiatry, obstetrics, neonatal pediatrics and child protection services allows for early and effective preventive interventions, both for the child's development and maternal mental health. The concept of shared parenting will be particularly developed.
What have we Learnt from the UK Triannual Case Reviews about the Role of Parental Mental Illness in Serious Abuse Related Harm of Young Children ?
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Up to one in four young children have been estimated to be exposed to parental mental illness. Although the majority of affected parents will not harm their children, is is now well established that parental mental illness places children at an increased risk of all types of injury. Both maternal and paternal mental illness are implicated.
Children of parents with mental illness are at the greatest excess risk of being injured in their first year of life, and this applies particularly to violence related harm. Within the first year, the risk is highest during the first three months after birth. A number of parental and family background factors have been identified in the UK triannual serious case reviews of abuse related harm to children and in other publications that can increase or decrease the risk.
These findings have significant implications for clinical practice. In order to mitigate the risks to young children, an early assessment of a parent with a mental illlness, close collaboration between mental health, social care and other involved professionals, and a comprehensive care package which aims to improve parental mental health health, reduce other risk factors and exploit parental strengths and protective social factors, are essential. Mental health professionals have an important role to play in achieving improved outcomes for children at risk and their families.