Natacha Vellut1, Jon M Cook, Anne Tursz. 1. CNRS UMR8211/Cermes3 (Centre de Recherche Médecine, Sciences, Santé, Santé mentale et Société), Paris, France.
Abstract
OBJECTIVES: Using judicial files on neonaticides, (1) to examine the frequency of the association between neonaticide and denial of pregnancy; (2) to assess the accuracy of the concept of denial of pregnancy; (3) to examine its usefulness in programs to prevent neonaticides. METHODS: Quantitative and qualitative analyses of data collected from judicial files during a population-based study carried out in 26 courts in 3 regions of France over a 5-year period. RESULTS: There were 32 cases of neonaticides identified; 24, perpetrated by 22 mothers, were solved by police investigation. Aged 26 years on average, the mothers had occupations that resembled those of the general population and 17 had jobs, 13 were multiparous and 11 lived in a couple relationship. No effective contraception was used by women in 20 cases. Psychopathology was rare but mothers shared a personality profile marked by immaturity, dependency, weak self esteem, absence of affective support, psychological isolation and poor communication with partners. No pregnancy was registered nor prenatal care followed. Two (perhaps 3) pregnancies were undiscovered until delivery. No typical denial of pregnancy was observed in the other cases. Pregnancies were experienced in secrecy, with conflicting feelings of desire and rejection of the infant and an inability to ask for help. Those around the mothers, often aware of the pregnancy, offered none. In the absence of parallel clinical data, it is not possible to calculate the frequency of the association between neonaticide and denial of pregnancy. CONCLUSIONS: The term 'denial of pregnancy' cannot fully reflect the complexity of emotions and feelings felt by all perpetrators of neonaticide and is used differently by different professionals. The term itself and its excessive generalization contribute to pathologizing women while absolving those around them and has little operational value in preventing neonaticides. The authors suggest rethinking the terms presently used to describe the phenomenon of pregnancy denial.
OBJECTIVES: Using judicial files on neonaticides, (1) to examine the frequency of the association between neonaticide and denial of pregnancy; (2) to assess the accuracy of the concept of denial of pregnancy; (3) to examine its usefulness in programs to prevent neonaticides. METHODS: Quantitative and qualitative analyses of data collected from judicial files during a population-based study carried out in 26 courts in 3 regions of France over a 5-year period. RESULTS: There were 32 cases of neonaticides identified; 24, perpetrated by 22 mothers, were solved by police investigation. Aged 26 years on average, the mothers had occupations that resembled those of the general population and 17 had jobs, 13 were multiparous and 11 lived in a couple relationship. No effective contraception was used by women in 20 cases. Psychopathology was rare but mothers shared a personality profile marked by immaturity, dependency, weak self esteem, absence of affective support, psychological isolation and poor communication with partners. No pregnancy was registered nor prenatal care followed. Two (perhaps 3) pregnancies were undiscovered until delivery. No typical denial of pregnancy was observed in the other cases. Pregnancies were experienced in secrecy, with conflicting feelings of desire and rejection of the infant and an inability to ask for help. Those around the mothers, often aware of the pregnancy, offered none. In the absence of parallel clinical data, it is not possible to calculate the frequency of the association between neonaticide and denial of pregnancy. CONCLUSIONS: The term 'denial of pregnancy' cannot fully reflect the complexity of emotions and feelings felt by all perpetrators of neonaticide and is used differently by different professionals. The term itself and its excessive generalization contribute to pathologizing women while absolving those around them and has little operational value in preventing neonaticides. The authors suggest rethinking the terms presently used to describe the phenomenon of pregnancy denial.