Friday, January 23, 2015

The mother who set her baby on fire... before you judge...

Today, I'm honored to feature a guest post from my friend and fellow writer, Janet Cincotta, MD. A family physician for 30 years, Jan retired to pursue her other passion -- writing. Click here to follow her blog, begin...begin again.

Jan wanted to write in response to a current news story that has shocked and appalled many of us. She has a different perspective and I'm so glad she's willing to share it with all of you. I believe it's THAT important, especially if you know anyone who has a new baby or is due to have one soon. I ask you read this, and to pay attention.

If you’re anything like me, you were horrified by reports of a newborn baby who died last week after her mother intentionally set her on fire, an unconscionable act of cruelty. This unleashed an outpouring of comments on social media demonizing the infant’s mother, labeling her “pure evil,” and “a monster,” some calling for her to suffer a slow, painful death by fire, too.

Wait a minute. Let’s not be so quick to judge.

This case shouts “postpartum psychosis” to me, and although I’m not an expert on the condition, as a family physician I am painfully aware of its existence and the devastating impact it can have on a new mother. You should be, too. If you recognize the symptoms in someone you know, you might be able to prevent a similar tragedy.

In fact, there exists a continuum of depressive disorders that are unique to the postpartum period, the days and weeks after the birth of a baby. They coincide with the dramatic shift in hormone levels that follows delivery. In most cases, the onset of these disorders can’t be anticipated or predicted. Every pregnant woman is vulnerable.

These disorders include:

·  The Baby Blues: This is a commonly occurring but temporary disorder that develops within a few days of birth, usually lasting 1-2 weeks, characterized by unexpected mood swings, anxiety, crying spells, poor concentration, and insomnia.

·  Postpartum Depression: More intense than “the blues,” this condition sometimes lasts for months if left untreated. Symptoms include sleep disturbance, extreme fatigue, loss of appetite, irritability, dramatic mood swings, lack of joy, withdrawal from family and friends, difficulty bonding with the infant (often leading to feelings of guilt or shame), and intrusive thoughts of harming oneself  or the baby. These thoughts may be frightening but are not acted upon.

·  Postpartum Psychosis: This is the rarest of these conditions, occurring at a rate of 1-2 cases per 1000 births. It is more likely to occur in women with a prior history of depression or Bipolar Disorder. The changes in the woman’s behavior mark an abrupt and extreme departure from her usual mental, physical, and emotional state. In addition to the above symptoms, she may appear to be confused or disoriented. Auditory or visual hallucinations can occur. She may display paranoia, becoming suspicious and accusatory toward previously trusted individuals. But the defining symptom is the intention/attempt to harm herself or, to harm or kill her baby.

In cases like this, reporters do not have the authority to speculate about motive, nor to guess at pre-existing mental health issues. Their job is to present an attention seeking story line—in this instance, an episode out of the life of a cruel, sadistic monster. Perhaps the rest of us should exercise caution about embracing it. Instead, we should be aware that postpartum depressive disorders are a grim fact of life, and that they are treatable. First, though, they must be recognized. With proper diagnosis and management, tragedies like this one can be averted.

I wonder how this story will turn out. If, in fact, postpartum psychosis did play a role in it, how was it missed by the people who were closest to this woman? Did anyone try to get help for her? Did the system fail to provide it? Unfortunately we may never know. Next week the media will report on the next gut-punching news story so as to stir up more knee-jerk outrage and merciless commentary, while this case slips out of awareness.

This post is not intended to excuse or justify what happened in this case. My hope is to raise awareness of this disorder, to urge women to get help at the first sign of postpartum depression, and to urge responsible and compassionate media coverage when the news is enough to break one’s heart.

Many thanks go out to Hana for inviting me to weigh in on this issue, and to share it with you.

If you’d like to know more, an excellent discussion of postpartum psychosis in plain English is posted at:

           ~JanetCincotta, MD

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