Local Psychiatrists Speak Out On Baby Killing

"The restrictive policy of permitting new mothers only 24 to 48 hours in the hospital means that doctors are unable to determine if women are suffering postpartum depression," said Dr. Carmel Foley, chief of child psychiatry at the Queens hospital.
She deplored the policy imposed on hospitals by HMOs which refuse to reimburse new mothers if they remain in the hospital for longer periods.
The tragic drowning deaths of five children in Houston by their 36-year-old mother, Andrea Pia Yates, was followed by a North Carolina woman who killed herself and her three children with car-exhaust fumes. Early press reports claimed Robin Parker, 33, killed her three daughters with car exhaust fumes in a "copycat" slaying.
Foley said that Europeans are more alert to the potentially dangerous postpartum depression or milder forms known as "baby blues" by dispatching "health visitors" who go to the new mothers home to check them for the conditions after the babys first week and then at six weeks.
"Postpartum depression can be profound and life-threatening," she said. "Our health system needs to take this condition more seriously."
Foley said the prevalence of depression is rising in the society because of a variety of environmental factors.
Her colleague at Schneider Childrens Hospital, Dr. William Kaplan, director of the Center for Psychiatry and Legal Services, a forensic psychiatrist, said the Yates case is one were all scratching our head about."
He called the killings a "horrendous event" that could have been successfully treated. Kaplan added that the less serious "baby blues" condition occurs in from 70 to 80 percent of cases.
"Its the more serious cases that lead to infanticide that is a puzzle to us," he said.
Kaplan, who frequently testifies in court cases, said that Yates probably wont be able to successfully bring an insanity defense in court. But he noted that it might be seen as a mitigating circumstance and perhaps spare her a death sentence.
"Thats particularly true," he said, "if Yates believed she was rescuing her children by killing them and sending them to a better place."
According to a Duke University assistant professor of obstetrics and gynecology and psychiatry, the best way to diagnose postpartum depression is through screening of the new mother at four to six week periods.
"Its hard to spot in the hospital today," Dr. Diana Dell said, "but years ago when women spent three or more days in the hospital it was easier." Dell said that the home visits conducted in Europe dont work in the U.S. She said that because of cultural differences Americans dont like the idea of being visited at home by health workers.
The Duke professor said that women experiencing episodes of postpartum depression are often confused about what is going on.
"They often have intrusive thoughts," she said. "These new mothers fear that if they reveal these thoughts that their baby will be taken away from them."
Dell said those suffering from the disorder isolate themselves and require education to recognize that they can be treated effectively with anti-depressants.
"We should be talking to the insurance industry," she said, in a reference to reimbursement from HMOs.