Postpartum Depression to Be Tested As A Defense 2 North Jersey Moms Set to Blame Disorder

The Record, Bergen County, NJ - July 2, 2001

The Texas mother who confessed to drowning her five children is 1,600 miles away but her expected defense will be heard in Bergen and Passaic county courthouses as well.

Like Andrea Yates of Houston, two North Jersey women one accused of murdering her toddler, another of endangering her newborn do not deny the details of their crimes. Instead, they plan to offer a rare defense, blaming a postpartum depression so crippling as to sometimes induce psychosis.

"From my standpoint as an advocate, I look at the Houston case and others like it, and while I feel great anguish at the tragedy, I also think, This is precisely the kind of case that the folks who came up with the insanity defense envisioned," said Ron Honberg, legal director for the National Alliance for the Mentally Ill. "Whether a jury is going to view it that way is another question."

Doctors say up to two of every 1,000 new mothers suffer from a severe form of postpartum depression. Those women are beset by hallucinations, extreme agitation, and suicidal or homicidal thoughts.

Such was the case with Martita Gonzalez of Paterson, said her attorney, William Fusco. Gonzalez was 17 when she dropped her 16- month-old son, Anthony Matthew Valentin, into the Passaic River in June 2000, after being unable to find a baby sitter so she could visit her boyfriend. A day later, she went to a hospital, reported suicidal impulses, and confessed to the crime.

At Gonzalez's bail hearing, Chief Assistant Prosecutor William Purdy called her irresponsible and selfish. Her attorney insists otherwise.

"What makes a woman love her child tremendously one day and annihilate him on the next?" Fusco said. "There are cases, like the one in Houston and the one I have, where a woman's behavior fits the defense: that she labored under a disease of the mind."

Lawyers plan to argue similarly in the February 2000 case of another Paterson woman, Michelle Booker. The single mother of five abandoned her son in the parking lot of the Sears store in Hackensack, 17 hours after giving birth to him alone at home. Booker, a secretary with two jobs, surrounded the boy with new clothes, warm blankets, bottles, and diapers, and waited in her car with her other children, ages 4, 3, 2, and 1, until a shopper found the newborn.

Police charged Booker with child endangerment. Her attorney, William Ware of Morristown, plans to argue that postpartum depression left her with a "diminished capacity," unable to understand the implications of her actions.

"Clearly, we're talking about someone who, by all accounts, has been a very good mother, except for this one aberration caused by a medical condition over which she had no control," said Ware, noting that the state Division of Youth and Family Services returned the newborn to Booker two days after the incident, deeming her a fit mother. "This isn't a case of a defense attorney trying to find a defense. This defense found me." Unlike an insanity verdict, which exonerates the defendant, the diminished-capacity verdict Ware hopes for would lead to a conviction of a lesser offense.

"Ten years ago, when I was a prosecutor, we'd sometimes have cases like this but it didn't have a name," Ware said. "Now that the condition has come to the forefront, it's hard to discount the legitimacy of it.

In the capital murder case against Yates, her attorney has said he is "headed" toward entering a plea of not guilty by reason of insanity, due to postpartum depression. After the birth of her fourth child, Yates attempted suicide. Medication seemed to ease the illness, but she tumbled into despair again after the birth of her fifth child six months ago.

Although some blame the tremendous upheaval in hormones during birth and its aftermath for postpartum depression, physicians now believe the disorder is prompted by several factors: physiological, psychological, social, and situational.

In Great Britain, women such as Yates are treated sympathetically, falling under the jurisdiction of the Infanticide Act of 1938, which says that if a mother kills her child within the first year, when her mind is "disturbed by reason of her not having fully recovered from the effect of giving birth," she should be punished as if guilty only of manslaughter.

The United States has no such statute. Lawyers here began using postpartum depression as the basis for an insanity defense only in the mid-1980s. Even since then, it has been used rarely, in part because the medical field wrestled over whether it was a distinct condition.

Not until 1994 did the American Psychiatric Association recognize postpartum psychosis in its bible of disorders. Some argue that even with that, the medical field has been slow to respond.

Just last week, an Old Bridge man sued his wife's obstetrician for medical malpractice for failing to adequately treat the depression that overtook her after she gave birth. Ultimately, she suffocated her 5-month-old daughter with a plastic bag, then hanged herself from an extension cord in the garage.

Judges and juries have responded with great variation to defenses involving postpartum depression from lengthy prison terms, to sympathetically lenient sentences, to mandated treatment in psychiatric facilities.

It is a range that reflects not only society's ambivalence, but also divisions within the medical and legal communities about the disorder, and whether women who commit these acts are, in fact, responsible for them.

Ann Green was a pediatric nurse in Manhattan who smothered her 5- day-old baby in 1980, and smothered her 3-week-old two years later. In 1988, she was found not guilty by reason of insanity, the first time a New York State jury had accepted postpartum psychosis as an insanity defense for murder.

"There are people in this world who are evil and people who are sick," Green's attorney told the jury in his summation. "To a large degree, the measure of our society is the ability to distinguish between the two."

Other women have met harsher fates. In 1985, Debra Gindorf fed crushed sleeping pills to her toddler and her newborn, tucked them into bed, then tried to kill herself by swallowing the same drug. The Illinois woman awoke the next morning with the sickening realization that she was alive and her children were not. She tried killing herself with a steak knife, a gas oven, ropes, and pillows, then turned herself in to the police. The court rejected her insanity defense, sentencing her to life in prison with no possibility of parole.

Insanity defenses in general have been highly controversial, with some jurisdictions abolishing them altogether and others restricting their use. In New Jersey, a person is not responsible for criminal conduct if, because of a "defect of reason, from disease of the mind," she doesn't know the nature of the act she's committing, or does not know that what she's doing is wrong.

Overall, the insanity defense is raised only once in every 100 felony cases, and is successful only one quarter of the time.

Some wonder if in insanity defenses involving postpartum psychosis, the hurdles may be all the greater, because such cases involve unspeakable acts. They violate deeply held beliefs about the sacred relationship between mother and child, upending the ideal of mother as life-giver, nurturer, and protector.

"These cases, after all, involve babies, the most innocent members of society," said Michelle Oberman, law professor at DePaul University in Chicago whose book, "Mothers Who Kill Their Children," is due out next month. "Often on juries and in the public, there is a cry for vengeance, some way to register protest or at least anguish at the crime."

To be sure, some say a defense involving postpartum depression is nonsense, that it will allow mothers to quite literally get away with murder.

The Irish Times ran a news feature in 1994 headlined "Don't hang it on hormones," in which the writer argued that if women can blame postpartum depression and premenstrual syndrome for their crimes, "why can't men rape and claim testosterone poisoning?"

Even some feminists worry that defenses based on hormones or gender will reinforce stereotypes of women as slaves to their biochemistry: uncontrollable, unpredictable, and undependable.

"My response to that is that if women are in fact different than men in their vulnerability to this mental illness, it's only going to make their health worse to simply say to them, Buck up and pretend to be the same as men," Oberman said. "Silencing women about that illness makes gender equality a hollow victory." Linda Klempner knows that well from her clients. As a therapist in Teaneck and a trustee of the national group Depression After Delivery, Inc., she often hears women's confusion about the intense sadness and anxiety they feel when everyone is exclaiming, "You must be so happy!"

"There's so much about this that's kept in the closet. For a lot of women, they're just too ashamed to say that they're not totally thrilled with this new baby, that they feel out of control, that they need help," Klempner said. "What their family and society have to realize is that they need help immediately."

Martita Gonzalez's family hopes that society takes that approach with their daughter. The family has said Gonzalez is a troubled girl who needs treatment, not punishment.

Said Fusco, her attorney: "She has good days and bad days. If we can get her out, it would be much better." Staff Writer Ruth Padawer's e-mail address is padawer@northjersey.com

The 3 levels of postpartum disorder

Baby Blues. This is an extremely common reaction occurring in the first few days after delivery, often on the third or fourth day.

Fifty to 75 percent of all new mothers experience this feeling of letdown. Symptoms may include crying for no apparent reason, impatience, irritability, restlessness, and anxiety. The symptoms usually disappear on their own.

Postpartum Depression. At least 10 percent of new mothers experience this condition within days after delivery. Sometimes, symptoms can appear up to a year later. Symptoms may include hopelessness, appetite and sleep disturbances, poor concentration, memory loss, uncontrollable crying, lack of interest in the baby, fear of harming oneself or the baby, and feelings of guilt, inadequacy, or worthlessness. Symptoms also may include anxiety or panic or features of obsessive-compulsive disorder.

Postpartum Psychosis. This is the most severe and rarest postpartum disorder, occurring in up to two-tenths of 1 percent of women shortly after delivery. Onset is sudden and usually occurs within the first two to three weeks. Symptoms involve losing touch with reality, including suffering from visual or auditory hallucinations, severe insomnia, extreme anxiety and agitation, and suicidal or homicidal thoughts.

Source: Depression After Delivery Inc.