Child Abuse & Neglect, Vol. 24, No. 11, pp.

1451–1460, 2000
Copyright © 2000 Elsevier Science Ltd.
Pergamon Printed in the USA. All rights reserved
0145-2134/00/$–see front matter

PII S0145-2134(00)00198-8

A QUALITATIVE STUDY OF FILICIDE BY MENTALLY

ILL MOTHERS

JOSEPHINE STANTON, ALEXANDER SIMPSON, AND TRECIA WOULDES

Department of Psychiatry and Behavioural Science, School of Medicine, Auckland University, Auckland, New Zealand

ABSTRACT

Objective: To examine descriptions of maternal filicide committed in the context of major mental illness from the frame
of reference of a group of perpetrators.
Method: Participants were accessed via their treating psychiatrists. A naturalistic paradigm was used. Semi-structured
individual interviews were audio-taped and transcribed. Theme analysis of the transcripts was done by repeated reading of
transcripts and coding utterances, individually, then jointly by the authors.
Results: Six women were identified, and interviewed. They described intense investment in mothering their child(ren).
Descriptions of external stressors were not extreme, but the experience of illness was described as extremely stressful. They
described little or no warning or planning. Their descriptions of their children were unremarkable. Motivation was described
as altruistic or as an extension of suicide. They described regretting the killings and feeling responsible even though they
knew they had been ill at the time.
Conclusions: The findings underline the difficulty of identification of risk and prevention of maternally ill filicide in the
women who described being very caring towards their children, and little or no warning of filicidal urges. They may be
better understood in terms of the illness than individual stress or psychodynamics. © 2000 Elsevier Science Ltd.

Key Words—Filicide, Infanticide, Child abuse, Mental disorder.

INTRODUCTION

FILICIDE IS A profoundly shocking event. Cross-culturally, the killing of unwanted female

children is most common (Judson, 1994). However, child homicide is a significant cause of child
mortality in wealthy industrialized nations (Jason, Gilliland, & Tyler, 1983; Marks & Kumar, 1993;
Sakuta & Saito, 1981; Somander & Rammer, 1991). Most child homicide, particularly of young
children, is perpetrated by parents though in the United States there is a significant group of older
children who are killed by non-family members (Jason et al., 1983). Study of maternal filicide is
more developed than that of paternal filicide.
Population based epidemiological studies have identified three broad, overlapping groups of
filidical mothers (Cheung, 1986; d’Orban, 1979). The first described (Resnick, 1970) and most
clearly delineated of these is the neonaticides, where a child is killed on the first day of life.
Perpetrators are usually young, unmarried, poorly educated women who have concealed or not
acknowledged their pregnancy. This can be understood in terms of primitive defenses such as
denial and dissociation in young, uneducated women (Marks, 1996). The second and largest group
was described by Resnick (1969) as “accidental filicide,” by d’Orban (1979) as “battering mothers”
and is more generally referred to in the child abuse literature as “fatal child abuse” or “fatal

Received for publication August 27, 1999; final revision received March 17, 2000; accepted March 24, 2000.
Requests for reprints should be sent to Josephine Stanton, Department of Psychiatry and Behavioural Science, Faculty of
Medicine and Health Service, University of Auckland, Private Bag 92– 019, Auckland, New Zealand.
1451
1452 J. Stanton, A. Simpson, and T. Wouldes

maltreatment.” These deaths occurred in a context of psychosocial stress and limited support. There
was not a clear impulse to kill, but a sudden impulsive act characterized by loss of temper (d’Orban,
1979). Steele (1987) described death in cases such as these as, “. . .an unexpected, undesired,
incidental result of the abuse” (p. 102).
Understanding of these cases is an extension of understanding of child abuse in general. Steele
(1987) has identified a set of necessary conditions for abuse which relate to the predisposition of
the perpetrator, a crisis causing increased stress, actual or perceived lack of support and perceived
shortcomings in the victim. Korbin (1989) focussed on the role of perpetrators’ networks in an
ethnographic qualitative study of a group of female perpetrators of fatal maltreatment. She
identified a circular process whereby denial of the seriousness of previous abuse in the mothers and
minimization of this abuse in members of the support networks fed back to augment each other and
undermine the urgency with which the cases might otherwise have been viewed.
The third major group of maternal filicides, which comprised approximately one third of d’Orban
and Cheung’s samples (Cheung, 1986; d’Orban, 1979), is the mothers who killed in the context of
major mental illness. These women were older, more often married and had a lower level of
psychosocial stress than those who killed in the context of fatal child abuse. This group has been
understood in terms of altruism as described by Baker in 1902 (Baker, 1902) “It may seem
paradoxical, but it is not vice that leads to the death of the infant, rather is it morbid and mistaken
maternal solicitude” (p. 16). Almost half of Resnick’s (1969) reviewed case studies were catego-
rized as “altruistic filicides.” McGrath (1992), in his series of mentally abnormal filicides, cited
examples of offenders’ initial statements, consistent with this theme, such as “I’ve given her
peace. . . I loved her more than anything else in the world.” “I’m not worthy to live, I’m not worthy
to die. . . I loved him so.” (McGrath, 1992, p. 284).
Thus there appear to be material differences in the processes underlying maternal filicide in the
context of major mental illness from those underlying fatal maltreatment or neonaticide. As a base
to developing understanding of any phenomenon adequate description is required. The purpose of
this study was to access the perpetrators’ frame of reference. This was done by collecting and
analyzing descriptions of the experience of a small number of women who killed their children in
the context of major mental illness

METHOD

This study used a naturalistic paradigm (Morse, 1994). This implies a commitment to constructivist
epistemologies, an emphasis of description rather than explanation, the representation of reality
through the eyes of the participants and emphasizing the emergence of concepts from the data
rather than their imposition from current theory. Thus the descriptions given by the participants are
the focus of the study, rather than being used as a means to access internal psychological states or
processes.
Ethical approval was gained via ethics committees attached to the health service providers.
Prospective participants were sought through psychiatrists. They were asked to identify women in
their care who had killed their children, were well enough to be approached to participate in the
study and give informed consent. Before the women were approached assurance was sought from
their treating teams that they were prepared to make extra resources available in the event that the
woman should become psychiatrically unwell as a result of the study. Clinicians then described the
study to the women and gave them a written invitation which included a form to return indicating
whether or not they wished to participate in the study. DSM IV diagnoses were sought from
psychiatrists for participants.
One or two semi-structured interviews were performed at the women’s place of residence.
Topics which were covered in these interviews included perceived available support, help seeking,
 Mentally ill filicide 1453

experience of illness, ideas about the children, experience of parenting, stressors, motivation for
killing, rehabilitation. In addition, the participants were encouraged to talk about what they felt
might have helped prevent their child’s death. Interviews were audiotaped and transcribed. The
transcripts were returned to the women for them to check. At this time they were encouraged to
change anything they had second thoughts about.
Data analysis was by repeated reading of the transcripts and categorizing utterances and
collecting together excerpts of transcript that addressed similar issues. NUDIST software was used
to aid in the process of categorizing, organizing and reducing the text. Repeated reading and coding
of complete transcripts, initially independently by the individual researchers, and then jointly, was
undertaken to increase the likelihood that the full range of discourse used by the participants was
exposed to analysis. Theme summaries were done by the first author and read through by the other
authors with reference to the transcripts, searching for contradictory or alternative interpretations.
In order to preserve the confidentiality of the women the cases are not identified. Descriptions
with respect to each issue were amalgamated. Because of the common themes this was felt by the
authors to represent the data adequately, regardless of the age of the child or other demographic
features. Some themes differed with the psychiatric diagnosis. Where there was disparity this has
been indicated.

RESULTS

The Participants
Twelve women were identified by psychiatrists. One woman remained too psychiatrically unwell
to be approached. Two women were difficult to engage in services for treatment and therefore
approaching them for involvement in research was not considered suitable by their psychiatrists.
For one woman the treating team was not able to assure the availability of extra support should she
become unwell. A further woman was approached but declined to participate.
Consent was obtained from seven women who were interviewed. Six of these had killed once in
the context of major mental disorder and are reported here. Time lapse from the event to the
interviews ranged from 12 to 23 years. One had a previous attempt on an older child. There was
no other history of previous abuse. None was living in a violent relationship. Abuse was not totally
absent from their personal histories, but neither was it a prominent feature. The women were mostly
Caucasian and were in their 20s at the time of the killings. Legal processes were completed for all
women. The women described a varying level of support but none was socially isolated and most
were in contact with health professionals.
Their illness were described as “major” in that they were severe mood or psychotic disorders
which had necessitated active, sustained inpatient and outpatient treatment over a period of at least
1 year. DSM IV diagnoses made by the referring psychiatrists included Major Depressive Disorder,
Schizo-affective Disorder (in either manic or depressed phase prior to the killing) and Schizophre-
nia. The women who described being manic prior to the filicide described mood incongruent
delusions at the time of the filicide. In each of the cases symptoms were identified from the
transcripts which fulfilled the diagnostic criteria for Major Depressive Disorder or for Criterion A
for Schizophrenia, confirming the clinicians’ diagnoses of major mental illness. All illnesses were
either not identified before the death or had changed markedly prior to the filicide (e.g., history of
depression with first manic episode).

Experience Prior to the Event

The women spoke about how important motherhood was to them, their different ways of
perceiving this and their experiences of illness and stress.
1454 J. Stanton, A. Simpson, and T. Wouldes

I had that 18 months with the three of them, you know, that’s not very long is it, and yet, you know, amazingly important.

Although they described enjoying the company of their children, of loving the children and
enjoying being with them several of the women spoke of how different the experience of parenting
had been with previous children, or prior to becoming unwell. They described the change in
mothering experience with their mental illness.

I remember thinking that the baby frowned a lot and that somehow, because I had been like really, really tired while I
was pregnant and stressed, that I thought the baby had . . .caught the stress from me. I felt so sorry for him ’cos I used to
look at him and he used to look worried and he’d scratch his face and like he seemed to sort of be like red, but then now
with (new baby), . . .they’re born all wrinkled and worried looking for a few days and (new baby) would go bright red when
he cried and also he used to scratch his face so that it was probably it was just my state of mind.

Being a good mother was important to all the women.

You know, I’ve always sort of wanted to be the perfect Mother.

The women talked of efforts they had made to be a good mother, such as mincing steak instead
of buying mince, playing with the child at home to make up for taking her shopping and choosing
to stay home with the children rather than working. Several of the women spoke of the responsi-
bility of child rearing and how hard it could be.
The women’s impressions of the quality of their mothering covered the full range from those
who described having felt good about their parenting, those with some dissatisfaction to one
woman’s description of her self as feeling like the worst mother in the world. Some were clear
about their perceptions of the quality of their mothering being affected by their illness

I expected so much of myself but when I look back now . . .I mean I was looking out the window and seeing, you know,
the neighbors and everything doing really well, but, and feeling that I wasn’t, but I actually was. I was actually just doing
so well and I couldn’t see it.

Descriptions of the level of psychosocial stressors varied. Some of the women described feeling
happy with their lives and enjoying their children prior to becoming ill. Others described ongoing
stressors such as custody issues and chronic sleep deprivation but they were not described as the
immediate precipitants to the filicides. Some of the depressed women described their lives as very
hard but also described this as the way they were experiencing their lives in the context of their
illness.

Everything was sort of like, black, of you know what I mean, like there was . . .it was winter, it was muddy, it was cold,
everything was . . .the baby cried, everything was hard for me, I can . . .nothing seemed to go right.

In the context of depression minor events could be experienced as intense stressors.

I remember a button falling off in the hall and I just stood there and cried and cried and I told myself “you thought you
could sew, you are just hopeless.”

Some of the women described living with delusions of persecution which represented persistent
severe stress.

I thought people were following me or vehicles were following me, or people were listening into where I was staying
or spying on me. It was terrible, yeh.
I used to shout and say, “go away, get out of my vagina” because I used to think they had something inside me.
 Mentally ill filicide 1455

One of the women described the continuous demands of living with the added meaning of a
psychotic reality where nothing was what it seemed.

B. One of the things I used to do was like watch cars go past, each color meant something different and each number
plate meant something different and they used to tell me things. The plates used to tell me things. I did that a lot. I hated
it.
A. So your life felt so controlled by the cars and their number plates?
B. Everything. Yeh. Even dogs barking down the street.

Another woman described the loss of faith as a potent stressor in the context of her delusional
world.

I realized I just couldn’t believe in God and that was the final thing that I had to do. If I couldn’t do it then I was just
wasting my time and my life was just a waste.

The descriptions of the women who were manic before they killed their children were artificially
positive.

Everything was so good and wonderful. . . .

Well, I felt I had it under control, really, I didn’t realize.

Some of the depressed women described having thought about the deaths for a few days or a few
weeks.

I started to think in that last week, that’s when I started all that week to just think about dying.

The psychotic women described no warning at all and were adamant that if they had been asked
about ideas about killing their children before the event they would have had no indication that it
was likely or even possible.

I hadn’t thought of it earlier.

The Children
The ages of their children ranged from a few weeks to 7 years.
Some of the women described having felt intensely concerned about their children in the context
of depression. However, they were clear in retrospect that these were not realistic concerns. One
decided her child would never learn to talk and could not be reassured. Another felt more
non-specific concern.

I was quite certain that there was like something wrong with him . . .I thought because I was so um, stressed that the baby
had been born with my stress.

One of the women described her daughter as not having developed much of a personality at 18
months. Otherwise there was a broad range of descriptions of the children not obviously different
from what one might expect to find among any group of mothers (e.g., demanding, easygoing,
quiet, clever). They showed photographs of their children with pride, and told anecdotes of their
endearing or perceptive behavior. One of the women described concerns about her child not being
particularly physical with good muscle tone and not being outgoing enough. But she also described
her as being clever and related incidents demonstrating this.
1456 J. Stanton, A. Simpson, and T. Wouldes

The Event
Most of the women killed one child, but some more than one. Methods included stabbing (3),
jumping with her child from a high place, setting fire to the house, attempted drowning, and
suffocation.
Most of the women were not able to give well organized accounts of what motivated them to kill
their child(ren) but altruism was prominent in the accounts of motivation which could be pieced
together from descriptions given through the transcripts.

A. I thought that they (people in the mother’s delusional world) were were going to use my daughter as well, I don’t
know, and um. . . .
B. So you were kind of scared for her?
A. Yeh, I thought she was going to go through what I had been through. I just thought that the devil was going to take
(baby) in a cot death, that I had to save her and return her to the angels because if he took her, she’d go to Purgatory, she’d
be stuck there forever.

As indicated in the comments above, some of the women described delusionally based mercy
killing, killing to protect or rescue the children from some awful fate that was indicated by their
delusional system. They were clear about their having acted in the interest of their child(ren). One
of the women described almost decapitating one of the children out of her sense of urgency to get
it over quickly so the child would not suffer. One of the women hesitated once she had started
killing her daughter and described her conflict.

. . .once I started I couldn’t leave her, to get, like once I started I couldn’t, . . .I’d hurt her and I couldn’t expect her to
ever trust me again or anybody, so I had to finish killing her and, um, and then, um, then I rang the police.

Another described her memories of the period after she killed her baby which clarify her clarity
over the baby’s death being a loss, but being the better outcome for her.

. . .sat down on the chair just holding her and just cuddling her and (older child) was awake and I said, “I’ve got some
sad news. I have just killed (baby).” . . .when the police arrived they said “he’s giving mouth to mouth resuscitation.” I said
“Oh no you can’t bring her back” cos I felt that all the good I’d done would be reversed.

For the women who described their killing in the context of their own suicide a recurrent theme
related to sense of identification with the children.

I didn’t want to live and I thought if I could only turn the gas on at Nan’s we could all go to sleep and wake up in heaven.
Because I created her, you know, because she was my responsibility.
It was that we all had to die and my husband would be free.

One of the women, in her account, spelt out the overlap between identification in an extended
suicide and delusionally based mercy killing.

Because the way I saw the world and everything was like there was just no hope. And there was no light, there was no
future for me, there was no future for anybody . . .. First it was just me. First of all it was look, oh, I just don’t want to live
any more. Everything looks terrible and then (sigh) I thought, well I couldn’t leave my daughter behind and I should do
something about that.

One of the women described feeling connected to God, even in the moment of suicide.

I said a prayer before I went over the edge, it was just like um, I never turned away from Him, it was just like “you’ll
understand” you know “if you are that sort of loving person that I just can’t do it any more.”
 Mentally ill filicide 1457

After the Event

Although one of the depressed women described some sense of relief at not having to manage
the difficulties of parenting immediately after the death, all of the women bitterly regretted the
deaths of their children, mourned their loss, and longed for what was done to be undone.

. . .if someone knocked on the door now and offered me my little son back I’d just be so happy. But you can’t you know,
(crying).

Although many of the women were found not legally responsible (that is, not guilty on the
grounds of insanity) and all recognized they were ill, most of the women expressed a strong sense
of personal responsibility. They described having killed their child(ren) as a terrible burden,
something they would have to live with for the rest of their lives. They described having had an
intention to kill, and knowing what they were doing rather than being out of control. None of the
women had attempted to evade detection. On the contrary they went to police, family, or neighbors
to let them know what they had done.

Even though that is what I have been diagnosed as, and, I can’t just say, Oh, I wasn’t in my right mind, everything is
fine. You know, I still blame myself and feel a lot of guilt.
I really hate myself that I didn’t get the right sort of help.

Only one of the women used language in describing the killing, which suggested a lack of control
over her actions.

And I stabbed and stabbed and my hand was coming again and again (demonstrates moving hand and arm in stabbing
motion) and it wouldn’t stop.

Only one woman described her illness as primarily responsible.

No I don’t (blame herself). It’s sort of nothing (weeping) I could have done. I think if I’d done something like I don’t
know, taken substances or something.

DISCUSSION

Clearly mentally abnormal filicide has some overlap with fatal maltreatment (Simpson & Stanton,
2000). Silverman and Kenedy (1988) raised concerns about high rates of mental illness at times
reported among maternal filicide perpetrators as being based on the tautology, ”if they killed their
kids they must be crazy“ (p. 123). The legal processes have tended to deal leniently with maternal
filicide offenders. Marks and Kumar (1993) reported that men committing filicide were more likely
than women to be imprisoned for the same offence. Korbin (1987) described mental illness and
some delusions in her sample. Steele (1987) described mental illness as distributed throughout child
abusers, but considered psychotically motivated child abuse and killing should be explained
separately from more common forms of abuse.
The overlap with the fatal maltreatment group in the sample in this study was minimal. In no case
was there a history of repeated abuse and all described a clear intention to kill. They fitted the
profile described in the group characterized as mentally ill filicide (Cheung, 1986; d’Orban, 1979).
Violent methods of killing, older children, and more than one child killed in several cases are all
features one would expect in a mentally ill group rather than in fatal child abuse (d’Orban, 1979;
Lewis, Baranoski, Buchanan, & Benedek, 1998). They tended to be older with reasonable support
networks and mild to moderate psychosocial stressors. Psychosocial stressors may function
differently in this group, by precipitating the illness but not the killing. Although the women
1458 J. Stanton, A. Simpson, and T. Wouldes

described limited external stressors some of them described extreme, pervading stress as part of
their illness. For the women who were manic prior to the filicide the issue is even more complex.
They did not describe experiencing stress but mania is known to deplete the sufferer’s resources
through periods of decreased sleep and increased activity.
The unremarkable perceptions of the children described by the women in this study are
consistent with those described in Rogosch, Mowbray, and Bogat’s (1992) study of mothers with
major mental illness. But they differ from Korbin’s sample many of whom described their child as
aggressive or developmentally abnormal (Korbin, 1987). Paternal filicide comprises mostly fatal
child abuse rather than mentally abnormal filicide and men who kill their children have also been
described as attributing inappropriate hostile, or manipulative mental states to their victims (Scott,
1973). Perception of the child as in some way unsatisfactory was a necessary condition cited by
Steele for abuse to occur (Steele, 1987). This may be an important difference between fatal child
abuse and mentally abnormal filicide.
Baker’s image of filicide arising out of “morbid and mistaken maternal solicitude” (Baker, 1902)
rather than neglect has been borne out in this study. It is important for people in contact with
women at risk to remember the danger of and be aware of the risks of dichotomous thinking such
as assuming a woman would not harm her baby, as she evidently care about it and worked hard at
being a good mother. The risk may be increased as a result of the mother’s emotional investment
in the child(ren). Those at risk from mentally disordered killers are those of psychological
significance to the perpetrator (Bowden, 1990). An increased risk may also be mediated by the
stress created by the pressure the women put on themselves to be good mothers. Korbin (1989) also
described the women in her study as desperately wanting to be good mothers. Harder (1967) has
argued that the development of delusions may post date the hostility towards the child. No such
hostility was described by these women, not even normal ambivalence. Sands’ (1995) sample of
mentally ill mothers did not describe difficulties with mothering. In each case this could be because
of a desire to be seen in a positive light. It could also be because of a fragile investment in the
mothering role whence ambivalence is too threatening to acknowledge.
The intensity of the regret the women describe for having killed their child(ren) further confirms
Baker’s view. Though the filicide may have been ego-syntonic within the delusional context of the
illness it was clearly ego-dystonic once the woman had recovered. Having to live with having killed
one’s own child is a considerable burden for someone already struggling with a major mental
illness. Thus the role of the mental health clinician in managing risk with a mentally ill mother need
not differentiate between the interests of the mother and that of the child. Preventing any possibility
of the mother harming her child is strongly in her own interest.
The range in the women’s assessments of the quality of their parenting is interesting in the
context of Sands’ study which compared a group of mentally ill mothers with a matched group of
single, low socio-economic status mothers (Sands, 1995). They found that the mentally ill mothers
were less likely to acknowledge they had difficulties managing their children, even though these
difficulties were observed in both groups. Korbin’s (1989) observation of battering mothers’
tendency to underestimate their level of danger could also be seen as a failure of self-monitoring.
Self-monitoring would have been impossible for the women who were manic before the filicide as
grandiosity and euphoria are core features of mania.
The lack of premeditation and planning described by the women who were psychotic was not
expected by the authors. From the women’s descriptions they would have been unable to identify
their filicidal impulses before the event even if asked by a clinician with whom they would share
such a thought. The women who were manic experienced an abrupt change in their experience of
illness prior to the filicide. They developed mood incongruent delusions and consequent distress,
which had not been present even 24 hours before. In contrast the depressed women described
contemplating their and their children’s deaths over days or weeks. The numbers are very small
 Mentally ill filicide 1459

here, but this could be further studied with a larger group with respect to more common events such
as serious suicide attempts.
In attempting to understand mentally ill filicide the mediating factor of the impaired reality
testing is vital though not sufficient. This enables one to understand the filicide but true mercy
killing, where a child was killed to rescue it from suffering that was not delusionally based, is
almost unknown (Cheung, 1986; d’Orban, 1979). Thus it seems difficult to explain the filicides on
the basis of rationality-within-irrationality, where-by one might see the violence as rational if the
delusions were assumed to be true (Link & Stueve, 1994). One might postulate that the intensity
of the suffering perceived in a delusional state is of such a magnitude as to explain the filicide
rationally. However, other features of the illness such as impaired impulse control, affective
dysregulation, lack of cognitive flexibility and unbalanced judgement are likely to contribute.
Most accounts of the origin of child abuse address combinations of factors in the child, the parent
and the socioeconomic and socio-cultural environment. Steele (1987) specified a history of abuse
or neglect as an important feature in the parent. These were not prominent in this sample. The
relevant features of the parent in the context of major mental illness are more likely to be
disorganized thinking and instability of mental state. The salient features in the children may be
simply that they are available, emotionally invested and vulnerable to victimization (Finkelhor &
Dzuiba-Leatherman, 1994).
Thus for the clinician attempting to predict risk of maternal violence this study indicates a
number of potentially confusing and misleading issues. Evident devotion to the child and parenting
is not likely to be a protective factor. The mentally ill mother is likely to have difficulty monitoring
her parenting effectiveness and level of risk. However, it does point to the importance of the
identification and early and effective treating and monitoring of major psychiatric illness.

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