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Journal of Psychiatry and Mental Health
ISSN 2474-7769 | Open Access
J Psychiatry Ment Health | JPMH
1
CASE REPORT
Case Study on Infancide in South Africa
Bergh LB*
Private Pracce, Medipark Medical Centre, Gauteng, South Africa
Received: 13 Apr, 2019 | Accepted: 01 Jun, 2019 | Published: 07 Jun, 2019
Volume 4 - Issue 1 | DOI: hp://dx.doi.org/10.16966/2474-7769.130
Aer the birth of the infant, N felt trapped and unable to bond
with the infant, due to K’s continued physical and emotional abuse.
According to N, K repeatedly told her that he “did not want to see that
thing” and that he would never recognize the infant as his rst-born.
She, however, remained infatuated with K.
N had no desire to take care of the infant and wanted to continue
with her social life as she had done prior to the birth. She had no
history of alcohol or any drug abuse. N became increasingly depressed
and anxious and oen contemplated suicide as well as having thoughts
of killing the infant during this time. N was also angry with her
mother who expected her to take care of the infant and discontinue
her tertiary studies, which resulted in anger outbursts towards her
mother.
A full-time nanny was employed by N’s mother to help N care for
the infant while she was away on a business trip. N’s mother requested
the nanny to ensure that the infant was cared for, bathed, clothed
and fed. Despite all these eorts to support N, she continued her
egocentric and selsh behavior which directly resulted in the eventual
poisoning and murder of the infant.
Aer the murder, N was kept at the Police station for 2 days,
then moved to holding cells at a prison and later transferred to
Weskoppies psychiatric hospital where she remained for 2 months
under observation. When N returned home from the Weskoppies
psychiatric hospital, while still awaiting trial, she met a new boyfriend
P and quickly embarked on a sexual relationship which led to her
falling pregnant again; another unplanned pregnancy.
e psycho-legal report conducted by a clinical psychologist
for the defense a few months later, determined that N’s intellectual
abilities were above average. However, her intellectual abilities were
inuenced by uctuating attention and concentration, emotional and
personality problems and a high anxiety level. She had a tendency
not to persevere when demands were complex and would give up
easily. Her social judgment was excellent but she did not apply this in
*Corresponding author: Bergh LB, Private Pracce, Medipark Medical Centre, Gauteng, South Africa, E-mail: Lorinda.bergh@telkomsa.net
Citaon: Bergh LB (2019) Case Study on Infancide in South Africa. J Psychiatry Ment Health 4(1): dx.doi.org/10.16966/2474-7769.130
Copyright: © 2019 Bergh LB. This is an open-access arcle distributed under the terms of the Creave Commons Aribuon License, which
permits unrestricted use, distribuon, and reproducon in any medium, provided the original author and source are credited.
Abstract
This case study summarizes my therapeuc experience over a period of more than 10 years working with a client convicted of murder of her
3-month-old infant (Infancide).
Keywords: Infancide; Infant; Psychologist; Inmate; Psychological treatment
Case Study
My client, referred to as N, a young woman aged 19 when found
guilty of the murder of her 3-month-old infant. Aer a plea-bargain,
N received a 15-year sentence of imprisonment of which 5 years was
suspended for 5 years on condition she not be convicted of murder
or any other oence of which violence is an element and for which
she is sentenced to direct imprisonment committed in the period
of suspension. N was released on parole aer serving 5 years of her
sentence.
N grew up in an auent black South African family with Christian
religious beliefs. Her parents instilled excellent norms and values in
their 3 children; N was the youngest of the siblings. ere was no
history of any form of abuse, childhood maltreatment or conduct
disorder.
Her parents separated when N was 7 years old and divorced when
she was 11 years old. N experienced the divorce as very traumatic.
Her father moved to Cape Town and she grew up with her mother
in Johannesburg. Her father, who occupies a senior position in
Government, spoilt and overindulged her with everything she wanted,
while her mother (a successful entrepreneur) had to discipline and
deal with N’s mood swings. is led to a strained mother-daughter
relationship.
N started a relationship with K, her co-accused and father of the
deceased infant, while she was still at school. She was impregnated by
K on a previous occasion and had an abortion at his insistence. e
deceased infant was from her second pregnancy by K. During this
pregnancy K again pressurized her to have an abortion and escorted
her to abortion clinics on more than one occasion. N refused and
decided to continue with the pregnancy. During this time K became
increasingly physically and emotionally abusive towards her. Despite
his behavior she remained obsessed with him and feared being
rejected by him. She completed her twelh grade of secondary school
and pursued her tertiary education while being pregnant.
Sci Forschen
Open HUB for Sc ie n t i f i c R e s e a r c h
Citaon: Bergh LB (2019) Case Study on Infancide in South Africa. J Psychiatry Ment Health 4(1): dx.doi.org/10.16966/2474-
7769.130 2
Journal of Psychiatry and Mental Health
Open Access Journal
makes the psychological transition to motherhood extremely dicult.
Gunn and Taylor [3] indicate that approximately 50% of women
convicted of Infanticide kill their children in the context of unwanted
or concealed pregnancies.
In N’s case the following stressors made it dicult for her to bond
with the fetus and the infant:
• N’s pregnancy with K was an unwanted 2nd preg nan cy.
• K did not want to have the infant, insisted on abortion, and was
emotionally and physically abusive. K called the infant “that
thing”.
• K impregnated another woman while in a relationship with N.
• N was expected to stay at home aer the birth, stop her studies
and take care of the infant.
• N experienced her family as being unsupportive.
e literature on postpartum depression clearly indicates that
women who kill their new-born and/or infants suer from distinct and
recognized mental disorders at the time of the killing [4]. According
to Spinelli MG [4] postpartum psychiatric illness constitutes a serious
complication at birth, with the most tragic outcomes being infanticide
and suicide. She also mentions that Infanticide is frequently committed
by women with a major depressive disorder, bipolar mood disorder,
or major depressive disorder with psychotic features [4]. Sometimes
these women have also been characterized as having a personality
disorder, because there is no other specic explanation to account for
the illness-this is relevant in the case of N as she was diagnosed with
strong traits of borderline personality disorder with some traits of anti-
social personality disorder, an unstable mood and clinical depression
during her psychological evaluation for the Court.
Spinelli MG [4] found that most women do not experience
postpartum symptoms at the trial as postpartum syndromes are oen
transitory conditions-this is relevant in the case of N as postpartum
depression was never diagnosed at the time of her psychological
evaluation before or during her court case.
Spinelli MG [4] found that many of these women are oen victims
of unplanned/unprotected pregnancies-relevant in the case of N.
e denition of Infanticide according to Spinelli MG [4] indicates
that “it applies to the killing of an infant under 1 year of age by its
mother”. e denition rests on the below 2 assumptions, all applicable
in the case of N:
• Child bearing disturbs the balance of the woman’s mind;
• It is likely to be a consequence of the mental instability associated
with childbearing.
For Spinelli MG, Infanticide is the ultimate failure of bonding [4] as
pre-existing conicts re-emerge (such as the relationship with the own
mother) and therefore these mothers are not emotionally ready and do
not really accept the responsibility of motherhood.
All of the aforementioned are relevant factors in the case of N,
herself still in the late stages of adolescence. We know that young
people today continue their education for longer, there is a delay in
terms of marriage and parenthood, etc. and these are all factors that
challenge old perceptions of when adulthood really begins, as some
scientists now say that Adolescence lasts from the ages of 10-24 years.
Spinelli MG [4] indicates that Infanticide is not caused by a single
factor and that there are dierent types of Infanticide, namely:
practice. She was easily inuenced by emotions and her interpersonal
relationships were poor. e report noted that N showed strong traits
of borderline personality disorder, was emotionally immature and
directed towards her own needs, infatuated with K and his needs and
unable to face consequences of her actions. She was not equipped to
take on a mother role for a new born infant. e report indicated that
at the time of the oence, N was able to appreciate the wrongfulness of
her actions and was able to act in accordance with such appreciation
of the wrongfulness but with diminished capacity due to her clinical
depression, deduced from the fact that she did not try to hide the
poison and the incriminating evidence against her.
N was pregnant during her trial and gave birth to her second baby
in a private hospital while incarcerated. N was not allowed to hold
the baby as the baby was immediately moved to ICU due to breathing
problems and N was returned to the correctional facility soon aer
the birth. N and P both signed guardianships over to N’s mother as
N’s mother did not want N to raise the baby in a prison facility and to
prevent N from harming this baby.
Psychotherapeutic Intervention before, during and
aer N’s Incarceration
I started psychotherapy with N as a private clinical psychologist to
establish a relationship before she was incarcerated in order to prepare
her for her incarceration due to my knowledge and experience of
correctional services. e Correctional Services Act (Act No. 111 of
1998) [1] and the Correctional Services Amendment Act (Act No. 32
of 2001) [2] provides for inmates to see a private psychologist (as well
as a medical practitioner, dentist and psychiatrist) at their own cost.
All N’s psychotherapeutic, psychiatric, medical and dental sessions
were paid for by her mother.
I conducted psychotherapy from 2011 with N at the Pretoria Female
Correctional Centre for 90 psychotherapy sessions, of which 47 were
individual psychotherapy sessions of 1 hour each and 43 consultation
visits of 2 hours each with her mother and her baby. Regular prison
consultation visits were conducted to ensure N bonded with the baby,
that the baby was thriving emotionally and physically and to intervene
when necessary.
N was initially extremely uncertain of herself and felt isolated and
detached from her new-born baby. She found it dicult to hold the
baby and expressed “feeling empty”. When the baby was 3 weeks
old, her mother brought the baby to the correctional facility for the
rst consultation visit, N’s behavior during the visit was emotionally
guarded. She was able to hold the baby but oen looked at her mother
for guidance and support. Initially N found it dicult to bond with the
baby as she only saw her baby for approximately 1 hour per week and
continued to feel alienated from her baby despite regular consultation
visits.
N’s bonding with her baby improved aer 3 months, possibly
because of the passing of the critical 3-month period directly related
to the death/murder of her infant. N portrayed a positive mind-set
throughout her incarceration and found it increasingly easier to bond
with her baby as time went by.
N had no psychotic symptoms before or aer her incarceration, she
also did not show any remorse.
eoretical Perspectives on Infanticide
For most pregnant woman the psychological transition to
motherhood begins at pregnancy. However, some women do not
experience the joy of being pregnant due to various stressors that
Sci Forschen
Open HUB for Sc ie n t i f i c R e s e a r c h
Citaon: Bergh LB (2019) Case Study on Infancide in South Africa. J Psychiatry Ment Health 4(1): dx.doi.org/10.16966/2474-
7769.130 3
Journal of Psychiatry and Mental Health
Open Access Journal
• Assisted/coerced infanticide (in conjunction with their partners
where the intimate partners are violent or abusive) -relevant for
N.
• Neglect, related infanticide- not relevant for N.
• Abuse, related infanticide-relevant for N.
• Mental-illness infanticide (severe mental illness, acute or
chronic) in persons who clearly are not prepared for the task of
mothering-relevant for N.
e risk factors for Infanticide according to Spinelli MG [4] are the
following:
• Mothers younger than 17 years.
• Mothers aged between 17-19 years-relevant for N
Spinelli MG [4] indicates that many of these women also experience
pregnancy denial. As with other forms of denial, denial of pregnancy
occurs along a spectrum of severity. Sometimes the existence of
pregnancy is cognitively acknowledged but its emotional signicance
is denied. Sometimes the knowledge of pregnancy is briey recognized
(cognitively) but suppressed to the point of unawareness [4]. Spinelli
MG identies 3 dierent types of pregnancy denial namely:
• Aective denial (feelings of detachment from the infant)-this
detachment contradicts the usual heightened emotional state of
the pregnant woman that is associated with the process of early
bonding. Woman with this form of denial continue to think, feel
and behave as though they were not pregnant-relevant for N.
• Pervasive denial-not relevant for N.
• Psychotic denial-not relevant for N.
ere are also dierent reasons for denial according to Spinelli [4].
• Cognitive models of denial that can include the threat of
painful aects as well as physical or external threats that
promotes cognitive dissonance-relevant for N.
• Emotional stressors related to pregnancy denial and a fear of
being abandoned by a partner-relevant for N.
Because of the diculty in identifying the symptoms of postpartum
depression it can oen be misinterpreted by family/health care
professionals [4] and therefore the illness may go unrecognized and
untreated. Spinelli indicates that out of fear or guilt the mother may
not share her thoughts and fears with others-N was only diagnosed
and treated for postpartum depression by a psychiatrist aer the birth
of the infant and shortly before her trial when she visited her father
in Cape Town. Her mother, unfamiliar with postpartum depression
and the possible outcomes thereof, stopped the medication when N
returned to Johannesburg and put N on herbal remedies. N never
expressed or shared her thoughts and fears with her mother about
her raising her infant as she “feared” her mother and did not want to
oppose her. She also did not share her thoughts with anyone else which
led to an escalation of her depression and anxiety.
Aer N was incarcerated, I referred N to a psychiatrist who
prescribed anti-depressants. I explained at length to both N and her
mother the vital importance of N receiving anti-depressants and/or a
mood stabilizer regularly as well as the possibility of future postpartum
depression if she were to fall pregnant again.
N and her mother initially came for individual and joint therapy
sessions aer N was placed on parole during the 1st and 2nd year, but
rarely came for therapy sessions from the 3rd year onwards.
At rst it seemed as if N adapted and bonded well with her
baby. is did not last and N’s mother indicated during her last
consultation with me in 2018 that N’s behavior had returned to
being increasingly self-centered, demanding and prone to lying.
N was secretly contacting and meeting up with P, despite the fact
that she knew P was going to get married to another woman. The
information provided by the mother and confirmed with N during
a separate consultation reconrmed N’s traits of possible borderline or
antisocial personality disorder.
e continuous negative and manipulative behavior of N behind
her mother’s back to obtain custody of the child (by then 8 years old)
caused N’s mother to approach the High Court of South Africa for a
sole custody order, as she became increasingly concerned about the
future health, safety and general wellbeing of her grandchild should
the child ever be placed in the care of N. A High Court Order was
granted and N’s mother was awarded sole custody due to the fact that
N is not able to provide the child with a similar balanced, constructive,
healthy and positive upbringing as what her mother had already
provided for a period of over 8 years.
Summary
South Africa has one of the world’s highest reported homicide rates
involving babies, and is considered a “serious social and public health
problem” [5,6]. Researchers, led by Naeemah Abrahams of the gender
and health research unit at the South African medical research council
in Cape Town, estimate that the South African rates for neonaticide
(killing a child within the rst 28 days of life) is 19.6 per 100,000 live
births, and for infanticide (killing a child under one year) is 27.7 per
100,000 live births, but this estimate may well be underestimated. A
review of 40 years of research on both infanticide and neonaticide
showed the incidence in developed countries-such as the United
States, United Kingdom and New Zealand-to range from 2.1 to 6.9 per
100,000 live births.
is case study of N was my rst experience with infanticide and
I share here my personal experience with others as research about
infanticide is not easily available, and research gures are oen
underestimated due to poor identication, reporting and recording of
these deaths, especially in poorer and more rural settings. is topic
also receives little research attention in South Africa.
Note
• In South Africa you are convicted of murder and nor for
Infanticide.
• e term infant is used to indicate the murdered child while the
term baby is used for the child that lived.
• South Africa does not have a law that decreases the penalty for
mothers who kill their children up to one year of age.
e Diagnostic and Statistical Manual of Mental Disorders (DSM
5, 2013) does not include postpartum depression as a diagnosis.
References
1. Correconal Services Act (1998) Government Gazee, Cape Town,
South Africa.
2. Correconal Services Amendment Act (2001) Government Gazee,
Cape Town, South Africa.
3. Gunn T, Taylor D (1995) Clinical, Legal and Ethical issues. Forensic
Psychiatry 8: 49-53.
Sci Forschen
Open HUB for Sc ie n t i f i c R e s e a r c h
Citaon: Bergh LB (2019) Case Study on Infancide in South Africa. J Psychiatry Ment Health 4(1): dx.doi.org/10.16966/2474-
7769.130 4
Journal of Psychiatry and Mental Health
Open Access Journal
4. Spinelli MG (2003) Infancide: Psychosocial and Legal Perspecves
on Mothers Who Kill. American Psychiatric Publishing, Washington
DC.
5. Naeemah Abrahams (2016) Baby killing in South Africa-uncovering
the unthinkable. Medical Brief.
6. Marks MN (2009) Characteriscs and causes of infancide in Britain.
Int Rev Psychiatry 8: 99-106.
