Can postpartum depression become so invasive as to cause a mother to kill her children? Since this happens very rarely, many scoff at the prospect. Interestingly, postpartum psychosis was first recognized as a disorder as early as 1850. According to Pregnancy Infonet, (2007), studies on rates of the disorder have shown that the number of women experiencing postpartum psychosis has not changed since the mid 1800s. Expert psychologists, psychiatrists, and behavioral scientists are discovering that postpartum depression, if not treated promptly and appropriately over a long period of time, can definitely develop into psychosis. Medical statements and evaluations, insufficient treatment, and failed suicides are things that must be considered in determining Andrea Yates’ mental defect at the time of her crime.

It has been argued that some of Yates’s thoughtful and logical actions prove that she was sane at the time of the incident. The fact that on two occasions she refused the medication and on another occasion she stopped taking it. The fact that she had “practice” filling the bathtub and individually tracking down her children and drugging them to death are arguments being promoted as evidence that she had full knowledge of what she was doing.

To understand the concept of postpartum depression and postpartum psychosis, one must first realize that the two conditions are not synonymous. Postpartum depression is described as something that can start any time within a year of birth. There is usually sadness, common after a trial like childbirth, and of course a loss of energy, also common after childbirth. Sometimes there will be a bout with the inability to focus, especially for new moms, and along with that, anxiety about motherhood. These are all symptoms of postpartum depression. Not all women experience these and some may experience only a few of them. However, these symptoms are quite different from those of postpartum psychosis. Catalina Roca, (April 2005)

Dr. Dan Williams, Psy.D., PA-C, “Peace and Healing,” (2006), describes postpartum psychosis as “very rare.” He goes on to say that “It is characterized by homicidal and suicidal impulses, hallucinations, delusions, disorganized and bizarre thinking.” Dr. Williams goes on to describe some of the consistent characteristics of someone suffering from postpartum psychosis.

“The dilemma is that these people often refuse treatment. This is a medical emergency situation. If postpartum psychosis is suspected, families should call 911 as emergency intervention is necessary. Medication will most likely be prescribed. The ultimate goal is to keep the baby and the mother safe.” “Peace and Healing”, (2006)

Yates was first diagnosed on July 21, 1999 with severe major depression by Eileen Starbranch, MD. This diagnosis came after his suicide attempts. During his week-long stay in the Methodist Hospital Psychiatric Unit, he was diagnosed with recurrent severe major depressive disorder with psychotic features. Additional problems diagnosed were social withdrawal and minimal verbal communications. It was during this psychological evaluation that Andrea Yates admitted to having thoughts of harming herself or someone else.

Eileen Starbranch, MD, Court TV, Psychiatric Evaluation July (1999) On August 5, 1999, Dr. Starbranch along with Dr. Arturo Rics, MD, had a consultation regarding Andrea’s ongoing care. The findings of this consultation revealed that the onset of her depression began about six weeks earlier along with symptoms of psychosis. Much of the documentation reviewed by both doctors indicated that Andrea remained withdrawn, cautious, and still had a persistent depressed mood. Eventually, Andrea responded to some degree to her medication, but Dr. Starbranch warned her not to have another child, as this could trigger another psychotic episode.

Dr. Arturo Rics, MD, Dr. Starbranch, MD, Methodist Hospital Psychiatric Center Julio (1999) Another psychiatrist, Dr. Melissa R. Ferguson, former medical director of psychiatric services at Harris County Jail, testified to that, in his opinion, Yates suffered from psychosis. According to Dr. Ferguson, Yates told her that she believed cartoon characters on television were telling her how bad she was for giving her children “too much candy and cereal.” Ferguson also testified that she believed Andrea was incapable of understanding the consequences of what she did. Dr. Milissa, former Harris County Jail Warden.

Andrea Yates had all the classic symptoms of postpartum psychosis. Although medications were administered, there was little supervision to ensure that he followed the doctor’s orders. Her hospital stays were short and therefore ineffective in a medically supervised setting, ensuring that, at best, the possibility of her harmonizing herself or others was minimized enough.

There is absolutely no question in anyone’s mind that Andrea Yates did, in fact, drown her children in a bathtub. There is no doubt that the “how” was too horrible to comprehend. Due to the rarity of this condition and its terrible results if left untreated, many Americans, particularly women, will judge women like Andrea Yates without compassion for the suffering or the effort to learn and understand the disease. What those people should realize is that by understanding this catastrophic disease, you are in no way condoning the actions taken as a result of that disease.

In conclusion, the state of Texas should be applauded for its efforts to recognize this rare, but debilitating and extremely dangerous disease. The Andrea Yates Bill became effective on September 3, 2003 and provides the following:

“Postpartum depression (PPD) is a serious disorder that affects between 10% and 15% of women who have given birth each year. This disorder, despite its high prevalence, often goes undetected and untreated In an attempt to address this public health issue, The State of Texas has enacted a law, House Bill 341 (also known as the “Andrea Yates Bill”), which went into effect on September 1, 2003. This law requires health care providers who treat pregnant women to provide them with information about resources related to counseling for postpartum depression and other emotional trauma associated with pregnancy and parenting.”

Blue Corss/Blue Shield of Texas Postpartum Depression and House Bill 341

References:

BlueCross BlueShield of Texas; Postpartum Depression and House Bill 341

(2007) Retrieved on September 9, 2007 from the World Wide Web:
http://www.bcbstx.com/provider/postpartum.htm

Ferguson, Dr. Melissa R. Former

Medical Director of Psychiatric Services at the Harris County Jail. Retrieved on September 8, 2007
from the World Wide Web: http://crime.about.com/b/a/257021.htm

Roca, Catherine, Chief, Women’s Programs, (2005) Depression during and after pregnancy

National Institute of Mental Health, (April 2005). Retrieved on September 7, 2007 from El Mundo
Broadband: [http://www.4woman.gov/faq/postpartum.htm#5]

The Pregnancy-Info Team, Postpartum Psychosis (2007) Retrieved on September 7, 2007 from the World Wide Web:
http://www.pregnancy-info.net/postpartum_psychosis.html

Starbranch, Eileen, MD Court TV

Retrieved on September 9, 2007 from the World Wide Web:
http://www.courttv.com/trials/yates/docs/gifs/psychiatric6.gif

Williams, Dan Psy.D., PA-C, (2006) Peace and Healing.

Retrieved on September 7, 2007 from the World Wide Web:
http://www.peaceandhealing.com/psychosis/postpartum.asp