Authorities in my town announced today that they have charged a 26-year-old woman with homicide in the death of a baby boy found inside a restaurant’s toilet tank. She admitted that after giving birth, she wrapped the boy in a plastic bag and left him in the tank to suffocate.

 Afterward, she went outside to smoke and then returned to join her oblivious companions to finish watching a televised tournament. No one even knew she was pregnant. She now could face the death penalty.

This incident sparked quite a reaction, not just that a mother killed her baby, but also her apparent callousness about leaving him where she did and then resuming her evening out.

The investigators could not explain it.

I once interviewed one of the foremost experts on child murder, Dr. Philip Resnick, who has testified in several high profile trials, including the Andrea Yates trial in Texas (a mother who drowned all five of her children). He teaches at Case Western Reserve University School of Law and is Director of the Division of Forensic Psychiatry at the CWRU School of Medicine, as well as Director of the Court Psychiatric Clinic at the Justice Center in Cleveland, Ohio.

In 1969, while Resnick was still a resident in psychiatry, he treated two women who had murdered their children. Curious, he reviewed the literature on this subject from as far back as 1751 (getting a grant to have papers in thirteen languages translated) and published what would become the seminal article on the phenomenon of child murder by parents.

Resnick examined 131 cases (88 mothers and 43 fathers), and divided them into two basic types: the killing of an unwanted neonate and the killing of a child with a clear place in the family. He coined the term, neonaticide, for the former and defined filicide as taking place at least twenty-four hours after birth. Our case here is a neonaticide.

Among the cases, he described a man who had drilled a hole through his son’s heart, a woman who thought her child was shrinking, and woman who tried taking her daughter with her off a cliff. Neither was killed, but the mother realized that her daughter would have terrible scars if she survived, so she tried choking the girl. When this did not work, she picked up a rock and bludgeoned her to death. During therapy sessions, she described unexpressed anger she felt toward her own mother.

Using the known cases, Resnick designed a classification system according to motive: altruistic, acutely psychotic, unwanted child, accidental, and spouse revenge. He also explored the psychodynamics of filicide as displaced aggression and offered some warning signs.

In a later report, Resnick showed that the filicide rate had risen dramatically. Between 1976 and 1985, 384 filicides were reported on average every year, with young children at the greatest risk. The older they were, the more likely the father would be the fatal parent.

Resnick noted that a release of tension accompanied many incidents. He added that while assessing murder in response to alleged command hallucination, the treating physician should always consider the possibility of malingering. Resnick described a study of twenty women who were adjudicated not guilty by reason of insanity. Most of them were suicidal and/or delusional, and tended to view the deceased child as defective, in need of saving from a terrible future fate, or demonically possessed. Few had attempted to conceal their crime.

One study indicates that neonaticidal mothers are generally between 16 and 38, but about 90% are 25 or younger. Less than 20% are married and less than 30% are psychotic or depressed (the studies are inconsistent on this number). Most are single, without resources, and have hidden their pregnancy from others. They usually give birth alone and dispose of the baby as quickly as possible, wherever they are (like our case).

It’s likely that, unless there’s a plea deal in this toilet tank incident, the case will become an issue of mental defect or disease. One could argue that placing a child into a toilet tank in a public place shows a lack of awareness, but it could also just be sheer ignorance, even indifference. The post-incident behavior suggests the latter.

For now, there are many questions. Even with comprehensive research on neonaticide and its reasons, it’s still a startling act that makes us demand answers.