Mental Health Awareness and my thoughts on "Baby Doe" cases

May is Mental Health Awareness month, and today I am opening the conversation about a hidden issue that affects millions of Americans and others around the globe. This was a painful post to write as it brought up difficult memories from my past professional work.

The first six years of my post-graduate school career were life-changing; these were the years I worked with girls, women, and families as a prenatal genetic counselor. I emphasize GIRLS any time I mention women throughout this post because many of the pregnant patients I worked with over the years were under age 18, the youngest being a child of age 12 whom I will write about further in a moment.

The issue I’d like to focus on today is that of the mental health of girls and women during pregnancy and the neonatal and post-partum periods. This should be a relevant topic every day, not just during an awareness month. But in light of recent changes to abortion laws in some U.S. states and the use of genetic genealogy to locate and make arrests in Baby Doe cases, it is becoming a relevant topic on which I can no longer remain silent.

I have not written about this topic before because I was not sure how to put words to my thoughts or which stories to share. My work with girls and women in high-risk pregnancies taught me about the realities of this period of life, a time which is grim for so many people. Many girls and women are faced with a pregnancy in a time and place where they do not have resources, emotionally or otherwise. Many are not safe, have no one to trust, and are not supported. Many girls and women struggle with their health, both mentally and physically, during and after a pregnancy. I will share some of my memories here before I share my thoughts on genetic genealogy applications on Baby Doe cases.

I remember sitting across from a teenage girl who had survived a suicide attempt by a bottle of pills after learning she was pregnant. She had no support, no one she could trust. My task as a genetic counselor on the team of care providers was to discuss with her the potential side effects on the baby from the pills she had taken. It was a pill that could lead to bleeding and birth defects depending on the gestational age of the baby when it was taken. We couldn’t be sure how much exposure the baby had before her stomach was pumped; the best we could do was watch and wait and observe how things were going with the baby using ultrasound. The grief on her face and the sound of her voice as she spoke to me and answered my questions will stay with me for life. I lost track of her as is what happens frequently for patients who visited our office only one time, but I still think about her regularly. I trust that the social worker who was involved and her doctor continued the support, but the reality is resources for people with mental health issues are limited, and available funds and resources continue to be slashed.

I remember a 12-year old girl I once sat in a room with who wore sparkly sneakers and a puffy vest -- it was either pink or purple, that part is fuzzy in my memory. She sat curled up in a chair in the room, a tiny belly jutting out between her knees. She was expecting a baby and it was not of her choosing. She was small and immature for her age, no bigger than most 9- or 10-year olds. I was still a genetic counseling student at the time of this encounter, so the genetic counselor I was shadowing did most of the communicating that day. The genetic counselor spoke with the young girl and her mother about the ultrasound she would be having. The mother discussed her own grief and devastation about what had happened to her daughter. She felt fear for her daughter and found it difficult to have to be seen in a high-risk OB clinic and to answer the questions we had to ask of them.  

I remember a woman I spoke with through a translator who had recently immigrated to the area, sponsored by a church-based program for refugees. She came from an ethnic minority group and had sought asylum to escape a war in her home country that was decimating her ethnic group. She attended the medical appointment alone, even though she lived with her husband and a mother-in-law. Like the teen I mentioned earlier, this woman had recently attempted suicide and survived. The trauma of war, the move to the states, and a pregnancy she had not chosen must have been overwhelming. I remember she did not answer many of my questions but instead sat there for most of the session, still and silent. My job was to discuss the possible effects of the pills on the baby, and we again, could not be sure what they would be. I think about her a lot, too.

I remember another woman who described her severe clinical depression to me openly and with clarity. She was 14 years out from a tubal ligation when she learn to her devastation that the procedure failed; she was unexpectedly pregnant with a chaotic house full of teens. None of them were doing well. She told me not to bother with any optimism, she did not see any silver lining to her situation. I must have made a naive comment about considering the choice of adoption, because I recall clearly that she said that for her, adoption for the baby was out of the question; it would only create more trauma and would not be a solution.

I remember a woman who described to a room of us in an in-service training about care for patients with post-partum depression that she had developed psychosis in her first pregnancy. She described feeling so ashamed that she told no one about her symptoms. Not her doctor, not even her husband. Once her baby was born, the psychosis worsened to the point that she could not go near him or pick him up as doing so would trigger visions inside her head of grabbing a knife and stabbing the baby over and over. If I’m remembering this part correctly, she had been a school teacher up to the point she delivered her baby. If it wasn’t school teacher, it was a similar job because she explained that she had always loved children and had been confused by her acute mental illness. How could it be possible that someone who loved children could have visions of stabbing one? Her pregnancy was wanted and planned; she and her husband had a good marriage. And yet, she had been terrified to tell him about the intrusive thoughts from fear that they would lose custody and never see their child again.

These are only a few of the stories of girls and women I carry with me every day. Many girls and women have life experiences most people will never be forced to confront. Many people will never even try to understand their experiences.

This brings me to the point of my thoughts about Baby Doe cases—when law enforcement investigates the discovery of a deceased newborn who has been abandoned—and the use of resources to find and prosecute girls and women implicated by the discovery based on DNA evidence.

Do you understand how it comes to be that Baby Doe cases exist? Because I do.

If you cannot understand how the tragedy of a Baby Doe happens, you are not listening.

I have already shared my thoughts about the slippery slope of forensic genealogy started by Baby Doe cases with Wired Magazine. I accept the fact that I won’t be able to stop law enforcement from doing what they will do to identify and arrest girls and women implicated by Baby Doe cases, whether that is using a CODIS database or databases created for the genetic genealogy community. And I was okay with the use of genetic genealogy databases for forensic genealogy searches for solving murders and capturing violent criminals on the loose who might still be endangering lives. But Baby Doe cases are different.

Sharing the stories above is my effort to help you to understand the circumstances of girls and women when they are pregnant and in distress. They are often young, sometimes children themselves. They might have been raped by a boyfriend, a male relative, or a stranger. They might have been in denial or unaware of being pregnant. In more cases than not, the girls and women were likely suffering from unrecognized and untreated mental health issues (which likely continued on, perhaps further worsened, after the delivery).

They might have had someone to trust but probably not. They likely had no place to turn where they felt safe.

If you are in the media, I ask you to please watch your words when you report on Baby Doe cases, and readers, be aware of click bait reporting. This is an example of reporting on a Baby Doe case and this is an example of something written about a Baby Doe case to generate clicks and to incite the public. In recent years, the media have changed the way they cover suicides and are attentive to the language they use to report on these cases. Readers who are from the media, please develop similar guidelines and protocol for coverage of Baby Doe cases. Look to the way other countries handle cases in the courts and in media coverage, thoughtfully and with acknowledgement of mental health issues and extenuating circumstances.

We cannot prevent future neonaticides and we cannot prevent future Baby Doe cases if we do not change the world and society for girls and women. We cannot fix this if we do not turn attention and resources to mental health services for all, especially girls and women in distress.

A few ways we can make a difference are by:

  • Understanding so many of these situations are the result of systemic problems and the failure to provide both sufficient protection and safety nets for girls and women in distress

  • Increasing the support for screening and providing free mental health services for girls and women, especially pre- and post-natally

  • Supporting the mental health needs of those who were the discoverer of a Baby Doe. These individuals likely carry the memory of the moment they discovered the baby’s body as a traumatic memory and possibly have developed PTSD from the experience. Support them, too.

  • Supporting the mental health needs of those who work in law enforcement. Working on these cases day after day, week after week, year after year must take a psychological toll. Baby Doe cases are tragedies for every person involved. Support these individuals, too. 

  • Supporting the mental health needs of girls and women who are later identified as mothers of Baby Does. Do not judge them as guilty on social media, and do not call them murderers and killers. To do so is to paint a complex situation as black and white.

  • Recognizing that criminal justice reform is needed to focus on restorative justice and rehabilitation rather than incarceration.

  • Advocating for resources to be focused on processing the deep backlog of rape kits and prioritizing those cases over Baby Doe cases. Solving recent and past rape cases could lead to the arrests of people who are continued hazards to society.

Some day, you might be called to serve on a jury for a Baby Doe case, and I want you to remember what I wrote today.

If you are a genetic genealogist or member of law enforcement working on solving these cases, remember what I wrote today.

Realize that “justice” for one or a few Baby Does will not fix the circumstances that lead to a woman giving birth to a stillborn baby in private or abandoning her newborn infant to die. “Justice” under the current system turns a girl or woman who was alone and in distress at the birth of her baby into a criminal, if not legally then at minimum within their family and society.

Neonaticides are not isolated traumas. They are not singular events or evidence of “evil” women. These are tragedies, often one in a long line of serial tragedies, for the girls and women involved.

If you don’t see this, open your eyes and find compassion somewhere in your heart, even if you have to dig to find it.