When Parents Kill: Two Forensic Cases Reveal Divergent Pathways to Child Homicide

Child homicide committed by a parent is among the rarest and most disturbing forms of violence, yet new forensic research suggests it is far from a single phenomenon. A case report published in Frontiers in Psychiatry by researchers at the Federal University of Rio de Janeiro examines two Brazilian women who killed their children and subsequently underwent forensic psychiatric evaluation, using their strikingly different stories to map out the distinct psychopathological pathways that can lead to such tragedies. The study, led by Renata de Souza Rosa Lima and colleagues, argues that understanding these pathways is essential not only for courts deciding criminal responsibility but also for clinicians trying to prevent family catastrophes before they occur.

The numbers alone are sobering. The risk of becoming a homicide victim is highest during the first year of life, when an individual is roughly four times more likely to be killed than at any other period. Infant homicide rates have been estimated at 4.5 per 100,000 live births in England and 8 per 100,000 in the United States, while a systematic review found neonaticide rates ranging from 0.07 per 100,000 births in Finland to 8.5 in Austria, with figures exceeding 5 per 100,000 in Lithuania and Estonia and reaching 27.7 per 100,000 in Tanzania. The terminology matters clinically: neonaticide generally refers to the killing of a child within the first 24 hours of life, infanticide to the killing of an infant up to one year of age, and filicide more broadly to the killing of a child by a parent. These distinctions are meaningful because the psychiatric and psychosocial profiles associated with each category can differ substantially.

The Brazilian legal context adds a distinctive layer to the analysis. Under the Brazilian Penal Code, a mother who kills her child during or shortly after childbirth may be charged with infanticide when the offense occurs under the influence of the puerperal state, a crime carrying a penalty of two to six years of imprisonment. Homicide, by contrast, carries six to twenty years. The concept of the puerperal state has no direct diagnostic equivalent in the DSM-5 or the ICD-11, which means Brazilian forensic psychiatrists must distinguish between transient psychological phenomena of the puerperium and severe disorders such as schizophrenia or psychotic depression, each with different implications for criminal responsibility. Determining that relationship is one of the most delicate tasks in forensic practice.

The first case involved a 28-year-old single, unemployed woman accused of killing her newborn son. Her pregnancy had been unplanned and concealed from most relatives throughout gestation. She told evaluators she hid the pregnancy because she feared family and social reactions, and because the child’s father refused to acknowledge paternity and became physically aggressive after learning of it. She described an unexpected, unattended delivery during which she lost consciousness, awakening to find the newborn inside a backpack, after which she acted in a confused and fearful manner while attempting to conceal the body. At the forensic examination, she showed no evidence of psychosis, major mood disorder, intellectual disability, or cognitive impairment: she was oriented, her thought processes were logical and organized, and there were no hallucinations or delusions, though she was anxious, emotionally labile, and tearful when recounting the events.

The authors emphasize that this later assessment cannot simply stand in for her mental state at the time of childbirth. The legally relevant question is whether a mental disorder or transient alteration of mental functioning was present at the moment of the offense and whether it impaired her capacity for understanding or self-determination. Her account of an unexpected delivery and loss of consciousness is difficult to interpret retrospectively: possible explanations include physiological loss of consciousness associated with childbirth, acute confusion, dissociative phenomena, severe emotional distress, a brief psychotic state, fragmented recall, or inaccurate retrospective reporting, with malingering another possibility that cannot be inferred solely from the unusual nature of the account. The available records did not provide sufficient corroborating evidence to establish that such a state was present at the legally relevant time, a distinction the authors stress between absence of sufficient evidence and evidence demonstrating that no transient alteration occurred.

Research on pregnancy denial and concealment frames this case. A study by Sablone and colleagues described childbirth following pregnancy denial as an acute psychological crisis in which panic, confusion, dissociative symptoms, intermittent amnesia, and transient alterations in consciousness may occur, and showed that two pregnancies in the same woman with different levels of awareness ended in adoption and neonaticide respectively, suggesting that awareness alone cannot predict outcome. Barnes distinguishes pregnancy denial, in which the woman is unaware of the pregnancy, from pregnancy concealment, in which the pregnancy is recognized but hidden, and argues that both may represent maladaptive responses to overwhelming distress, frequently associated with childhood trauma and dissociative processes. Concealment, the authors caution, should not automatically be equated with premeditation, and Barnes further argues that the absence of pregnancy denial from the DSM may hinder its recognition in forensic evaluations.

The second case followed a very different trajectory. A 21-year-old woman was charged with killing her two-year-old son by repeatedly striking him with a sharp instrument. She had a longstanding history of severe psychiatric illness beginning before the offense, with multiple hospitalizations for psychomotor agitation, aggressive behavior, and psychotic symptoms, including an episode in which she reportedly attempted to kill her older brother. Crucially, she was no longer engaged in regular outpatient psychiatric follow-up before the offense, though the records did not document why treatment had lapsed. During evaluation she was guarded and suspicious, admitted hearing voices that warned her she was in danger and that her son was in imminent danger, and expressed persecutory delusions, at times suggesting that killing her son was the only way to protect him from a fate worse than death. Based on the evaluation and longitudinal history, she met diagnostic criteria for schizophrenia, and the psychotic symptoms were judged directly related to the offense, leading to a finding of criminal irresponsibility and referral for treatment in a forensic facility.

The contrast between the two cases mirrors a well-documented gradient in the international literature. In an early English study of 89 women imprisoned after killing 109 children, only 14 were diagnosed with psychotic disorders, and none of the women who committed neonaticide were considered mentally ill; neonaticide was instead associated with younger age and unmarried status. A Brazilian retrospective study of 53 women accused of killing newborns in Rio de Janeiro between 1900 and 1995 found most were unmarried migrant domestic workers with limited education, and only four of nine women evaluated reported abnormal mental states during the offense. By contrast, among 39 filicidal women found not guilty by reason of insanity, 82 percent had a psychotic or mood disorder, 59 percent experienced auditory hallucinations, 74 percent had delusions frequently involving the child, and roughly half attempted suicide immediately after the filicide. A New York forensic-center study found 63 percent of 57 women who committed or attempted filicide had schizophrenia-spectrum disorders and 30 percent had mood-spectrum disorders.

The report also situates filicide within a broader framework of heterogeneous classifications. Resnick’s classic review proposed five categories: altruistic filicide, in which the parent believes death will protect the child from suffering; acutely psychotic filicide; unwanted-child filicide; accidental filicide arising from abuse or neglect; and spousal-revenge filicide. More recent latent class analysis identified empirically derived groups including Homicidal-Suicidal Fathers, Violent Impulsive Parents, and Prosocial Psychotic Parents, reinforcing that filicide arises through different pathways rather than a single psychiatric condition. Suicidality is a critical dimension: reported rates of suicide following filicide range from approximately 16 to 29 percent among mothers and 40 to 60 percent among fathers, and the combination of severe depression, suicidal intent, psychotic beliefs about the child, and perceived altruistic motivation constitutes a particularly dangerous pathway. Gender differences matter too, with female perpetrators more often associated with unwanted pregnancy, psychiatric disorders, and social deprivation, and male perpetrators more often with intimate-partner conflict, jealousy, and revenge.

The authors conclude with a preventive agenda grounded in perinatal mental health. Psychiatrists, obstetricians, and pediatricians should screen postpartum women for clinically significant psychiatric symptoms, and clinicians must distinguish common, ego-dystonic intrusive thoughts of infant harm, which do not by themselves indicate risk, from homicidal ideation associated with intent, planning, command hallucinations, or delusional beliefs involving the child, which warrant immediate comprehensive risk assessment and possible hospitalization. Treatment disengagement and non-adherence frequently precede violent behavior in severe mental illness, so mental health services must work to prevent loss of contact rather than exclude patients with criminal records from care. Supporting socially vulnerable pregnant women, even those without diagnosable disorders, is equally critical. The authors acknowledge the study’s limitations, including its retrospective design and the unavailability of some clinical and psychosocial information, and call for multicenter, prospective research. Their central message is that filicide is best understood as a heterogeneous outcome at the intersection of psychopathology, psychosocial vulnerability, family relationships, and legal frameworks, and that early identification and continuous treatment of severe perinatal psychiatric illness should be a public health priority.

Subject of Research: Forensic psychiatric analysis of neonaticide, infanticide, and filicide pathways through two maternal case reports

Article Title: Case Report: Neonaticide, infanticide, and filicide — psychopathological aspects and forensic implications

Article References: Lima, R. D. S. R., Schechtman, J. D. B. C., Nardi, A. E., & Valença, A. M. (2026). Case Report: Neonaticide, infanticide, and filicide — psychopathological aspects and forensic implications. Frontiers in Psychiatry, 17, Article 1824900. https://doi.org/10.3389/fpsyt.2026.1824900

Image Credits: AI Generated

DOI: 10.3389/fpsyt.2026.1824900

Keywords: filicide, neonaticide, infanticide, forensic psychiatry, postpartum psychosis, schizophrenia, pregnancy denial, puerperal state, criminal responsibility, perinatal mental health, suicidality, Brazil