Family Matters

In Zahra Baker’s Case, Postpartum Depression Exacted a Heavy Toll

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Maybe it’s because my son has those same disarming freckles sprinkled across his nose, but I can’t stop thinking about Australian-born Zahra Baker. Mine is not a singular preoccupation; judging by the 1.5 million results that Google returned on a search of the 10-year-old’s name, I have plenty of company in trying to figure out how a little kid — and one who battled cancer and lost her leg at the age of 5 — ended up so reviled that someone cut her into pieces.

This week brought news reports that not only was Zahra’s body dismembered and wrapped in a comforter and a car cover for disposal, but she may have been raped as well. Her stepmother, Elisa Baker, is in jail on obstruction of justice charges; she not so smartly penned a ransom note, trying to throw investigators off the trail of the purple- and pink-loving little girl who was reported missing in October. Neither Baker nor her husband and Zahra’s father, Adam Baker, are charged in Zahra’s death, although they appear to be leading suspects.

That someone didn’t want Zahra around is just another mournful yet not unexpected chapter in her life story. Her biological mother, Emily Dietrich of New South Wales, Australia, says a bout of postpartum depression persuaded her to give custody to Adam Baker when Zahra was eight months old. “I never got to say goodbye,” various news outlets reported Dietrich as saying. “I never even got to say hello.” (More on Pediatricians Should Start Screening for Postpartum Depression)

Dietrich says she later regretted the decision and tried unsuccessfully to track down father and daughter. Relying on social networking, she finally discovered Zahra’s whereabouts — a rundown brick home in Hickory, N.C. — three days before her daughter was reported missing.

“I can’t explain the anger, the hurt,” she said. “He had no right to do any of it, to keep her from me.”

What exactly compelled her to give up custody in the first place? Postpartum depression is the most common pregnancy complication, but rarely does it strike so severely that a mom kisses her baby goodbye.

“There are plenty of women who have thought, This isn’t working. I can’t do this. I should give the baby up for adoption,” says Samantha Meltzer-Brody, director of the perinatal psychiatry program at the Center for Women’s Mood Disorders at the University of North Carolina at Chapel Hill (UNC). “Women may think about it in a passive way, but if push came to shove, they absolutely would not do it.” (More on Having Kids, Especially Young Ones, Ramps Up Depression)

In Meltzer-Brody’s experience, relinquishing custody is generally the result of a confluence of circumstances. Although postpartum depression may play a role, it most commonly besets women in their first six months after giving birth. In most cases where women give up their children, substance abuse factors in heavily, and domestic violence can too.

In most cases, there would be a father or grandparents in the mix who would realize the mother needs treatment and help her access it.

“The number of women who are so impaired chronically that they decide to relinquish their role as mother because they’re suffering from postpartum depression would be exceedingly small,” she says. “Most people are not going to feel they need to ditch the kid.” (More on Can Physical Therapy Help New Moms Avoid Baby Blues?)

The few who do can find help at UNC where Meltzer-Brody works, which supports the country’s only inpatient unit devoted to moms battling postpartum depression. Launched two years ago, the five-bed Perinatal Mood Disorders Inpatient Program — which treats pregnant and postpartum women — is full most of the time. As word of the program spreads, patients are coming from far beyond North Carolina to find psychiatrists who avoid prescribing medications that interfere with nursing, a unique policy that allows children, including newborns, to visit the ward (most psych wards allow only kids 12 and older), yoga and counseling focused on anxiety and bonding. The paradigm allows moms to heal in the company of other moms, a stark contrast to other psych units where women struggling with postpartum depression are in treatment in locked units alongside drug addicts, schizophrenics and patients with bipolar or eating disorders.

When they were designing the UNC program, doctors fashioned it after psychiatric units in Europe and Australia that allow babies to room in with their mothers.

Did Dietrich have access to one of those units Down Under? Who knows. “Certainly, untreated depression could make people feel they can not adequately parent,” says Meltzer-Brody. In Dietrich’s case, she observes, “who knows what the backstory is.

“Whatever lingering guilt she feels that she gave up her child,” says Meltzer-Brody,” can you imagine what kind of guilt she’s feeling now?”

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