The case of a Timaru woman convicted of murdering her three daughters has been “triggering” for some mothers and may reinforce stigma around women struggling to cope with parenthood, experts say.
Lauren Dickason was yesterday found guilty of murder. She had admitted killing Liané, Maya and Karla, but denied the murder charge on grounds of infanticide and insanity.
The case has brought issues around perinatal depression and anxiety, in pregnancy and after giving birth, to the surface and many mothers feel there is a general lack of understanding of what that really looks and feels like.
Kristina Grace, founder and general manager of Mothers Helpers, a charity that supports mothers experiencing stress, said coverage and reaction to the case has been difficult for some.
“Many of our mothers are triggered by the insensitive and judgmental comments on social media towards Lauren Dickason,” said the registered social worker, former nurse and trained counsellor.
“Some even feel the attitudes they have read take New Zealand backwards in terms of stigma towards mental health, and particularly maternal mental health, where mothers feel this expectation that they should be ‘coping’ and ‘enjoying’ motherhood and a lack of understanding of just how difficult the reality of it can be.”
Another expert in the field, Dr Sophie Mace, agreed it has been a difficult time. The GP specialising in maternal and infant mental health in Motueka said: “There are actually many issues at play, including the voyeurism of the media coverage of this case, the lack of support many pregnant people receive, and societal expectations of mothers and parents which can directly lead to increased risk of perinatal anxiety and mood disorders.”
Complex case
At the time of the killings, Dickason and husband Graham had just emigrated from South Africa to New Zealand and the court heard the context to her actions were complex. She described feeling stressed and overwhelmed during the immigration process, which included the family being in managed quarantine when they arrived during the Covid-19 pandemic. It emerged she had also battled with depression and anxiety and had suffered through a lengthy process of IVF.
In 2013, on the seventh round, she conceived but miscarried at 18 weeks. Her three children were eventually conceived through donor eggs.
Grace said many mothers feel like there is a general lack of understanding of what perinatal depression and anxiety really looks and feels like.
She said some mothers are worried and frightened that if they express distress people will automatically think they will hurt their baby.
“One mother said she's even afraid to talk to her husband in case he thinks that she's at risk of hurting their children.”
She said one in eight women will experience depression or anxiety during pregnancy and one in five post-natally. “It’s now referred to as perinatal depression or anxiety (PNDA) – which refers to pregnancy and the first-year post-partum.”
Grace said there were compounding issues Dickason had faced which increased her risk factors.
“She had a previous history of depression, she had difficulty conceiving and then IVF treatment, she had a miscarriage, she had multiples (twins), she had babies during the Covid pandemic and she was a new migrant.
“New migrants have a high rate of PNDA - up to 30% of new migrant mothers’ experience PNDA. Apart from the stress of moving to a new country and new community, they are usually leaving behind their support network and extended family while also adjusting to significant change in an unfamiliar place.”
According to Grace, previous depression is the strongest risk factor. “We are seeing a lot of mothers who have longed for a baby and had trouble conceiving, receiving help from IVF only to find motherhood to be extremely stressful and then experience guilt that they're not enjoying it. We had a huge increase of birth trauma and depression and anxiety amongst mothers during the worst of the Covid pandemic.”
She said this is because mothers were often separated from or experienced reduced support from their partner and families as well as in-person support from midwives and other maternity clinicians. “This reduced support has not fully recovered yet.”
Common symptoms
She said some of the common symptoms of PNDA are tearfulness, low mood, irritability and anger, not enjoying things they used to enjoy, and difficulty concentrating. Difficulty with sleep - either sleeping too much or having trouble getting to sleep and staying asleep even when their baby is sleeping can also happen. Affected mothers can also experience poor appetite or overeating, low energy and low motivation.
Other risk factors include intimate partner or family violence, poor family support, breastfeeding issues, and less than five hours unbroken sleep that is prolonged.
“As you can see - most mothers will have some of these risk factors. The perinatal stage is a time where a woman or birthing person will be most vulnerable to developing depression and anxiety.”
But she believes infanticide in New Zealand is rare. “Most mothers in these cases want to die but have the delusion that it would be better for their children to die also and see it as a mercy which is part of the psychosis,” Grace said.
“Severe untreated depression can lead to psychosis. Since [Lauren Dickason] stopped taking her medication one month before killing the children, it is very possible that she developed psychosis and this was the opinion of the psychiatrist for the defence.”
Grace said what is more common is the thought a mother may have of harming herself or her child.
“Those thoughts are common and the vast majority won't act on it. It's really important that mothers know how common those thoughts and feelings are and that if they are honest about it, they will get help rather than fearing that their children will be taken away from them, which is often why they keep their silence.
“I want to reassure mothers that in my 13 years of working in this field, it is extremely rare that Oranga Tamariki get involved with our clients - maybe a handful out of hundreds and hundreds that come to us every year. It's so important that mothers feel that it's safe to reach out for help.”
Grace believes funded therapy is key to increasing support for mothers, to mitigate the risks posed by perinatal depression and anxiety.
“Especially following what has been years of reduced support and heightened anxiety since the Covid pandemic.”
Moderate to severe mental health issues
Karla Bergquist, Te Whatu Ora’s Mental Health and Addiction lead, said women who are pregnant or have a baby under one and are experiencing moderate to severe mental health issues may be referred to specialist maternal mental health services.
“Referrals can be made by GPs, lead maternity carers or other health professionals who are caring for pregnant women or new mothers experiencing symptoms of mental illness. Once the referral from a health professional is accepted, the service will arrange a time to meet and carry out an assessment.”
She said if specialist mental health support is assessed as most appropriate to help a pregnant woman or new mother, a plan will be developed outlining the care and treatment required. Partners and whānau are encouraged to take part in developing the plan with their loved one.
“The maternal mental health team will then work with the woman and her whānau to consider a range of treatment options, including individualised or group support, therapy and medication, alongside other health care providers such as their family doctor or other services they may be receiving care from.”
GP Mace believes there are significant barriers to receiving good perinatal care.
She said support varies depending on where someone lives, and some patients, especially Māori and Pasifika, receive less support for perinatal mental health difficulties.
“One major issue is that in order to get support, the parent or whānau must recognise there is a problem, feel comfortable asking for help and then this bid for support be received well by their healthcare practitioners who can then refer on. Each of these steps can introduce significant barriers.”
What help is available?
At Mothers Helpers, women are assessed free of charge ahead of a potential care plan.
“This ensures they don't fall through the cracks even if they don't want our service, we can refer them to the right places,” Grace said.
A mother can check whether she might have depression/anxiety by checking her Edinburgh score.
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