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Denial of pregnancy and neonaticide: A historical overview and case report
Authors:Sara Sablone MD  Anna Margari MD  Francesco Introna MD  Roberto Catanesi MD  Gabriele Mandarelli MD  PhD
Affiliation:1. Interdisciplinary Department of Medicine, Section of Legal Medicine, Bari Policlinico Hospital, University of Bari “Aldo Moro”, Bari, Italy;2. Interdisciplinary Department of Medicine, Section of Criminology and Forensic Psychiatry, University of Bari “Aldo Moro”, Bari, Italy
Abstract:While denial of pregnancy and neonaticide are rare, they are potentially associated and share some risk factors. Neonaticide has been proposed as the extreme outcome of a denial of pregnancy. However, the process leading to such a possible outcome is not yet fully understood. The primary goal of this essay is to examine the various definitions and ambiguities surrounding the denial of pregnancy. The case of a young woman with a history of two denied pregnancies with diverse characteristics and outcomes, the latest of which resulted in neonaticide, is then reported and examined. A forensic psychiatric evaluation was also performed to reconstruct the woman's mental state at the time of the crime. The forensic pathological analysis of the newborn, abandoned near the sea while still alive, is described. The victim's body showed signs of shaken baby syndrome. We contend that differing levels of awareness during a denial of pregnancy might not be predictive of the potential delivery outcome in terms of threat to the newborn's survival, according to the forensic pathological and psychopathological data of the current case. Early identification of women affected by denial of pregnancy who pose a danger of committing infanticide is hampered by both intrinsic traits (dissimulation, unawareness, low propensity to seek assistance) and environmental factors (isolation, low socioeconomic level, poor education.). A previous history of denial of pregnancy should activate health and support services to reduce the potential risks for the mother and the child.
Keywords:acute dissociative reaction  borderline personality disorder  denial of pregnancy  neonaticide  newborn skull fractures  shaken baby syndrome
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