Donald I. Fine, Inc. This 214-page book, consisting of 42 chapters and an epilogue, is an account of a woman who killed her newborn child, unsuccessfully attempted suicide, and was tried for murder. Carl Burak is a psychiatrist and attorney and Michelle Remington is his patient. Remington was found temporarily insane and acquitted. The authors maintain that some 5 million women experience postpartum depression but give no indication of where this figure comes from. The book provides a long and detailed description of the trial in which the mother's experts diagnosed her as depressed and not responsible. Her prenatal care bordered on medical neglect and, after the murder, she was condemned by medical personnel and her community. The mother claimed she heard a voice in her head to get her gun and "do it" (p. 90). The judge (this was a bench trial), after acquitting her by reason of temporary insanity, ordered outpatient treatment despite the recommendation of experts. Postpartum depression is difficult to define since it covers a wide variety of changed and disturbed behaviors, ranging from tears and sadness to suicidal and homicidal feelings. A small percentage of women develop psychotic symptoms, including delusions and hallucinations, and may threaten to or actually injure their child. Williamson (1993), in a discussion of postpartum depression as a defense to criminal behavior, including infanticide, observes that, "While there is general agreement that such a condition does exist postpartum, there is no definitive agreement as to its cause" (p. 163). There are a number of different theories. Williamson also notes that much of the medical community in the United States refuses to accept postpartum depression as a psychiatric illness. These problems with a claimed postpartum depression syndrome trouble the court in this case. This book provides an interesting account of one such case and the response to it by the justice system. Williamson, G.L. (1993) Postpartum depression syndrome as a defense to criminal behavior. Journal of Family Violence, 8, 151-165. Reviewed by LeRoy G. Schultz, Professor Emeritus of Social Work, West Virginia University.
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