When Illness Becomes Guilt

Postpartum psychosis is not an independent criminal defense in the United States. A mother must satisfy the insanity or lack-of-criminal-responsibility standard of the jurisdiction in which she is prosecuted.

Those standards and burdens of proof differ by jurisdiction. Under Massachusetts law, once criminal responsibility is properly raised, the Commonwealth must prove beyond a reasonable doubt that the defendant did not have a mental disease or defect or that the condition did not cause her to lack substantial capacity either to appreciate the wrongfulness of her conduct or to conform her conduct to the requirements of the law.

In Massachusetts, a finding of not criminally responsible means that the Commonwealth failed to prove criminal responsibility beyond a reasonable doubt. In other jurisdictions, including California and Texas, insanity is an affirmative defense that the defendant must prove by a preponderance of the evidence. That difference in the allocation of proof can itself affect whether maternal mental illness results in acquittal or conviction.

A jury may believe that a mother was profoundly ill and still find that she failed to satisfy the applicable legal test. A finding of not criminally responsible does not deny that the mother killed her children or diminish the value of their lives. It determines that the legal requirements for imposing ordinary criminal responsibility were not satisfied.

Applying the legal standard requires jurors to decide what severe mental illness looks like, how a “real” victim behaves, and whether the defendant’s psychiatric explanation is credible. Those decisions are vulnerable to racialized beliefs about motherhood.

White motherhood is culturally associated with innocence, devotion, vulnerability, and private tragedy. Black motherhood has been shaped by slavery, coerced reproduction, forced family separation, myths about neglectful and welfare-dependent mothers, and continuing surveillance by hospitals, police, and child-protective agencies.

The question is not limited to whether an individual juror consciously dislikes Black women. The more difficult question is whether the image of a loving mother overtaken by mental illness attaches more readily to a white woman than to a Black woman.

Several cases involving Black mothers illustrate the problem.