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Foetal Abuse Archives of Women's Mental Health (2019) 22:569–573 https://doi.org/10.1007/s00737-018-0922-2 REVIEW ARTICLE Foetal abuse Paula Fernandez Arias1,2 & Keiko Yoshida3 & Ian F Brockington4 & Jennifer Kernreiter5 & Claudia M Klier5 Received: 7 March 2018 /Accepted: 18 October 2018 /Published online: 24 October 2018 # Springer-Verlag GmbH Austria, part of Springer Nature 2018 Abstract Pregnancy and motherhood are often presented as natural and unproblematic for women. The fact that there are some women who engage in violent behaviour towards their unborn child suggests that motherhood is not as unproblematic as we are led to believe. This paper presents six previously unpublished cases of foetal abuse that is physical assaults on the foetus by the mothers themselves, and examines how the prevailing myth of the good mother might be further endangering mothers and their unborn children. So far, the research suggests there are some common, possibly co-occurring, features that might be an antecedent to foetal abuse: unplanned pregnancies, prior mental health issues in the mother, trauma, pregnancy denial up to 20 weeks or until birth, and ideation of harm correlated to in utero movements. Keywords Foetal abuse . Pregnancy . Pregnancy denial . Motherhood . Neonaticide . Childhood abuse Introduction foetal abuse is to indirectly examine the prevailing cultural understanding of motherhood. While child abuse is a concept that has been broadly Given the limited research focusing exclusively on foetal recognised, and well researched, since the 1960s, the same abuse, this paper incorporates research done on anonymous cannot be said about foetal abuse. To many, the idea that an birth and pregnancy denial given the similarities between expectant mother would think about causing harm to their them. So far, the research done has shown that there are some unborn child, let alone actually doing so, is an unfathomable common features that might be an antecedent to foetal abuse: idea (Kent et al. 1997). A concept such as foetal abuse trans- unplanned pregnancies, prior mental health issues in the moth- gresses all traditional cultural and societal norms regarding er, trauma, pregnancy denial up to 20 weeks or until birth, and femininity, motherhood, and the ‘natural order of things’. ideations of harm correlated to in utero movements. These Feminist scholarship has long argued that western notions of features can but need not be co-occurring. intensive mothering are unrealistic, detrimental to women, and often used to further the surveillance of female bodies (Rich 1986). Arguably then, to examine the phenomenon of The good mother Motherhood, like all other social norms, is culturally con- structed and perpetuated through social institutions (Feasey * Paula Fernandez Arias 2013). Sinai-Glazer (2015) identifies six dimensions that [email protected] make up the ‘good mother myth’: idealisation vs. demoniza- tion; expectation of unconditional maternal love; motherhood 1 Society & Health Research Center (CISS), Universidad Mayor, as natural and instinctive to every woman; mothers as objects; Santiago, Chile the mother as an asexual woman; and exclusive responsibility 2 Monash Deakin Filicide Research Hub, Department of Social Work, for a child’s welfare and mother blaming. Given the focus of Monash University, Melbourne, Australia this paper, we are particularly interested in the ‘expectation of 3 Iris Psychiatric Clinic, 3-4-28, Sakurazaka, Cho-ku, Fukuoka, Japan unconditional maternal love’ and ‘motherhood as natural and 4 University of Birmingham, Lower Brockington Farm, Bredenbury, instinctive to every woman’. Bromyard, Herefordshire HR7 4TE, UK Sinai-Glazer (2015) argues that mothers are expected to 5 Department of Paediatrics and Adolescent Medicine, Medical love their children always and under every circumstance, an University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria expectation that does not extend onto any other kind of 570 P. F. Arias et al. relationship. This idea, she notes, is rooted in the belief that women (8%) occasionally felt that they wanted to hurt or motherhood is Ban integral part of a woman’s personality, punish the unborn child and 11 (9%) men believed their wife femininity, and biological reproduction system^ (Sinai- occasionally felt like hurting the foetus when feeling irritated Glazer 2015, 355). Meanwhile, Feasey (2013) notes that the (Condon 1987, 611). Further to this, he also found that 21% of emergence of the good mother myth was a response to women felt a mixture of tenderness and irritation towards with women’s growing economic and social independence, unborn child (Condon 1987). increased participation in the labour force, and entry into Kent et al. (1997) describe five cases where women traditionally male arenas. The ill effects of this myth have physically assaulted themselves while pregnant. They not- been reported in studies examining the correlation between ed that the most common form of abuse was punching their the public discourse of motherhood and the rise in stress abdomen as a response to foetal movements. Kent et al. levels, social isolation, and anxiety disclosed by mothers (1997) also note that all five women in their sample were (Henderson et al. 2016), particularly in the USA. depressed and had comorbid anxiety. Further to this, four of the pregnancies were unplanned and the women had Foetal abuse considered a termination and were generally ambivalent about their pregnancies throughout. None of the women Perhaps the first mention of foetal abuse is in Oppenheim’s had any alcohol or drug abuse issues. (1919) article on Misopädie (hatred of children) where one of Pollock and Percy (1999) found that negative preoccupied the mothers in his study (case five) threatened to drive a nail maternal antenatal emotional attachment (MAEA) was asso- into the foetus. While this physical, and extreme, form of ciated with increased likelihood of reported irritation with the foetal abuse has not been extensively researched, considerable foetus; however, none of the 40 pregnant women reported the resources have gone into examining the impact of other fe- intention to harm the foetus. However, as Brockington et al. male behaviours classified as foetal abuse, one such example (2006) has discussed, relying on self-reporting might under- is women’s drug and alcohol consumption during pregnancy. estimate the prevalence. When two postpartum bonding ques- This form of foetal abuse became well known during the tionnaires were compared Wittkowski et al. (2007) found that 1990s when the effects of in utero exposure to drugs and the Postpartum Bonding Questionnaire was unlikely to iden- alcohol were turned into a public health issue that dispropor- tify risk for abuse in postpartum women. Brockington et al. tionately impacted on women’s lives (Schroedel and Peretz (2006) studied over 120 mothers, all referred to mother-infant 1994). psychiatric services, from Birmingham (UK) and Likewise, as public awareness of the prevalence of domes- Christchurch (New Zealand) using the 2-hour Birmingham tic violence increased, a small number of publications dealing Interview. Two New Zealand mothers had impulses to abuse with the impact of intimate partner violence on pregnant wom- the foetus and two Birmingham mothers did. Foetal abuse en deployed the idea of foetal abuse to describe the outcomes predicted rejection of the child (relative risk 3.0, p < .001) of physical violence against pregnant women. Most notorious- and pathological anger towards it (relative risk 4.0, p =.007). ly, Pugh (1978) published a small piece inquiring why the Pregnancy denial, similarly to foetal abuse, defies general- battered foetus was not an issue comparable to the battered ised belief however, as Sandoz (2011) points out, there might baby. Pugh (1978) asserted that physicians needed to pay be physiological reasons women do not present as pregnant to more attention to signs, such as bruising of the abdominal themselves or their environment. Sandoz (2011)arguesthat wall, during antenatal visits that might indicate that the expec- the silhouette effect, women who are pregnant but do not have tant mother was subjected to physical violence. the correct shape, is due to the conscious mind not knowing This paper, however, is concerned with assaults on an un- about pregnancy and therefore not generating the correct born child done by the mother herself. This form of foetal physiological response, what he terms a cybernetic disorder. abuse has been most neglected by researchers as it presents This persistent state of denial is also aided by the fact that the considerable challenges. Condon (1987; 1986) has, perhaps, foetus is horizontal (Seigneurie and Limosin 2012). Once the produced the most comprehensive foetal abuse research. woman is given proof of her pregnancy, the body almost in- Condon (1986) found that when ‘specific inquiry’ was made, stantly takes on the expected shape and symptomatology of the impulse to harm the foetus was not an uncommon thought pregnancy. Kenner and Nicolson (2015) conclude that trauma among pregnant women. He described three foetal abuse plays the most important role in pregnancy denial. In their cases where the women had either been victims of abuse as review of the research, they found no substantive evidence children or had dysfunctional relationships as adults (Condon that rejection of parenthood was the underlying motivation 1986). Condon’s main concern was to identify if foetal abuse for denial. They
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