Arch Womens Ment Health (2016) 19:291–297 DOI 10.1007/s00737-015-0567-3 ORIGINAL ARTICLE Anonymous birth law saves babies—optimization, sustainability and public awareness Chryssa Grylli1 & Ian Brockington2 & Christian Fiala3 & Mercedes Huscsava4 & Thomas Waldhoer5 & Claudia M. Klier1 Received: 5 April 2015 /Accepted: 30 July 2015 /Published online: 13 August 2015 # Springer-Verlag Wien 2015 Abstract The aims of this study are to assess the impact of neonaticides. The subsequent significantly decreasing num- Austria’s anonymous birth law from the time relevant statisti- bers of anonymous births with an accompanying increase of cal records are available and to evaluate the use of hatches neonaticides represents additional evidence for the effective- versus anonymous hospital delivery. This study is a complete ness of the measure. census of police-reported neonaticides (1975–2012) as well as anonymous births including baby hatches in Austria during Keywords Anonymous birth . Baby hatches . Neonaticide . 2002–2012. The time trends of neonaticide rates, anonymous Child abandonment legislation births and baby hatches were analysed by means of Poisson and logistic regression model. Predicted and observed rates were derived and compared using a Bayesian Poisson regres- sion model. Predicted numbers of neonaticides for the period Introduction of the active awareness campaign, 2002–2004, were more than three times larger than the observed number (p= The day of birth is the day in which an individual runs the 0.0067). Of the 365 women who benefitted from this legisla- highest risk of being murdered. The term ‘neonaticide’ has tion, only 11.5 % chose to put their babies in a baby hatch. replaced the old term ‘infanticide’ to denote the murder of a Since the law was introduced, a significant decreasing tenden- baby within 24 h of its birth, while ‘filicide’ (also previously cy of numbers of anonymous births (p=047) was observed, called ‘infanticide’ or sometimes ‘family murder’)isnow while there was significant increase of neonaticide rates (p= used for the parental killing of a child up to the age of 18 years 0.0001). The implementation of the anonymous delivery law (Resnick 1970). One can distinguish between ‘customary is associated with a decrease in the number of police-reported neonaticide’, which in some cultures was an accepted means of population control, from ‘anomic’ or ‘criminal neonaticide’, which has no social legitimacy, but results from the panic or fury of a woman who has in despair concealed or * Chryssa Grylli denied her pregnancy and has consequently given birth secret- [email protected] ly (Friedman and Resnick 2009; Craig 2004). This used to be a common crime and was considered a 1 Department of Pediatrics and Adolescent Medicine, Medical major public health problem. In the 1780s, a judge in University of Vienna, Währinger-Gürtel 18-20, 1090 Vienna, Austria Mannheim, Germany, gave a prize for an essay on the 2 University of Birmingham, Lower Brockington Farm, Bredenbury, prevention of this crime, which was won by Pfeil (1788) Bromyard, Herefordshire HR7 4TE, UK who suggested 38 different solutions (Ulbricht 1990; 3 GynMed, Clinic, Mariahilfer Gürtel 37, 1150 Vienna, Austria Michalik 1997). In the twentieth century, as rates of this crime 4 Department of Child and Adolescent Psychiatry, Währinger-Gürtel were already dropping, sociologists and psychologists began 18-20, Vienna 1090, Austria to study the social background and motives of women who 5 Department of Epidemiology, Center for Public Health, Medical were perpetrators. Gleispach (1907) found that almost half University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria were illiterate. Gummersbach (1938), who wrote a series of 292 C. Grylli et al. papers in the 1930s, emphasised passivity in their attitudes baby (Austrian Ministry of Justice 2001). This law allows towards sexual exploitation and pregnancy. mothers to give birth in any hospital anonymously and Today, despite contraception, widespread legalisation of free of charge or to place the baby in a baby hatch without pregnancy termination procedures, toleration of single moth- risking criminal prosecution for abandoning it. The mod- erhood and provision for social welfare benefits, this crime ern hatch is an incubator at the outer wall of a hospital, has not been contained. where the baby can be left, whereupon a signal is given to In the modern literature, Bonnet (1993) conducted 22 psy- the staff to collect it. The introduction of the new law in choanalytic interviews with women who used the anonymous Austria was followed by a public awareness campaign. birth law in France, including four who killed their babies. Women are also encouraged to attend ante-natal care According to her analysis, relinquishment resulted primarily anonymously at a hospital as early as possible, so that from a combination of psycho-dynamic rather than socio- the mother can receive free counselling and social service economic factors: for example, traumatic experiences such support. A child born anonymously or placed in a baby as rape and/or incest, fear to act out negative feelings, failure hatch becomes the responsibility of the child welfare au- to act at the right time, violent fantasies and finally denial and thorities and is put up for adoption. It remains in hospital despair were the most important factors in both groups of until an adoptive family is found. mothers she studied (Bonnet 1993). In Austria, this only lasts a few days given the waiting list In a previous study where national registers were used to for adoption. The biological mother has the right to reclaim examine all neonaticide cases occurring in Austria and her child at any time up until the completion of the adoption Finland in 1995–2005 (Amon et al. 2012), unwanted pregnan- process, which usually takes several months. She is also en- cy, concurrent with denial or deliberate concealment, was couraged to leave information about herself that the child may identified as a potential predictor of neonaticide, while fear have access to in the future (Anonymous Birth as an emergen- of abandonment by the partner, close family members and cy solution 2013). Official municipal or regional web pages friends were identified as predominant motives. Unlike fili- clearly state that the mother should leave some information for cide, the crime of neonaticide is committed at a moment of the child, invite her to come into care as soon as pregnancy is emotional crisis, most of the time without evidence of mental detected and make it clear that she can decide after birth if she illness, such as psychosis or depression (Amon et al. 2012). would like to remain anonymous. There is an increasing trend Neonaticide can be relatively easily concealed, and most (up to 40 %) of mothers who decide at a later stage to make perpetrators are never found; it is safe to assume therefore that themselves known and either opt for a conventional adoption the recorded cases represent only the tip of the iceberg. In or live with the child (Orthofer and Orthofer 2013). most countries, neonaticide is not defined as a distinct crime, Interestingly, anonymous birth was made possible in and coroners’ reports are often inconclusive (Marcikic et al. Austria as early as 1784 when Emperor Joseph II opened the 2006; Baralic et al. 2010; Tursz and Cook 2011). These factors General Hospital in Vienna and included an obstetric clinic make research and assessment of preventive measures partic- with an adjacent foundling hospital where mothers could ularly difficult. leave their infant after birth without disclosing their identity A number of countries have introduced legislation to ad- (Pawlowsky 2001). The mortality rate of these children was dress this issue. In France, many laws and regulations have initially as high as 100 % in the nursery or at the foster homes, been implemented in the past 50 years (Bonnet 1992). The but greatly improved over time. Although as many as 100 most recent in 2002 concerned the establishment of a national births per month were recorded, this practice was stopped in council to regulate the exchange of information and facilitate 1910 due to lack of funding. encounters, in case the mother later decided to disclose her In 1974, neonaticide became a specific crime in Austrian identity (National Council for the Access of Personal Origins law (§79 Austrian Penal Code 1974). 2013). The effectiveness of the French model has not yet been evaluated. In the USA, there is a so-called ‘safe haven law’ in …A mother, who kills her child during child birth, or as at least 45 of the 50 States, and similar practices have been long as she was influenced by the process of giving introduced in various countries worldwide, such as Belgium, birth, should be punished with one to five years of the Czech Republic, France, Germany, Hungary, India, Italy, imprisonment… Japan, Pakistan, the Philippines, South Africa and Switzerland (Friedman and Resnick 2009), but there are no statistical data Austrian police statistics categorise therefore neonaticide available on the impact of these legal measures on the record- cases separately from homicide cases and therefore recorded ed number of babies abandoned or killed. separately from filicides. For this reason, Austria represents a In 2001, after a number of highly publicised cases, Austria unique opportunity to study the epidemiology of neonaticide enacted a law on Anonymous Delivery/Birth, which also in- and most importantly to assess the impact of the adopted leg- cluded the possibility to anonymously attend ante-natal care islation and other preventive measures. Anonymous birth law saves babies 293 In our first analysis, we demonstrated a significant decrease ensure that the awareness campaign was still active in Austria. in neonaticide rates after the implementation of the new law Rates are given per 100,000 births. (Klier et al. 2013). When comparing to Sweden and Finland, Poisson regression was also used for reported neonaticides we did not find a similar decrease in the same period (1992– in 2002–2012 and for anonymous birth in 2002–2012.