Denial as Defense? The Criminalisation of Women who Conceal Pregnancy and Birth

Aim: This paper presents a reconceptualization of concealed pregnancy to explore denial of pregnancy as a defense strategy in criminal cases. Background: Women who conceal a pregnancy/birth may face criminal prosecution in... [ view full abstract ]

Aim:
This paper presents a reconceptualization of concealed pregnancy to explore denial of pregnancy as a defense strategy in criminal cases.

Background:
Women who conceal a pregnancy/birth may face criminal prosecution in cases where negative outcomes have occurred e.g. concealed birth, stillbirth, perinatal death, abandonment or neonaticide/infanticide. Denial of pregnancy has been considered within the literature as an abnormal reaction; consequently women holding this position have been viewed as potentially mentally ill. However, little consideration within the biomedical literature has been given to denial as a legal defense to mitigate against punitive sentencing in cases where infanticide has occurred.

Methods:
Thirty women who were concealing or had concealed at least one pregnancy took part in a grounded theory study to explore and understand why women conceal a pregnancy.

Analysis and Results:
All participating women indicated that they were aware of the pregnancy even though they used strategies to avoid coming to terms with the situation. The data show that women are aware of their pregnancies and conceal them as a way of coping with what is perceived to be a crisis within a context of paralyzing fearfulness. Many women have indicated that the fear emanates from a dependent and oppressive relationship with family members or intimate partners that are sometimes characterized by violence, which may be of a sexual nature in some cases.

Recommendations:
This study found evidence that women who experience a concealed pregnancy may be pathologised as mentally ill or even criminalized in the event of an unassisted birth or tragic neonatal outcome. The denial as defense argument in many criminal cases is understandable when the consequences for women are so punitive. However, the criminalization of women for concealing a birth or abandoning their newborn warrants urgent attention by legal and judicial systems.


Keywords: Concealed pregnancy, denied pregnancy, criminalization, grounded theory, neonaticide, infanticide

Acknowledgements: We would like to thank the 30 women who took part in The Keeping it Secret (KISS) Study and the Health Research Board who funded this study.