Post-partum depression was under the spotlight this week when High Court proceedings in New Zealand began unravelling the circumstances leading to the tragic deaths of three little girls at the hands of their mother, a South African doctor, writes MedicalBrief.
Ex-pat Lauren Dickason has been charged with murdering twin daughters Maya and Karla (2) and their older sister Liane (6) who were found dead on 16 September 2021 in their Timaru home in New Zealand by their father, Graham Dickason, an orthopaedic surgeon from Pretoria.
Lauren has pleaded not guilty and is using a defence of insanity and infanticide. Since her arrest, she has been in a psychiatric institution, undergoing mental evaluation, News24 reports.
The family had moved from Pretoria to the town on South Island after the Covid-19 lockdown, which delayed their move from South Africa and required compulsory quarantine on their arrival in New Zealand.
On the night in question, the court heard, she allegedly killed the children after they made her angry by jumping on the sofa.
Christchurch prosecutor Andrew McRae said the state would lead evidence that Dickason “harboured resentment and anger” towards her children, citing messages she sent to friends, but defence lawyer Kerryn Beaton said in an opening statement that Dickason was suffering a severe breakdown in her mental health at the time of the murders. She had also been formally diagnosed with post-partum depression.
McRae said that phone messages, which would be used as evidence, showed that Lauren had, at times, threatened to “smack”, “suffocate” and “murder” her children, and that she reportedly searched the internet for information on how to overdose children.
On the night of the murders, Lauren apparently waited for her husband to leave for a dinner with new colleagues before fetching cable ties from the garage and telling the girls they were “going to make necklaces”.
When she realised that would not be enough to kill the girls, she smothered Karla, then Liané and finally, Maya.
She then placed their bodies in their beds and covered them, after which she tried unsuccessfully to kill herself using a knife and an overdose of drugs.
Her husband returned home to find his wife disorientated in the kitchen. When she responded that it was “too late”, he realised something was wrong and went to the girls. He reportedly cut the cable ties and listened for a heartbeat and breathing, but couldn’t hear anything.
In a panic, he called a colleague he’d been out with and asked for help. Emergency services were called shortly after.
The court heard that before they had left to start a new life in New Zealand, tensions in their marriage had escalated, and coupled with her post-partum depression and her anxiety at leaving behind family and friends, several acrimonious outbursts had ensued.
Giving his evidence via video link from Pretoria, the children’s father said his wife had told him she wanted to harm the girls before they left South Africa, but he did not take her thoughts seriously.
He said she had also spoken to him about giving the children sleeping pills and cutting their femoral arteries, reports TimesLIVE.
Defence lawyer Anne Toohey had asked if he recalled saying to her: “Do you know how crazy you sound? We’re emigrating to New Zealand in 13 days,” and telling her to “pull on your big girl panties and pull yourself together”.
IOL reports that he did remember this, saying that his mother-in-law was also concerned about her daughter’s mental health but that his only thought was to get her to New Zealand and away from things that stressed her out.
Despite the Dickasons wanting children so much that they underwent fertility treatment to have them, the court heard she struggled with being a mother of three.
She had apparently told a friend: “Three kids have really killed all the passion and a lot of the happiness.”
She also had a lifelong issue with depression, anxiety and perfectionism, and had told her husband in 2019 and 2021 that she had thoughts of harming her children. She had been scared of these thoughts and sought help.
1News reports that her husband was questioned about the couple’s long and stressful fertility battle, multiple rounds of IVF, and the stillbirth of their baby Sarah at just 18 weeks’ gestation. Because the baby was under 20 weeks, it was treated as a miscarriage.
He recalled Lauren crying every day for two months afterwards and that it was a difficult time for her.
They subsequently decided to use donor eggs in the next rounds of IVF, resulting in the birth of their daughter Liané. After a difficult and stressful pregnancy, in 2015 she saw a psychiatrist who diagnosed her formally with major depressive disorder, post-partum depression and anxiety.
Postnatal depression can last for up to three years, and affect a mother’s ability to care for her baby.
In very rare cases (one in 1 000 births), doctors believe that the hormonal changes before and after childbirth may help to trigger postnatal psychosis. Some women who get this disorder have been previously diagnosed with bipolar disorder or schizophrenia, for example, but most have no previous history of mental illness.
At the heart of the Dickason case is the argument around her mental state at the time of the murders.
McRae argued that while she was probably suffering from major depression, she knew what she was doing and “acted clinically”.
However, reports IOL, according to a former colleague, Dickason had been on chronic medication before she left South Africa but stopped taking it because she feared it would affect their immigration application.
New Zealand has strict requirements and potential immigrants can be turned down on the basis of a chronic illness.
The former colleague said that stress combined with Dickason not taking her medication could have led to the tragic murders of the children.
“The immigration process for New Zealand is extremely traumatic,” the former colleague, also a doctor, said. “I understand the place where the Dickason family had to spend their quarantine was basically like a prison. You don’t see anyone, your food is delivered to your door, and you are only let out for about an hour a day.”
A Psychology Today report says research estimates that postpartum depression occurs in about 17% of mothers across the world. For most mothers, symptoms of depression emerge four to six weeks after birth and gradually decrease in subsequent months. However, postpartum depression can occur at any time in the three years after a pregnancy or birth.
Postpartum depression often co-occurs with anxiety. Research finds that two out of three women with postpartum depression may also have an anxiety disorder. Although postpartum depression may be more commonly discussed, postpartum anxiety may actually be the most common postpartum mood disorder. During the postpartum period, about 18% of women experience anxiety in postpartum weeks one to four, 15% in weeks four to 24, and 15% after week 24.
1News article – Husband cross-examined in Lauren Dickason’s murder trial (Open access)
Psychology Today – How to Improve Postpartum Mental Health
See more from MedicalBrief archives:
Dickason tragedy: Mom’s mental evaluation to take up to 18 months
Dickason tragedy: Further mental observation and trial date
Murder-accused SA doctor to plead insanity and infanticide
Court date for SA mother after daughters’ murders in New Zealand