Cold Cases of Neonaticide, Genetic Genealogy, and Forensic Psychiatry

The Hidden Phenomenon of Neonaticide

Neonaticide is unique among homicides, since it is almost always perpetrated by the mother, a woman, acting alone.³ The primary motive in cases of neonaticide is that the infant is unwanted.^1,2 During the pregnancy that predates the homicide, these women often experience hidden pregnancies: pregnancies that were denied or concealed.²

Several subtypes of denial of pregnancy have been described: pervasive denial, affective denial, and psychotic denial.^5,6 As initially described by Miller,⁵ in pervasive denial, the pregnancy is kept from self-awareness. The woman may either not experience weight gain and amenorrhea, or these may be misinterpreted in her own mind or rationalized, explained away. The experience of labor itself may also be misinterpreted. In contrast, in affective denial, women are intellectually aware that they are pregnant but do not make emotional or physical preparation, continuing to push the pregnancy from their mind and behaving as if they are not pregnant. In the third group, psychotic denial, women may have a psychotic disorder and often a history of custody loss. Friedman et al.⁶ found that the most common type of denial of pregnancy among women who presented to the hospital for delivery was affective denial, followed by pervasive denial. Although some women with pervasive denial experienced denial through their entire pregnancy, in other cases, women did note their pregnancy in the third trimester but continued not to obtain prenatal care.

Some women deny their pregnancy for some time prior to acknowledging it, at which point they may tell others they are pregnant; alternatively, they may begin concealing their pregnancy.⁶ This may occur against a backdrop of the woman’s deep concerns about the overwhelming implications of the pregnancy for her family, her culture, or her religion. Other factors may include young age, social isolation, irregular menses, and intellectual limitations, psychiatric disorder, or substance use disorder.⁶ Psychological conflicts may include fears of abandonment, religious or cultural prohibitions against sexuality, problems in relationships with the woman’s parents or with the father of the pregnancy, and fears of custody loss.⁶ Often no one around her has an idea that she is pregnant; her denial or concealment is effective. Limited social support is common.^2,3 In both denial and concealment of pregnancy, inadequate prenatal care occurs.

Upon delivery, the pregnancy can no longer be denied or concealed, and a crisis point may occur. Some women present to the hospital to deliver, and approximately three-quarters of these maintained custody of their infant at hospital discharge.⁷ Others who have hidden pregnancies deliver at home or elsewhere in secret, with reports of dissociation in some cases.⁸ Some go on to raise the infants they delivered at home. Some women kill the baby at birth, others abandon their infant with the expectation of death, and still others abandon their infant safely, such as at a hospital, fire station, or church. (Safe abandonment occurred long before American safe haven laws came into existence in recent decades.²)

Women who commit neonaticide have substantial differences from mothers who kill their children after the first day of life,⁸ and there is a limited intersection of serious mental illness with neonaticide. Rarely is the woman psychotic.⁸ What has been described is at times immaturity, passivity, indecisiveness, and avoidance. Further, maternal suicide is quite uncommon in neonaticide cases.² From an evolutionary psychology standpoint, these young women are acting in an adaptive way.⁹ Forensic psychiatrists must be careful in such cases, even when they are detected and referred immediately after the offending,¹⁰ to discern whether mental health symptoms occurred at the time of the offending or whether they occurred subsequently (such as adjustment disorders or posttraumatic stress disorder).

Often cases of neonaticide are discovered fortuitously rather than proactively. For example, recently a mother discarded her unwanted dead infant in the recycling bin rather than the trash bin right next to it.¹¹ Had the recycling not been sorted on a conveyor belt, the infant’s remains would not have been discovered. Even when efforts to describe rates of neonaticide are attempted, they are believed to be underestimates. When infants’ bodies are discovered, for example, it can be difficult to determine whether they were born alive.¹² Rarely, from what we know about this hidden crime, do such women reoffend and kill other infants.³ And it may be that we only know about the tip of the iceberg, as these cases are hidden in trash bins, garages, and nature parks.

Genetic Genealogy

Genetic genealogy applies “DNA analysis and traditional genealogy to infer relationships between individuals” (Ref. 13, p 4). Genetic genealogy is used when DNA obtained at a crime scene does not match DNA in the Federal Bureau of Investigation’s (FBI’s) National DNA Index System (NDIS) and no viable suspects have been identified through investigation.¹⁴ Investigators search publicly available databases that hold DNA information from people who are searching for missing relatives.¹⁴ DNA profiles from crime scenes are searched against direct-to-consumer testing. Then “a family tree or multiple family trees are developed to create a pool of potential suspects” (Ref. 14, p 114), before this is further investigated by using information about location, age, sex, and proximity to the crime. After potential suspects are pinpointed, investigators obtain and compare other samples for reference.¹⁴ Costs average $5,000 per case,¹³ bringing into question the cost-benefit, with limited police resources, for pursuing cases from the distant past involving often nonreoffending perpetrators.

The Golden State Killer (GSK) case was solved by genetic genealogy,¹³ which brought its use to prominence. The so-called Golden State Killer murdered a dozen people and raped more than 50 others in California from 1974 to 1986.^13,14 The GSK case was unsolved until 2018, when DNA from a crime scene was compared with the genealogical website GEDMatch, and a family tree was created with a match to a likely fourth cousin. DNA was obtained from a discarded tissue and a car door handle.¹⁴ Former police officer Joseph James DeAngelo was charged.¹⁴

On this backdrop, and because most neonaticides are perpetrated by the biological mother acting alone, cold case neonaticides from decades ago are being solved. Matches with DNA evidence from cold cases allows building of a family tree. Potential relatives of the neonate are identified and further samples and information about relationship histories sought. Currently, in dozens of American neonaticides, genetic genealogy has been utilized to identify mothers, who are the most likely perpetrators.^4,15,–,24 These include both recent cases and cold cases.

The Darker Sides of Genetic Genealogy

Discovering the identity of the mother, by far the most likely perpetrator, is only the beginning. Ethics concerns have been raised about the use of genetic genealogy because of both racism and privacy rights. In addition to concerns about the general use of such technology (discussed below), additional ethics questions are raised regarding appropriate punishments after its use to solve historical cold cases. Women are then arrested for homicides from decades earlier, after which they have built new lives, often with no other criminal history.^15,–,24

Wickenheiser noted “Concerns have been raised regarding the higher representation in the offender databases of minorities, the violation of rights of suspected family members, the use of the profiles for means not originally proposed when offender databases were originated, and rights issues of those housed in the database itself as their family members are indirectly implicated” (Ref. 14, p 118). The interests in conflict are public safety, individual rights to privacy, and parens patriae.¹⁴ Yet innocent third parties may become secondary victims in the investigation, such as those who are distantly related to perpetrators, who find themselves repeatedly interrogated about their family through no fault of their own.

Our British counterparts present differing views. The U.K.’s Biometrics and Forensic Ethics Group report indicated that uploading DNA from the crime scene in the GSK case to the GEDmatch database violated the website’s terms and conditions at the time.¹³ “Upon learning of the Golden State Killer case, GEDMatch updated their confidentiality statement to include information that genetic information can be searched by law enforcement” (Ref. 14, p 115). As the U.K. report noted, however, the GSK’s brother was a convicted felon, and if his profile had been in Combined DNA Index System (CODIS) and familial searching used, the GSK would have been identified earlier,¹³ which would have entirely forgone the ethics implications of utilizing GEDMatch.

In traditional investigative situations, a “reasonable suspicion” is often required, as opposed to a routine database search in genetic genealogy.¹⁴ This contrasts with the National DNA Index System (NDIS) investigative database, which only includes those who have been arrested or convicted for specific offenses, using a form of “just cause.” This balances the value of society’s needs against individual privacy by having limited personal genetic information available.¹⁴ One logical extension would be to only include those who have exact matches in consumer databases rather than performing genetic genealogy. (This can be thought of similarly to fingerprinting and availability of fingerprints for reasons other than arrest.)

The U.K. report identified that genetic genealogy should only be used if established methods are no longer effective and adequate, with avoidance of unnecessary invasion of privacy, among other concerns.¹³ On point, the U.K. report noted that “identification of cases where genetic genealogy may be appropriate must be carefully defined to enable an ethical and reasoned decision to be made (avoiding historic problems, such as the identification and prosecution of women who abandoned their newborn babies decades ago, based on analysis of the deceased baby’s DNA followed by a forensic genealogical approach)” (Ref. 13, p 12). This suggests quite explicitly that historical cases of maternal neonaticides are specifically different than others who have historically killed, at least in the U.K.

Neonaticide Cold Case Example

Genetic genealogy is being used for current cases. Yet another dilemma arises when it is being used for cases from decades ago. Recall that, in 1993, the United States was well into the Roe v. Wade era,²⁵ and abortion was relatively legal. Safe haven laws, in which an unharmed, unwanted infant may be safely left with a designated professional, were not passed until the late 1990s,² but women were rarely if ever prosecuted for the act of turning over an unharmed infant in a safe location.

On the morning of March 25, 1993, an infant’s body was found on the road by a newspaper delivery person in Geauga, Ohio. The infant’s body was missing an arm and a leg and skin,²⁶ having been damaged by animals,⁴ but the umbilical cord remained intact. Autopsy had revealed that the boy infant had been live-born full-term, and the death was classified a homicide.²⁶

The community held a funeral and named the infant Geauga’s Child.⁴ Investigators left a camera at the 1993 memorial hoping to find the mother visiting, but she was not found.⁴

In 2018, DNA from the infant’s tooth bud was compared with online databases, seeking to identify the family and thus the perpetrator.²⁶ Investigators built a family tree and narrowed the infant’s mother and perpetrator to Ms. Gail Ritchey.^4,26 She was 23 at the time of the infant’s birth and death and 49 at the time of her questioning.⁴

In her police interview, she said that she did not realize she was pregnant until three months prior to delivery, when she stopped menstruating. She did not tell anyone about the pregnancy. She gave birth at the home of a family for whom she was nannying. She did not look at the baby and indicated that she did not recall whether the child moved or made noise. She put the infant in a garbage bag in her car’s trunk. Later when she spent the weekend at a camp in another county, she drove to an unknown location where she laid the bag in the woods.²⁶

In March 1993, at 22, Gail Ritchey had been in a long-term relationship with her future husband who was the neonate’s father. She had experienced verbal abuse at home and limited support. Her pregnancy had been hidden from family, friends, her future husband, and her employers. But 26 years later, at questioning, she was a married mother who worked at a well-respected local dance studio. She had three living children and a grandchild, and she volunteered at a food pantry.⁴ One might pause here to consider the appropriateness and rationale for incarceration and punishment two decades after her young-adult offending.

Ms. Ritchey also admitted that she had abandoned another newborn two years prior to Geauga’s Child at age 21 (without specifying whether the baby had been born alive).⁴ If one’s thought two sentences ago was that punishment served no purpose decades later, one might hypothetically have a changed thought about punishment upon learning about recidivism.

Ms. Ritchey was tried by jury for aggravated murder and murder in 2022. A pathologist called by the defense testified that it was not possible to determine whether the infant had been born alive. Ms. Ritchey was found not guilty of aggravated murder, but guilty of murder; she was sentenced to an indefinite prison term of 15 years to life. Ms. Ritchey appealed her conviction, but the conviction was affirmed. She had appealed with six assignments of error, each of which was found to be without merit.²⁶ Two argued errors related to location, one to testimony regarding the live birth, one regarding the current deputy medical examiner who testified based on information gathered by a deceased expert, and one regarding the “manifest weight of the evidence” (Ref. 26, p 711). The argued error most relevant to forensic psychiatrists was whether the trial court erred by refusing to allow the defense to present evidence of dissociative disorder.

A psychologist for the defense submitted a report about hidden pregnancies which asserted that dissociative disorder is “one of the ‘hallmarks of this reproductive aberration’” (Ref. 26, p 718). The state’s motion to exclude the report and trial testimony was granted, as it was inadmissible evidence of “diminished capacity” (Ref. 26, p 17). The defense argued that the testimony was rather meant to explain how Ms. Ritchey could transition from delivery to her nannying duties and the voluntariness of actions. The court determined that evidence as to Ms. Ritchey’s function as a nanny was not relevant to the case and that the claim of relevance to voluntariness or actus reus was undermined by the report itself.²⁶ The court further noted that the report’s “descriptions of the dissociative state [were] contrasting if not contradictory” (Ref. 26, p 719). In addition, the expert had not based the opinion on the facts of the case nor on an examination of Ms. Ritchey, and it was within the trial court’s discretion to exclude both the report and the testimony.²⁶

Cold Case Neonaticides and Ethics Discussion

Ms. Ritchey’s case brings up many of the aforementioned ethics concerns. In such cases, the DNA of the infant is used to search for the mother, who in turn is virtually always the perpetrator. This is different from other DNA cases, where the DNA match is for DNA of the perpetrator (such as from DNA under the victim’s fingernails from scratching at the perpetrator). The neonate’s father appears of little concern in neonaticide prosecutions. Ramchandani posed the question regarding whether prison was the correct outcome in Ms. Ritchey’s case: “if the life she had built over decades might matter more than one action of her youth” (Ref. 4, n.p.). Similarly, Bryan Stevenson argues “Each of us is more than the worst thing we’ve ever done” (Ref. 27, p 17).

We must remember that many cases of neonaticide, across history, were never discovered. Hidden pregnancies, hidden infants, hidden deaths. Add that neonaticide has an immense sentencing variation,²⁸ even when women are caught soon after the homicide, ranging from probation to the death penalty, and that is when a prosecutor has decided to even charge the case as murder. This likely relates to our collective perceptions and myths about motherhood, and women being dichotomized as Madonna or whore.²⁷ How society perceives these women may relate to not only the facts of the case, but biases related to race, culture, religion, age, and financial status.²⁹

In the cold cases now being prosecuted, however, there was often collective community grieving. Babies were named by the community, funerals funded by the community. Community members innocently walking their dogs or delivering newspapers were traumatized by discovering dead and mauled babies.

We need to consider why these cold cases are being prosecuted now. Many may argue that justice is not served by incarcerating women who have lived for two dozen years with this secret, women who have led apparently upstanding lives since. The purposes of incarceration are generally rehabilitation, incapacitation, deterrence, and punishment or retribution. In contrast to recent neonaticide cases with a perpetrator who is currently in her teens or early 20s, in cold cases, there is not concern for recidivism because these women are no longer of childbearing age. Arguably, rehabilitation was not needed in cases where these women have not had further criminality. Punishing perpetrating women 20 years later is unlikely to deter others’ crimes as so much time has passed. Prevention rather lies in sexual education, birth control availability, and providing information about safe havens.² Thus, only punishment, retribution remains. Returning to the idea of secondary victims, however, there may be devastating effects for the current living children of these women, which may play a role in legal outcomes.

Those who argue that punishment is unjust in these cases should be reminded that murder has no statute of limitations for a reason. Arguably, not prosecuting cold case neonaticides (as certain contemporary cases are not prosecuted) would devalue the life of the infant, the grieving of the community. Still others argue that the moral value of the neonate’s life is different than that of older children.

Perhaps more poignantly, the much-heralded GSK homicides occurred prior to cold case neonaticides currently being prosecuted. Unlike neonaticides, there has not been a similar complaint in that case that the perpetrator had been living a good life since. Some argue society should not punish a young woman for one bad decision she made when she was 16. But this statement itself may be related to gender and cultural biases. It is hard to imagine the same argument being made when a homicide perpetrator was anyone other than a young woman. Many others who have killed in America find themselves on death row, also based on a single action in their youth.²⁷

Forensic Psychiatry Considerations

Forensic psychiatrists may be consulted in cold cases of neonaticide, most likely regarding mitigation of penalty, as the vast bulk of neonaticide perpetrators would not qualify for a finding of insanity because of the lack of serious mental illness. Caution is certainly indicated in determinations of mental state from decades ago, as evidenced in the Geauga’s Child case. Psychiatrists in such cases need to ensure they are not engaging in advocacy bias but rather that they can complete a proper evaluation of the defendant. All mitigation and insanity evaluations are, by their nature, retrospective evaluations. But cold case evaluations are of mental states decades prior, far outside the realm of most forensic evaluations. Yet forensic mental health professionals are the experts who can assist the court in such matters.

Gutheil noted the implications of completing retrospective evaluations, including spontaneous evolution of mental conditions over time, “so that the person seen today may not be the same person psychologically who was acting at the time of the crime” (Ref. 30, p 81). The more time has elapsed, the more opportunity for normal forgetfulness to confound the evaluation.³⁰ Additionally, the stress of pursuit, arrest, and incarceration, as well as recognition that one may be facing a significant sentence, can affect presentation.³⁰ An additional concern noted is of reported amnesia. If a woman were to have amnesia for her offending, per Wilson,³¹ the prosecution would need to provide her with additional information about the occurrences during the offending. Such information may be difficult to obtain, however, because medical records are often destroyed long before.

Women must be asked what they understood and perceived at the time of the offending, rather than what they now know with decades of adult experience. Mitigating and aggravating factors should be considered from around the time of the offending. Inquiry regarding denial and concealment of pregnancy is important, and the court may require education about these conditions in any neonaticide case.¹⁰ Often by virtue of the mysterious nature of these cold cases, with maternal perpetrators who were long unidentified, this means that the neonate was not left in a private home but rather had been transported elsewhere to decrease risk of detection. This information may help the examiner in conceptualizing mental state at the time of the offending.

Interestingly, were these cold cases prosecuted internationally in one of the two dozen countries (including Canada) with infanticide acts, which lower the penalty for killing infants under one year old to be more akin to manslaughter than murder,⁸ these women may well all be disposed of under such lenient acts with probation or short sentences. The lack of infanticide acts in the United States is amplified in these cold cases. (This is a separate consideration from the inherent gender bias of such laws.⁸) Infanticide acts, in one sense, allow the law to function because routinely mothers are charged with the homicides of their children, whereas in American jurisdictions, prosecutors have discretion. Forensic psychiatrists testifying in infanticide act cases may have a lesser burden in understanding historical mental state than in other mitigation cases.

In conclusion, cold case neonaticides in which the identity of the mother (the likely perpetrator) is solved by genetic genealogy raise a host of ethics concerns, from the very use of the technology to questions regarding punishment of alleged perpetrators decades hence. Forensic psychiatrists should wade into such evaluations with caution and humility.