I found this article written by Karen Houppert and how depressing to see what PostNatal Depression can lead to

photo – Scott Buchholz

Otty Sanchez and her son, Scott Wesley Buchholz-Sanchez, whom she's accused of killing, in a July 18 photo.

Aug. 1, 2009 | As news of the 33-year-old Texas woman who murdered her infant son and then ate bits of his brain and a few toes zips around the Internet, our morbid curiosity grows. The story of Otty Sanchez taps deep veins, unfolding like a Greek tragedy: A new mother breaks with her lover three weeks after giving birth to their child. Insane with grief, she hears voices telling her to kill her baby — the fruit of their union. After murdering the infant, she begins to consume him, returning him to the body from whence he so recently came. In a moment of clarity she sees what she has done. Horrified, she tries to take her own life, stabbing herself in the heart and slitting her own throat.

Our literature profs would have us list the sweeping, irresistible themes: love, abandonment, insanity, infanticide, cannibalism, religion, an epic battle between the forces of good and evil ("He made me do it," Sanchez allegedly wailed in the aftermath, referring to the devil), divine retribution.

The Sanchez incident nestles neatly into a literary canon that packages parental ambivalence into clear plots and simple motives: Abraham, who is told by God to sacrifice his son Isaac as a burnt offering; Medea, who kills her two sons to punish their father for leaving her; Hansel and Gretel, abandoned by selfish parents because it was so costly to feed them (leaving them prey to a mean old woman who planned to eat more than their brains and toes).

Alas, the details of the Otty Sanchez incident are now trickling out, ruining our tidy narrative with a clutter of problematic facts. Already our story is getting unruly.

Both Sanchez (mom) and Scott Buchholz (dad) have schizophrenia. Sanchez was off her drugs. She was in counseling for postpartum depression — but there were signs that it was worsening. Sanchez and Buchholz separated when the baby was 3 weeks old. Sanchez came by Buchholz’s house a few days later and "stormed out" when Buchholz demanded a copy of the birth certificate. Buchholz called the police when Sanchez put the baby’s car seat in the front, neglected to strap him in, and sped off. The police followed up in a lackadaisical manner. Sanchez, possibly experiencing the onset of a psychotic break, sought help in a local hospital emergency room but was released in less than 24 hours and sent home to care for her newborn. Sanchez heard voices. The voices told her to kill the baby. She gave the baby to her sister, who shares the house with her; she did not want the child near her. Then, when Sanchez finally seemed calm, the sister returned the baby to her. Sanchez killed the baby, tried to kill herself, but did not succeed.

Questions muddle up our clean story line.

What was going on between Buchholz and Sanchez that they separated three weeks after their baby was born?

With all new parents this is a stressful time. We are all reeling during these early days, struggling to define what our roles will be, how to distribute baby care fairly (or, in any case, develop a job-share we can live with), suffer from sleep deprivation, are anxious about our new identity, remain frazzled by a crying infant and, for moms, are still recovering physically from giving birth. Buchholz and Sanchez, with a history of mental illness, are hit with a double whammy here; coping was clearly especially difficult.

How is it that Buchholz has known Sanchez for six years, lived with her, and had a baby with her, as the AP reports, but professes to be unaware until last week that she had been diagnosed as schizophrenic?

Since Buchholz himself is schizophrenic, currently on a six-drug daily regimen, this does not seem like something Sanchez would be too embarrassed to share with him. Maybe she did mention it, but he forgot? Or perhaps he was in denial, dismissing her behavior as "baby blues" or simple "bitchiness"?

Why was Sanchez, who was in counseling for postpartum depression and who had a history of mental illness, off her meds?

Women get a lot of mixed messages about the dangers of drugs during pregnancy and while breast-feeding — even though postpartum is a particularly dangerous time for women to do without. They want to do right by their baby, but aren’t sure what "right” is. And doctors often don’t know much about how such drugs affect the fetus or breast-feeding newborn. Historically, physician drug labels have simply sorted the level of danger into vague categories without providing specific information about the quantity of the drug transferred to the infant via breast milk, nor of the impact. In 2008, the FDA began changing its labeling criteria to provide more detailed information — but doctors are still behind the curve here. When in doubt, many are reluctant to prescribe drugs, especially ones considered optional, like antidepressants, to pregnant or nursing women. The bible of women’s healthcare, Our Bodies, Ourselves," advises women to "work with a provider who is knowledgeable about medications and breast-feeding" but such folks can be hard to come by. Weigh the pros and cons, the authors suggest, adding that "[w]hile the second generation of antidepressants do pass into breast milk, the short-term negative effects on babies, if any, appear to be transient." Still, in what has become an enduring refrain when it comes to drugs, pregnancy and breast-feeding, the authors note: "Additional research … is needed."

Finally, one has to wonder how it is that a new mother diagnosed as schizophrenic and suffering from severe postpartum depression showed up in a hospital emergency room in some kind of mental health crisis and was blithely sent home?

The details of just what transpired at the hospital haven’t been released yet, but if Sanchez’s postpartum psychosis went untreated, that would not be unusual. According to the American Psychological Association, mental health issues are regularly missed in hospital emergency rooms. Indeed, a 2005 article in the organization’s Journal of Consulting and Clinical Psychology found that emergency room doctors routinely overlooked problems like schizophrenia, depression and anxiety, finding a psychiatric diagnosis rate of 5.27 percent in emergency rooms, compared to a national prevalence rate of 20 to 28 percent. For African-Americans, the rate of under-diagnosis is even higher. (The study did not look at rates for Hispanics.)

These particulars, after a while, make it hard to shoehorn the Sanchez story into our fictional literary canon. After all, Medea and Abraham and the old witch in Hansel and Gretel are buoyed along on a current of "inevitability" that floats our fictional narratives of infanticide. This Sanchez case suggests — oh, bother — that there are some steps we as a society should be taking to support new mothers and the mentally ill.