A Psychiatrist Told Us Why Her Patient Killed Her Children

Rudy Coronado was working on his truck outside his home near Carson, California, on May 20, 2014, when his mother-in-law started screaming.

Rudy rushed into the house to reveal a gruesome scene: the bodies of his three daughters—two-year-old Sophia, one-year-old Yazmine and three-month-old Xenia—lying on the bed. His wife, Carol, had slit their throats. She had struck Yazmine’s head with a hammer, and stabbed Sophia and Xenia in the heart. On each girl’s chest, she had scrawled a bloody cross.

Videos by VICE

Carol, naked, crouched over the bodies and waved a knife at her husband and mother before stabbing herself in the chest. When the police arrived, they found Carol lying beside her daughters, staring blankly at the ceiling, covered in blood. She had punctured a lung, but survived.

In 2016, Carol was sentenced to three life prison terms without parol for the murder of her three daughters. A state appellate court upheld the conviction in February.

Crimes like Coronado’s are rare, but not singular. A recent Brown University study calculated an average of about 200 cases of maternal filicide—a mother murdering her own child—in the US, per year from 1976 to 2007. Last year, an Indiana mother was sentenced to 130 years in prison for smothering her two children, ages six and seven, to death with her hands. And in March, Sarah and Jennifer Hart drove their SUV off a cliff in California, killing themselves and their six adopted children, shortly after Child Protective Services visited their home, contacted by a neighbor when one of the children began regularly asking for food, which he said his mothers denied him as punishment.

Such cases provoke intense public reaction; we view them as violations of not only justice, but nature itself. “We think of a mother’s love for her child as something that is sacred, that no matter what danger comes toward a child from the outside world, the mother would protect the child,” says Michelle Oberman, a professor at Santa Clara University School of Law and co-author of the book When Mothers Kill. Maternal filicide “shocks us at a core level. The mother has betrayed her role as a mother.” But it may be that our understanding of this role needs re-examining. The circumstances surrounding these tragedies suggest that our contemporary views of motherhood are distorted—and, in turn, dangerous.

A Case Western Reserve University analysis found a high prevalence of mental illness among women who were either incarcerated for maternal filicide or hospitalized after being acquitted of the crime due to insanity. Indeed, Torang Sepah, who treated Coronado at Twin Towers Correctional Facility in Los Angeles and testified in her trial, believes postpartum psychosis—a volatile mental state following childbirth, often involving delusions and hallucinations—largely drove her to kill her daughters. (Since Sepah’s commentary on Coronado is based on her public testimony, it isn’t considered protected health information.) But mental illness only scratches the surface. Societal expectations that motherhood should bring joy and “come naturally” can make new mothers struggling with mental health issues, like Coronado, ashamed to seek help or afraid of getting in trouble, leaving them untreated. A lack of social support, sleeplessness, and other stressors could further nudge these mothers to the edge.

Postpartum psychosis falls at the far end of a spectrum that starts with mood swings, or the “baby blues,” followed by postpartum depression, estimated to affect more than 1 in 10 women and whose symptoms include feelings of sadness and guilt. Postpartum psychosis is rarer—with a 2017 review reporting incidences ranging from only about 1 to 3 women in 1,000—as well as more severe, involving disorganized thinking, erratic behavior, and disturbing thoughts. A week before the murders, for instance, Coronado disconnected the power to the house while her husband watched TV, scolding him for watching “Family Guy” around the kids, the Daily Breeze reports. In another instance a few days before the killings, her husband said she pounced on him while he lounged on the sofa. On the morning of, she called her mother to say she was afraid of him and left her a string of frantic voicemail messages.

Sepah, now an assistant clinical professor of psychiatry at USC’s Keck School of Medicine and a physician specialist at Presbyterian Inter-Community Hospitals, diagnosed Coronado with psychosis in 2014. She says Coronado described “having very evil thoughts, scary thoughts” the day of the murder but couldn’t remember her thought process leading up to it, much less the murder itself. (It’s not uncommon for people who experience or commit a violent act to repress their memories of it, Sepah says.)

Watch this from VICE:

Sixteen to 29 percent of maternal filicides end in the mother committing suicide, while many others, like Coronado, make non-fatal attempts, according to the Case Western analysis. In contrast to those involving maltreatment, like neglect, such cases often have an “altruistic” motive. Instead of allowing her children to grow up motherless in an unkind world, or face what she views as a fate worse than death, the mother thinks she’s acting in their best interest, says Philip Resnick, a leading filicide researcher who co-authored the analysis. She believes killing her children will protect them from sexual abuse, abduction, or some other harm. Resnick, for instance, testified that Andrea Yates drowned her five children in the bathtub of their Houston home in 2001 because she believed they would burn in hell for eternity if they didn’t die before the ‘age of accountability,’ [a religious reference]” or age ten. “It’s a very tragic manifestation of a maternal instinct,” Sepah says.

Resnick adds that acute psychosis might spur mothers to kill without any comprehensible motive. For instance, they may carry out commands to kill their children from voices they hear in their heads, as one Arizona woman who stabbed her five-month-old son to death last year claims to have done.

Sepah says Coronado also suffered from severe postpartum depression—reporting progressively worse depression after each pregnancy—which increases the risk of psychosis. Depression “has a kindling effect,” she says. “Neurons start to maladaptively fire together in depression…There’s a spreading of that,” making it more likely to spark psychosis.

Many of the mothers in Oberman’s research experienced postpartum mental illness compounded by maternal isolation—spending hours on end each day alone with their kids. Although Sepah says Rudy was “very supportive of Carol,” he worked long hours at a swap meet selling auto parts, leaving her to shoulder the bulk of the childcare. A supportive spouse may lighten the load, “but long hours alone with a child while you have psychosis—that’s not enough,” Oberman says.

Sepah testified that a history of trauma can also increase the risk of psychosis and indeed, Coronado had been molested at gunpoint at age five and gang-raped as an adolescent, according to testimony from Diana Lynn Barnes, a marriage and family therapist. Sleeplessness was also a risk factor, Sepah adds, noting that no one helped Coronado with childcare at night. Her husband told the court that, leading up to the crime, “she had not slept for days,” she says. “He felt very bad for… not being more aware that he could have been more helpful.”

Yet Sepah is careful not to point fingers. Although low-income families like the Coronados often struggle to access mental healthcare, LA County offers it for free to residents who don’t have access to mental healthcare otherwise. The problem is, she says, the medical community needs to do a better job at educating the public about how to spot abnormal changes in a new mother, which could allow for earlier intervention—and postpartum psychosis does respond to medication. “When a new mother says ‘I need help, I’m going crazy,’ we need to take that seriously.”

But new mothers may feel ashamed to share their mental health struggles amid what we often paint as a joyous, rosy affair, leaving them wondering, “What’s wrong with me?” Sepah says. “I’m supposed to be on cloud nine.” Doctors often echo that cultural expectation, rushing to congratulate patients. “We don’t always give a chance for a woman to say she’s not sleeping, or needs help, or feeling blue, or having thoughts that are really disturbing, We don’t make room for that because we have made motherhood into the world’s happiest experience. It’s a Pinterest board.”

Coronado strove to stay positive in an effort to be “the anchor” of her family, which may have made warning signs easier to miss, Sepah says. “She would try so hard not to be down and depressed… She was always trying to move forward and make the best out of every situation.”

In her practice, Sepah tries to shift the focus from the baby back to the mother, acknowledging that transitioning to motherhood is challenging, and asking her if she has anyone to help with childcare, if she misses going to work—questions that reassure her it’s okay that not everything is sunshine and daisies.

Until recent generations, a new mother’s neighbors, friends and family members would pitch in with childcare, allowing her some reprieve, like napping or bathing, Oberman says. “That model has gone out the window, but we still haven’t discarded the iconic images of the gentle mother.” Expecting a mother to maintain earth goddess-like calm, all while caring for a newborn on her own, on little sleep, “is a tall order.”

On top of that, our capitalistic system, which sees having children as a private choice with individual consequences, wasn’t built with the interests of new moms and babies in mind, Oberman asserts. With newborn care no longer a collective effort, professional childcare is the only alternative—for those who can afford it. A report from the think tank New America found that the average cost of full-time daycare comes out to $9,589 a year for kids up to four years old, more than the average cost of in-state college tuition ($9,410 a year). It’s especially burdensome for lower-income families when childcare costs nearly two-thirds of minimum wage workers’ income, on average.

Other reasons Resnick’s research has identified for filicide include viewing the child as a hindrance, and accidentally killing him or her due to maltreatment, such as abuse or neglect. Yet these, too, speak to larger systemic problems. The latter is especially common among poorer parents who can’t afford childcare. “They get frustrated when the children are crying, and they’re overwhelmed, and they shake the baby,” Resnick says. Rarely do parents kill their children to seek revenge against a spouse. Prosecutors cited this as Coronado’s motive, describing how her husband had threatened divorce and left her to care for their daughters mostly on her own, and accusing her of feigning symptoms. But Sepah doesn’t buy that argument, especially because the two other psychiatrists who testified independently diagnosed her with psychosis, as well.

“What happened to Carol is representative of our cultural view of what motherhood should be,” Sepah says. “We are all responsible for what happened, essentially, even those of us who weren’t there and didn’t know Carol. This isn’t an outcome that one person did with one act. This happened from somebody falling through the cracks about 20 times.”