A childbearing timeline describes Ms. Yates’s psychiatric history. She had five full-term births (February 1994, December 1995, September 1997, February 1999, and November 2001) and one miscarriage (November 1996). Continued breastfeeding between pregnancies intensifies the disruption in the hormonal milieu of a woman who is vulnerable to psychiatric illness. Ms. Yates spiraled further into mental illness with childbirth. Her early births were associated with depression, "visual images," social isolation, and withdrawal from all recreational activities (2). Her final two deliveries were associated with suicide attempts and four psychiatric hospitalizations for documented "postpartum depression." During her last pregnancy, she was an energetic, home-schooling mom, often baking and sewing late into the night. After her delivery on Nov. 30, 2001, her mood continued to spiral downward. In April 2002, she was admitted to the hospital for depression, psychosis, and suicidality. She drowned her five children in June.