Dr. Ken Robbins, a forensic psychiatrist and clinical professor of psychiatry at the University of Wisconsin in Madison, said many people who study infanticide believe it is generally associated with postpartum depression.
"About 15 percent of women develop postpartum depression," Robbins said. "When depressed, such mothers often feel hopeless about the future, and surveys suggest it is common for such women to wonder if life is worth living either for them or for their babies."
"Often the thought is to save the baby from a miserable life by ending it now, then for the mother to kill herself," Robbins said.
Worse, he said, an estimated 20 percent of mothers dealing with postpartum depression also suffer from psychotic symptoms, such as delusions, which put them at an even higher risk of harming themselves or their infants.
"To prevent tragic outcomes, it is critical to carefully screen pregnant women and new mothers for depression," Robbins said. "If depression is discovered, they must be referred for further screening, both to determine if the depression is associated with psychotic symptoms and to understand if such women have thoughts of harming themselves or their babies."
For these mothers, just discussing thoughts of infanticide may help to lower the chance that they will carry through with these plans.
As for the case at hand, the psychological issues behind the killings have already become a hot topic. On Monday, a battle of experts took place in the courtroom on the issue of pregnancy denial, a major element for the defense because it could have meant a lesser responsibility and thus a lesser sentence.
French gynecologist-obstetrician Israël Nisand, testifying for the defense, told the court that a pregnancy denial is characterized by a pregnancy "which develops without the woman's knowledge."
The woman "can't manage to express the existence of a child. She represses. The denial is a pathology. The pregnancy is a physical but also psychological phenomenon," he said.
But on Tuesday, two psychiatrists dismissed the notion of pregnancy denial in Courjault's case, instead speaking about a "lie of pregnancy," and claiming that she was aware of her condition.
"There is no total or partial pregnancy denial. Madame Courjault always said she was aware of her pregnancies. She knew," Dr. Fanny Puel-Metivier, who met with the defendant on several occasions, told the court.
"This is a complicated affair, a difficult case. The best proof is that the experts in psychology can have different opinions," Henri Leclerc, one of Coujault's lawers, told the court.
Veronique Courjault was alone in the dock. Her husband, Jean-Louis, had been indicted for complicity in the murder but was later cleared of any involvement. His wife has always said he "was not aware."
Jean-Louis Courjault, who has been in the Tours courthouse every day of the trial, told reporters Wednesday that his support for this "woman he loves, the mother of his children" is unfailing, even though she is on trial for killing three of their children.
On Wednesday, according to reports from the courtroom, Veronique Courjault said: "I know I killed my children. ... When my son Nicolas talks about his younger brothers, it's difficult for me.
"The pre-trial investigation allowed me to become aware of many things, to ask myself questions. But I still don't have any answer. I hope to find some."