Dark Side of Childbirth : What Should Have Been a Blessed Event in Victoria Karter’s Life May Have Caused the Condition That Led to Her Death

Late on a Friday afternoon in September, Victoria Karter walked into the Four Seasons Hotel, declined an offered fourth-floor room and took one instead on the 19th floor.

A tall, dark-haired woman with an angular face, Karter, 33, carried a garment bag as well as a purse. She stayed in the room only an hour or so, but it was long enough to leave cigarettes snuffed out in ashtrays and to put a ring of lipstick around the neck of the Jack Daniels liquor bottle she brought with her. Long enough, too, to make a telephone call.

The call was intended for Kathy Boone, the woman who had been Karter’s friend for more than 20 years. But because Boone wasn’t there, Karter talked to Virginia Rivera, Boone’s mother and a woman who considered Karter a member of her own family.

Karter told Rivera what she had been telling Boone since soon after the birth of her first child 4 1/2 months earlier: She wanted to commit suicide.

“She told me that she wanted to talk to Kathy and she needed to tell her a few things before she would kill herself,” Rivera said. “I said, ‘Vicky, give me your number and I’ll have Kathy call you. She should be here any moment.’ ”

But Karter refused to say where she was.

“She said, ‘Mrs. Rivera, I’m so sick, I feel so sick.’ At that moment it seemed like she dropped the phone. I kept calling her. I could hear noises. I thought maybe someone was there with her. I stayed on the phone the longest time. Then all of a sudden I didn’t hear anything.”

Victoria Karter had walked out on the balcony of Room 1902 and jumped to her death.

Gregory Owen Lee sits in the living room of his comfortable Newport Beach home, bouncing his daughter, Rachel, on his knee and then putting a bottle in her mouth. Periodically, he stops talking to fight back tears.

A dark-haired, bespectacled businessman who chooses his words carefully, Lee says that both he and Karter had wanted children. “My personal point of view is . . . that’s what life is all about, to have a family and raise kids.”

Lee, 35, thinks of himself as an “old-fashioned kind of guy” who wanted to marry just once, “settle down and live happily ever after. Unfortunately, happily ever after in my case was three years.”

Six months ago he was on top of the world. A husband and father-to-be.

Today he is a widower, left to raise an infant daughter on his own. He tries to juggle his work schedule to spend as much time as possible with his child. He hopes he doesn’t hear an old favorite song on the radio to make him burst into tears.

“I know that despite the adversity that I’m facing right now, my primary focus has to be toward my baby,” Lee says.

“I’m sitting here right now and you see me and I’m pretty composed and I can talk to you about the incident. A few weeks ago, if you had seen me, I would be crying and . . . distraught about not knowing what’s going to happen.”

Baby books and toys dot the house. There is other literature, too, explaining a condition Lee said he never heard of before Rachel’s birth: postpartum depression.

The official cause of Karter’s death: Injuries sustained in a suicide jump.

But her husband blames her death on postpartum depression, for which she was being treated at the time of her suicide and an illness Lee said he heard about for the first time when his wife was hospitalized at UCI Medical Center.

That was almost three months after Rachel’s birth in late April, a typically happy, blessed event for most women, but one that plunged Karter into despair.

Doctors say that while most mothers get the “baby blues” after giving birth, the condition lasts only a short while. Postpartum depression, by contrast, strikes about 10% of new mothers and does not “cure itself.” Postpartum depression typically requires psychiatric therapy and/or medication, including anti-depressants.

An even more rare disorder is postpartum psychosis, from which sufferers may lose touch with reality, experts say.

Postpartum disorders have been known for centuries, but only in the past 10 to 15 years have they been studied in depth. Medical opinion is divided on whether the depression stems from a chemical imbalance after childbirth or if it is caused largely by existing emotional problems--troubles that Lee said did not appear in Karter before giving birth.

Psychiatrists say only a small minority of those who develop a full-fledged depression wind up killing themselves or their children. One doctor calls the number small but significant.

Susan Hickman, a San Diego psychologist who has treated hundreds of women suffering from postpartum depression, said women who have depression but not psychosis kill themselves but not their children. She said the number of suicides is not known.

In fact, the National Institute of Mental Health has no statistics on suicides linked to postpartum disorders.

Kathy Boone and Vicky Karter met in 1968, 11-year-old junior high school students. Boone described her friend as happy and outgoing, an artist talented at drawing, a writer of poetry, a journalism student, “very creative.”

Boone’s mother, Virginia Rivera, called Karter “an average, normal girl.” She was at the Rivera house in Montebello so often as a child that Rivera “felt like she was our stepdaughter or adopted daughter.” The death of her mother a year or so after Karter graduated from high school struck her hard, Rivera said.

“It bothered her a lot that she didn’t have her mother there for her. I told her whenever she needed someone, just call me, and she always did.”

Over the years, even after Karter went off to college at Cal State Long Beach and Boone married not long after high school, the friends remained close. Karter would bring boyfriends by to meet Boone’s mother, but she kept waiting to meet the right one to marry.

Karter and Lee met at a dance in Beverly Hills in 1985. After dating for two years, they married in Las Vegas on her 30th birthday, the first marriage for each. They held a party later for friends at the Newport Beach house that had been his and became theirs. She worked in the family office supply store in East Los Angeles. He worked at the office machine distribution company he had founded after graduating from USC in 1980.

If there was one smudge on the picture, it was Karter’s frequent concern with what other people would think, and her tendency to make mountains out of molehills, Boone said.

“Vicky was the kind of person that would make everything into a major problem,” she said. “When she was thinking of marrying Greg, she would wonder, should she do it, shouldn’t she do it. . . . What if it didn’t work out? What if she got divorced?”

But the marriage was a happy one, Lee said.

“I won’t say we agreed on everything 100%, but we never had fights, yelling fights or anything like that. . . . We got along exceptionally well.”

And a little more than two years after their marriage, Karter became pregnant. “She seemed the happiest I’ve ever seen her,” Boone remembered.

But after Rachel’s birth, Karter’s attitude apparently changed.

“I went with my kids to the hospital with balloons,” Boone said. Karter “didn’t seem like someone who had a baby. It didn’t seem like a joyous thing to her.”

Boone recalled that one day, about a month after the birth, receiving an “hysterical” phone call from Karter. “She said she didn’t know what to do. The baby cried a lot, had colic; Vicky wasn’t prepared, I guess, for that. She was stuck in the house. She didn’t know what to do.”

Lee said the newborn baby was in intensive care for three days for treatment of jaundice. When mother and daughter came home, Rachel cried seemingly around the clock for nearly three months, he said. But while his wife wasn’t getting much sleep at all, he didn’t see any “abnormal type problems.”

That changed in mid-July.

First came a call from Karter’s sister, Lee said, telling him that “she was very concerned for Vicky’s safety and Vicky had expressed some thoughts of suicide to her.” The next day came a call from Boone, saying she, too, was worried about Vicky.

An alarmed Lee took Karter to UCI Medical Center, where she was hospitalized until the end of the month. Lee said doctors there diagnosed her condition as postpartum depression and prescribed the anti-depressant drug Pamelor, the trade name for a generic drug known as nortriptyline. (A medical center spokeswoman said that because of state and federal laws protecting the privacy of psychiatric patients, the hospital could neither confirm she had been a patient there, nor discuss her case.)

When she came home from the hospital, Lee and Karter hired a nanny/housekeeper to help with Rachel. Lee, who attended Lamaze classes with his wife during her pregnancy and was in the delivery room during birth, said he also tried to help more with the baby.

After about two weeks at home, in which Karter received lots of rest, Lee said, the medication seemed to take full effect, and “I was utterly amazed,” Lee said. Normally an even-tempered person, after Rachel’s birth Karter had swung into deep depression. Suddenly, “she was uncharacteristically too enthusiastic. . . . All of a sudden she’s the most enthusiastic, energetic person I’ve ever met. And I’m thinking to myself, ‘Wow, these drugs are working great. This is fantastic. It’s a miracle.’ ”

Boone saw the change, too. One day Karter telephoned her “and said she felt great . . . just felt wonderful. She had told me before that she felt she was walking around in a cloud, a fog, that she couldn’t function. Then this one day she was wonderful, her head was clear, and for about three weeks she was like that, everything was fine.”

But before long Karter became depressed again. Lee said his wife told him she didn’t understand what was happening, that she would go to the mall, see other women smiling happily as they pushed their babies in strollers. “And here I am, I’ve got a nice home and a nice husband and a nice baby, and yet I’m feeling weird,” Lee remembered his wife saying.

“And dumb me, I’m saying, ‘Ah, things will pass, you’re just getting back (to normal). Did you take your medicine?’ ”

Boone said Karter told her that the doctors rejected her request to stop taking Pamelor when she was feeling better, but agreed to lower the dosage. Later it was increased again, but it didn’t seem to help. (The doctor at the Santa Ana psychiatric offices of the Kaiser Permanente Medical Care Program whom Lee said treated his wife after she was discharged from the hospital, declined comment, referring inquiries to the facility’s administrator, who did not return phone calls.)

Karter told Boone in one of their almost daily telephone conversations that she just couldn’t function.

“She kept telling me she was a bad person and everyone would be better off without her,” Boone recalled. Karter said that after she died her husband eventually “would find somebody else and that person would take care of the baby.”

Karter rejected Boone’s advice to get away for a few days. She said she was afraid to leave the baby at home for fear people would think she wasn’t a good mother. She was afraid to admit her thoughts of suicide to her doctors for fear she would be institutionalized for the rest of her life, which would bankrupt her husband, Boone said.

On Sept. 19, a Wednesday, a woman who declined to give her name showed up at Newport Beach police headquarters at 8 p.m. with a disturbing tale.

The woman said she had been at Cliff Drive Park in the Newport Heights section of Newport Beach a little earlier. While there she saw a woman with an infant. The woman seemed “despondent.” The good Samaritan walked the woman to her car, copied her license plate number, and told police of her concern.

Police traced the number to Karter and visited her and Lee at their home. After interviewing the husband and wife separately and together, police concluded Karter was no danger to herself or anyone else then, had resources she could turn to if she needed help, and left.

Two days later, Karter told her housekeeper she was going out for a while. At 1 p.m., she made a reservation for a room at the Four Seasons Hotel in Newport Beach. She showed up at 3:30 p.m. to check in. One hotel employee called her “pleasant.” Another described her as “distant.”

Shortly after 4 p.m., Karter called Rivera to ask if Boone was there. Rivera said no, that her daughter was probably either still at her home in Cerritos or on her way to the Rivera house in Montebello. Karter said she’d try the Cerritos number.

About 4:30, Karter called Rivera again, saying she hadn’t been able to reach Boone. “I told her to leave her number where she was and I’d have Kathy call her,” Rivera remembered. “She said she was going to kill herself. She said she didn’t want anyone to know where she was, she didn’t want anyone to stop her.”

Minutes after she heard the phone drop and her pleas to Karter go unanswered, Rivera’s daughter arrived.

Boone called Karter’s housekeeper. She called Lee at one of his company’s offices, in Moreno Valley. She called the Newport Beach police.

Lee began frantically calling Newport Beach police. He also called the Sheriff’s Department and California Highway Patrol. Then he drove home, where he made more phone calls. And waited.

He called the Newport Beach police again, but found the dispatcher “evasive.” He called the Costa Mesa police to see if they knew anything about his wife. He called Newport Beach again, talking to a dispatcher whom Lee said promised “to have detectives talk to me.”

“Not knowing is worse than knowing,” Lee said, and for more than three hours he didn’t know. About 8:30 that night, however, two detectives and a deputy coroner showed up at his house “and said they had information about my wife.”

He knew.