It could start with a miscarriage or a breakup.

The distraught woman sees a baby as the solution and begins elaborate planning. A pregnancy announcement. A baby shower. Cultivation of a relationship with a pregnant woman.

In rare cases, the fantasy leads to criminal acts: stealing a child, or kidnapping and killing a mother and taking her child.

FBI behavioral analysts say they believe a Houston woman was driven to kidnap her friend’s infant daughter and — after the woman was strangled — hide the mother’s corpse in a car in her backyard by an overwhelming compulsion to have a baby that they term “maternal desire.”

Magen Fieramusca, who was charged last month with kidnapping Austin mother Heidi Broussard and her 3-week-old baby, Margo, and tampering with Broussard’s body, would not be the first woman motivated to commit those crimes due to this compulsive condition.

“The desire to have a child can become pathological,” said Asim Shah, professor and executive vice chair of Community Psychiatry at Baylor College of Medicine. “When the woman so desperately wants a child, she may try to take one from somebody close to her.”

The motive of maternal desire may develop after one or more failed pregnancies, or a woman who has not been pregnant may completely fabricate a pregnancy.

The women triggered by the compulsive desire to have a baby meticulously plan schemes to obtain infants. The lengths to which women have gone range from impersonating medical workers to quietly steal children to befriending and manipulating pregnant women to gain access to their babies.

Sometimes the abductions are violent, ending in murders of the mothers. In rare cases, women have cut open pregnant mothers to steal fetuses from their wombs.

“It’s erratic, abnormal behavior,” Shah said. “It happens usually in people who are either depressed, anxious, have a psychosis or personality disorder, or are in a delusional state.”

Broussard, 33, and her baby were reported missing by the Austin Police Department on Dec. 13. Her body was found on Dec. 19 stuffed into a duffel bag in the trunk of a car parked in the backyard of the house where Fieramusca, also 33, lived near Jersey Village, according to an affidavit of arrest. Baby Margo was found safe inside the home.

Fiermusca presented the baby as her own during that time, police said. She also apparently convinced Chris Green, her ex-boyfriend with whom she lived, that the child was his. Investigators said Fieramusca either lost a pregnancy or entirely fabricated one in the months leading up to Margo’s kidnapping.

Broussard’s death was ruled a homicide by the Harris County Institute of Forensic Sciences. She was killed by ligature strangulation. Fieramusca has not been charged with killing Broussard.

There have been 327 infant abductions across the country since 1964, according to an analysis by the National Center for Missing and Exploited Children. Of those, only about 5 percent were reportedly motivated by maternal desire.

Though violent infant abductions fueled by a woman’s pathological obsession with becoming a mother are relatively rare, recent cases have devastated communities across the nation. A 2017 case in Houston was apparently sparked by a miscarriage.

Investigators said Erika Jisela Miranda-Alvarez stabbed 33-year-old mother Carolina Flores to death on Dec. 19, 2017, and kidnapped her infant. Miranda-Alvarez, 28 at the time, was due to give birth to a baby of her own around that time but had a miscarriage, police said. She didn’t tell anyone in her family about losing the baby and later went to a hospital to pretend to give birth, according to authorities. She is facing a capital murder charge in the case.

Some cases don’t end in bloodshed. In Pittsburgh in 2012, Breona Moore, then 19, told her boyfriend that he couldn’t break up with her because she was pregnant. But she wasn’t. Instead, Moore impersonated a nurse and stole a newborn baby from Magee-Womens Hospital. She posted baby photos on social media and convinced her friends and family that the baby was hers. She was sentenced to five years in prison.

In rare violent instances, maternal desire can lead to fetal abduction.

Korena Roberts cut open the abdomen of her pregnant friend, 21-year-old Heather Snively, to take the woman’s baby boy and pretend it was her own in June 2009. Roberts, 27 at the time, hid Snively’s body in the crawl space of her home in Hillsboro, Ore. The baby did not survive. Roberts is serving life in prison.

Elaborate planning

In the first phase of an infant abduction motivated by maternal desire, psychiatric professionals say, studies of the cases indicate the women went to great lengths to use deception to act out a pregnancy fantasy.

In Fiearmusca’s case, her warrant says all the people around her believed she was pregnant, including Broussard. Green said that he touched Fieramusca’s stomach and that it felt hard like she was pregnant, but he never saw her bare stomach.

An online baby registry under the names Maygen Humphrey, an alias police say Fieramusca used on all her social media accounts, and Chris Green shows family and friends purchased most of the desired gifts the couple listed.

In cases in which the woman was never pregnant in the first place, she may pretend to be pregnant because she perceives mothers to be held in a higher regard in society and desperately wants to be one. In other cases, the woman may want to restore a failing relationship.

“They may be insecure in a relationship and their hope is that if they have a child, their relationship will be secure,” said Sanjay Adhia, a forensic psychiatrist at McGovern Medical School at UTHealth.

The woman imagines that the fake pregnancy will bring with it more attention from her partner, as well as others in her social circle.

Green told FBI agents he ended his relationship with Fieramusca in March. Around the same time, Fieramusca told him she was pregnant.

Often, the woman wants to prove to herself and others that she is capable of being a mother.

Infant abductions Profile of an infant abductor, based on an analysis of cases that occurred between 1983 and 2007 by the National Center for Missing and Endangered Children: Usually female of “childbearing” age (between 12 and 50.) Often overweight. Compulsive and frequently relies on manipulation, lying and deception. Usually states she has lost a baby or is incapable of having a child. Often married or cohabiting with a male partner. Frequently, the abductor lives or is familiar with the community where the abduction takes place. Usually visits the nursery or maternity ward at more than one health care facility prior to the abduction and has asked detailed questions about procedures and the maternity floor layout. May also try to abduct from the home setting. Other infant abductions motivated by maternal desire: Clarisa Figueroa, 46, met pregnant Marlen Ochoa-Lopez on a Facebook group for mothers in April. The 19-year-old expectant mother went missing shortly after that. Figueroa allegedly strangled the woman to death with cable and removed the unborn baby from her womb. Ochoa-Lopez’ body was found in a garbage can in Figueroa’s backyard, police said, and the baby was found alive but in critical condition. Carolyn Simpson, 21, was sliced open with razors by an acquaintance, killing her and her unborn baby in December 2003. Effie Goodson admitted she did it because she wanted the woman’s baby when she pleaded guilty to the killings. She is currently serving life in prison. Theresa Andrews went missing in 2000 in Ohio when Michelle Bica abducted her. She cut the dead mother’s womb open and took the near-full term baby out. The baby boy survived and Bica presented it as her own. She died by suicide before police could arrest her. Stephanie Foster, 34, faked a pregnancy planned to attack a couple and kidnap their newborn in 2010 in Indiana. She drove to the house and knocked on the family’s door to ask to use a telephone. When she was told no, Foster got a gun from her car and forced her way into the home. She began to try to kill the baby’s mother with a kife, but the father was awoken and called 911 and intervened. Both parents were stabbed, but survived. The baby was unharmed. Foster was convicted of attempted murder and sentenced to 28 years in prison.

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In maternal desire abductions, psychiatrists say the act of taking the baby is not impulsive — it’s been planned extensively. The women rehearse their stories and become obsessed with their plan. They may impersonate a health care professional or nanny to gain access to a baby, or they may befriend an expecting mother.

Fieramusca had known Broussard for more than a decade, talked to her on the phone regularly and was there for the birth of Margo on Nov. 26, police said.

“They will try to copy the person that is actually pregnant,” Shah said.

Fieramusca told Broussard that they had conceived at the same time, police said. The online baby registry lists Dec. 12 — the day Broussard went missing — as Fieramusca’s delivery due date.

When violence is involved in the abduction, it’s because the woman is so irrationally fixated on having a baby that she will do anything to get one and keep it, experts said.

“In these cases, the women usually have a social personality disorder,” Adhia said. “They disregard all rules and have no empathy.”

In the final phase, after the baby has been taken, the woman will attempt to enter the child into her social circle as her own.

“They are so focused on the child that they end up believing that they are actually the mother,” Shah said.

Warning signs

The intensity of the would-be mother’s emotions can sometimes provide warning signs.

Broussard’s family found it odd when Fieramusca interrupted Margo’s first meeting with her grandfather in the hospital so she could hold the baby.

Such possessive behavior toward a baby can be a sign of an unhealthy desire, Adhia said.

Going alone to medical appointments or other steps to conceal the fact that a pregnancy is not real are other signals of a potential problem. The fact that Fieramusca’s ex-boyfriend never saw her bare stomach during the time she claimed to be pregnant is another red flag, he added.

A defense attorney representing Fieramusca was not immediately available for comment. Texas Department of Public Safety officials said the investigation is ongoing.

Fieramusca is scheduled to appear in Travis County Court in February.

hannah.dellinger@chron.com