Susannah Birch was just two years old when the person she trusted the most almost killed her.
"My parents were Seventh Day Adventist but lived an otherwise normal life — church, friends and work," Susannah tells news.com.au.
"My father was a carpenter, and my mother was living at home while I was young."
But on Australia Day 1989, everything changed.
"My father woke early and prepared to do a small weekend job for a client. My mother had bathed me and put me in a new pair of pyjamas," she says.
"My father returned later that morning to find the cottage surrounded by police cars.
"Some time while he was gone, my mother had placed me on a tea chest, cut my throat with a knife and left me laying there for an estimated 40 minutes before coming out of her psychosis enough to phone the police."
Hospitalised for more than three months, Susannah sustained a severed laryngeal nerve and trachea and received more than 50 stitches.
"It took me five weeks to talk again," she says.
"I had a tracheostomy tube in my throat for 11 years and have had quite a few surgeries over those years and after, until age 15.
"As an adult, I have one paralysed vocal cord and one which flutters slightly, as well as a scar around my neck."
Susannah's mother was diagnosed as bipolar and was not charged due to insanity at the time of the attack.
She spent a year in a mental health ward before coming home for supervised visits, then eventually moving home.
"I remember the event in photograph-like images," Susannah says. "I remember being in a kitchen with at least one knife sitting in a pot being boiled. I have an image of the knife approaching my face. I remember being on a stretcher outside, and I remember laying on a stretcher in the helicopter.
"When I was around age three, I was eating dinner with my father and said, 'Mum cut my neck'.
"From that point forward, he talked to me about the event whenever and however I wanted, based on advice from a psychologist."
After that, life went on as normal — for a while.
"Scarily normal, for me at least," Susannah says. "It wasn't till I was around age 11 that she had another psychotic slide that led to a series of events and behaviour changes that led to my parents' divorce just before my 14th birthday."
Despite having little contact with her mother since 2008, Susannah has been left with physical and emotional scars as a result of her mother's abuse.
"I had a phobia of things near my face," she says. "At age 10, I experienced depression. As a teen, I was suicidal at some points.
"As I grew older, I experienced depression and anxiety. I get easily worked up if and when she comes into my life, even through mentions. Having children was confronting, too."
According to counselling psychotherapist Dr Karen Phillip, child abuse at the hands of mothers remains a particularly shocking crime, highly detrimental to victims due to the trusted relationship between mother and child and how infrequently it takes place.
"The mother-child bond is cemented and felt strongly by both mother and child," says Dr Phillip.
"Most mothers do the very best job they are capable of, therefore we seldom see intentional malice directed to the child.
"Saying this, we do unfortunately see mothers who abuse their child, intentionally or inadvertently.
"This is unusual."
Renee* was just three years old when she was first abused by the woman she trusted the most, an incident that led to years of horrific child abuse perpetrated, or arranged, by her mother.
At least, that's as far back as she can remember. It may have started even earlier.
"My earliest recollection is seeing my mother watch and allow the abuse," Renee says.
"But what I didn't realise was that she was the instigator."
Growing up, Renee lived with her mother and stepfather as well as her two younger siblings whom she loved fiercely and did her best to protect.
Despite her best efforts, though, the three children suffered extensive abuse — physical, sexual and emotional — at the hands of their mother or her accomplices.
"I was drugged and so was my brother," says Renee. "We were sexually abused, repeated, over and over, and then I was expected to cook and clean.
"My mother would literally hand me to (my stepfather), or other times, she would drug me, and I would be in her bed. I thought it was special time, however I was just abused by both of them."
Along with the physical and sexual abuse, Renee was also verbally assaulted and treated cruelly by her mother.
"I saved my money and bought porcelain clowns, which she would smash when she was angry with me," Renee says.
"I was made to inject her with morphine and pethidine and to massage her feet."
At 14, Renee had had enough and left home for the last time after being hit across the side of her head with a telephone, but the psychological repercussions of the abuse would last for years to come.
"I often wondered why she hated me so much, what did I ever do? All kids love their parents, I tried to get her to love me and be proud of me," she says.
"Even after I left home, she still controlled me and my thoughts. I had to get her out of my head.
"The last time I tried to speak with her, I was 16 and had a six-month-old baby. She went to hit me again and verbally abused me.
"I've had several bad relationships and have tried to raise my five sons without a good role model or experience
"But I have been to every available parenting group and am a fierce protector of my boys."
Dr Phillip says mothers who abuse children have often experienced childhood abuse themselves, or drug or alcohol issues are involved.
"We often see mothers who have been raised by disconnected parents lacking love, attention and affection who take these attributes into their own parenting style," she says.
"Then we have the mothers with sociopathic or narcissistic personalities who lack the ability to affectionately love or feel empathy for their child, resulting in a disengaged relationship."
But when it comes to severe acts of violence and even murder, while those committed by fathers are often attributed to a desire for vengeance against the child's mother, those committed by mothers are usually linked to mental illness or depression.
This, says Susannah, is leading to children being sent back to potentially unsafe situations because people cannot comprehend a mother would abuse their children.
Dr Phillip agrees but says more needs to be done to support mothers suffering from severe depression or mental illness.
"It appears children are sent back to abusive mothers due to the fact we struggle with understanding how any mother could abuse her child," Dr Phillip says.
"Children living with an abusive mother or a mother suffering mental illness are at risk of developing social, emotional and behavioural problems.
"These children face challenges they are not emotionally equipped to manage, with many children at greater risk of drug use, poor school performance, alcoholism, poor social relationships and behavioural issues.
"Any mother struggling to manage needs to reach out for support. It is not only an impact on her but an enormous impact on the child she is raising and loves.
"No mother wants to hear she is failing, therefore, if you see a mother in distress, subtle slow steps to encourage and support is mandatory."
* Name has been changed
Nicole Madigan is a freelance journalist. This article was first published on news.com.au.
WHERE TO GET HELP:
If you are worried about your or someone else's mental health, the best place to get help is your GP or local mental health provider. However, if you or someone else is in danger or endangering others, call police immediately on 111.
OR IF YOU NEED TO TALK TO SOMEONE ELSE:
• 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP) (available 24/7)
• YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757 or TEXT 4202