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I think Susan Smith was possessed by the devil, not insane. As for mothers killing their own children, the fact that Andrea Yates didn't get the needle for murdering her five kids (her overturned conviction came with a forty-year sentence) demonstrates that there is a legal foundation for the idea that doing such a thing is proof of insanity.

However, being found not guilty by reason of insanity is not a ticket to resume normal life. In many cases, those found to have been not guilty of a given crime by reason of insanity receive a court order to report to a state-sanctioned mental institution for psychiatric treatment, and are kept there until authorities determine that they are no longer a threat to themselves or others. The Supreme Court of the United States ruled in Foucha v. Louisiana (1992) that such periods of treatment were not punitive under the law, and could not be continued indefinitely, but it is perfectly legal to confine such persons for a long, long time. This is what happened to Yates; she is living at the North Texas State Hospital in Vernon in a room with Dena Schlosser, the Plano woman that murdered her infant daughter by cutting off the baby's arms. (I strongly suspect that it will be many decades before any court in Texas deems either woman psychologically fit to return to society.)

In the case of a typical abortion, the court could order that the mother receive such treatment for a limited time in lieu of imprisonment (which would serve no positive purpose). In cases like Yates and Smith, the court could order longer periods of psychiatric treatment, so long as these did not coninue "indefinitely". To me, this would seem to be a way to distinguish between some scared teenager who gets talked into an abortion by her boyfriend and a diabolical serial killer like Andrea Yates.