A woman charged with drowning her two young daughters in a bathtub had been getting them ready to be dressed in case she had to be taken to a hospital, her aunt said.

The morning of their deaths, Amber Hill spoke with her mother on the phone about whether Hill needed to be hospitalized. Her mother agreed to come over and take her, if necessary, said Carolyn Hill, aunt of the 22-year-old.

"That's why the kids were in the tub, because Amber was bathing them, getting them ready to get dressed. I don't know exactly what was hurt on her," she said.

Amber Hill is charged with killing Janelle Cintron, 4, and Cecess Hill, 2, Monday in the bathtub of the apartment where they lived. Now authorities are trying to figure out what might explain a horrific contradiction — how a pleasant young woman who relatives say adored her children could be accused of becoming their emotionless killer.

"She used to be a really lively, young lady, as a teen," Carolyn Hill said. "Very bubbly and always smiling.

"She loved those kids, too much. They were her world. The youngest one was such a dainty little thing ... They (were) just two beautiful little girls."

A memorial service for the two girls was held Saturday, with mourners — family members, friends and strangers alike — streaming into a funeral home to pay their respects. Five Cleveland police officers rode in a motorcycle escort that took the funeral procession to Riverside Cemetery, where the girls were buried.

Authorities have not offered a motive for the killings and say Amber Hill had no documented history of neglecting the girls.

A judge on Wednesday recommended that Amber Hill receive medical and psychological treatment. No further details about the court ordered treatment was given.

She had been held in city jail on suicide watch, and appeared at the hearing in black paper overalls issued to inmates considered a danger to themselves.

Police said she seemed vacant of emotion when investigators tried to talk to her when the girls were found in the tub. In court two days later, she said nothing and kept her head bowed.

On Monday, she made a phone call at about 12:30 p.m. to Jamie Cintron, 23, father of the girls, at his job at a Burger King. He told police she said the girls were at peace. He went to the apartment, where he had been living with Hill, pulled them out of the tub and made a chilling 911 emergency call.

"Both my daughters are laying here dead! Why? Why are my daughters dead?" the sobbing man screamed.

The cause of death has been listed as drowning.

But Cuyahoga County's coroner, Dr. Frank Miller, said Friday his staff was considering whether to add strangulation as a factor in the 4-year-old's death.

"There were marks around the neck and bleeding in the small blood vessels in the eyelids," Miller said. "So there is some suggestion the 4-year-old was strangled, at least partially if not completely."

Part of the investigation involves Hill's turbulent relationship with the girls' father.

"We know there was some turmoil in the family," Miller said. "There were domestic violence issues."

In 2004 and 2006, Cintron pleaded no contest and was found guilty of domestic violence against Hill, according to court records. In the latest case, he had picked up a hammer during an argument with Hill and broke the TV with it, grabbed her by the neck and shoved her, according to a Cleveland Municipal Court record.

Until about two months ago Amber Hill had attended the Cleveland branch of Remington College, studying to be a medical assistant.

"She had the kind of struggles that every single mother, every young mother, has, trying to go to school, trying to take care of kids," said Ashley Merritt, 22, a friend. "I do know she was a good mother, and she loved those girls."

Experts say women who turn against their children do it for a variety of reasons, including mental illness, abuse that turned deadly or revenge against the youngsters' father. Others intend to commit suicide and decide to kill their children so they won't be left alone, said Geoffrey McKee, author of "Why Mothers Kill: A Forensic Psychologist's Casebook."

Andrea Yates drowned her five children in the family's Houston bathtub in 2001. She was found innocent by reason of insanity and sent to a state mental hospital. Yates initially was convicted of capital murder, but that verdict was overturned.