Beyond the Headlines: What the Lindsay Clancy Case Is Asking Us to Confront

Content warning: This article discusses maternal mental health, postpartum psychosis, suicide, and the deaths of children. Some details may be distressing or triggering for readers.

The ongoing trial of Lindsay Clancy has brought an extremely difficult conversation about maternal mental health into public view. In January 2023, Clancy was accused of killing her three young children in Massachusetts before attempting to take her own life. Her defense has argued that she was experiencing severe postpartum mental illness, including postpartum psychosis, while prosecutors dispute the defense's account and maintain that she is criminally responsible. As the trial continues, testimony and evidence are still being presented, and the court has yet to determine the outcome.

There is no simple way to talk about the deaths of three children, and there should not be. The grief and devastation experienced by their family deserve to remain at the center of what happened. At the same time, the attention surrounding this case has opened a wider conversation that extends beyond one mother, one family, or one courtroom: what happens when maternal mental health is misunderstood, overlooked, minimized, or treated as something a woman should simply be able to manage?

That question matters because maternal mental health is not an occasional complication of motherhood. It is part of maternal health, and the evidence tells us that it is far more common than the attention it receives would suggest.

Maternal mental health is still too easy to overlook.

Pregnancy and childbirth are routinely monitored for physical complications, with care teams tracking blood pressure, blood sugar, fetal growth, bleeding, infection and other indicators that can signal risk. Mental health, however, has historically received less consistent attention, despite the fact that perinatal mental health conditions are among the most common complications associated with pregnancy and the first year after birth. 

ACOG describes these conditions as frequently underdiagnosed and undertreated, while recommending routine screening and systems that connect screening with assessment, treatment and follow-up.

The scale of the issue is significant. The CDC reports that approximately 1 in 8 women with a recent live birth experience symptoms of postpartum depression, while its research has also identified missed opportunities in care, with about 1 in 5 women reporting that they were not asked about depression during a prenatal visit and about 1 in 8 reporting that they were not asked during a postpartum visit.

These numbers are not simply statistics about screening. They reflect how easily a mother's emotional and psychological health can become secondary to everything else happening around pregnancy and birth.

There is also a cultural layer to this problem. New mothers are often surrounded by expectations that they should feel grateful, capable, protective and happy, even while recovering physically, navigating major hormonal changes, sleeping poorly and adjusting to a completely different identity and routine. When distress is met with phrases such as "everyone feels this way" or "you're just exhausted," an experience that deserves attention can become something a mother learns to hide.

Normalizing the challenges of motherhood is important, but normalizing symptoms that require care is not.

Postpartum Depression, Anxiety, and Psychosis are not the same.

One reason conversations about cases such as Clancy's can become confusing is that postpartum depression, anxiety and psychosis are sometimes discussed as though they are variations of the same condition. They are not.

Postpartum depression is common and can involve persistent sadness, hopelessness, anxiety, anger, loss of interest, exhaustion, difficulty bonding with the baby and feelings of inadequacy. It is different from the temporary "baby blues," and it is treatable with appropriate support and clinical care.

Postpartum psychosis is a very different and much more severe condition. It occurs in approximately 1 to 2 out of every 1,000 deliveries and can involve hallucinations, delusions, paranoia, severe confusion, agitation and a loss of connection with reality. ACOG and Postpartum Support International both emphasize that suspected postpartum psychosis requires immediate medical attention. Postpartum psychosis often develops abruptly, most commonly within the first days or weeks after birth, and is strongly associated with bipolar-spectrum illness in the psychiatric literature. Its presentation can include manic symptoms, rapidly changing mood, disorganized thinking, markedly decreased need for sleep, delusions, hallucinations, or impaired insight.

Understanding that distinction is important not only for clinicians, but for families and communities as well. A mother experiencing depression is not inherently dangerous, and having intrusive thoughts does not mean someone has postpartum psychosis. At the same time, significant changes in behavior, severe sleep disruption, paranoia, hallucinations, delusions or thoughts of suicide should never be dismissed as simply part of becoming a parent. Unwanted intrusive thoughts can occur in postpartum anxiety and obsessive-compulsive presentations and are not the same as wanting, intending, or planning to harm a baby. The overwhelming majority of people experiencing perinatal mental-health conditions do not harm themselves or their children.

The danger of waiting until something looks like a crisis.

Perhaps the most important lesson from the wider conversation is that maternal mental healthcare cannot depend on a crisis becoming obvious to everyone around a mother.

ACOG recommends screening for depression and anxiety during pregnancy and postpartum, along with appropriate assessment for bipolar disorder, suicidality and postpartum psychosis. Importantly, ACOG also recommends that screening be accompanied by systems that provide timely access to assessment, treatment and ongoing monitoring.

That last part is critical. Screening is not care by itself.

The gap is not whether we have a screening questionnaire. It is what happens between screening, clinical evaluation, referral, treatment and follow-up, and whether changes are noticed when a mother is no longer sitting inside a clinic. Maternal mental health requires continuity, not a single score collected at a single point in time.

Asking a mother whether she is struggling matters, but the answer needs somewhere to go. A positive screening result needs clinical assessment, and a mother who requires treatment needs access to that treatment. Someone experiencing a psychiatric emergency needs a clear and immediate pathway to appropriate care.

This is where maternal mental health often becomes difficult in practice. The traditional postpartum model can create a gap between appointments, while a mother's needs do not necessarily follow an appointment schedule. A concern can emerge in the middle of the night, anxiety can intensify over several days, sleep can deteriorate gradually, or a partner may notice a change that the mother herself cannot fully recognize.

The healthcare system cannot be present every minute, but it can be designed to make it easier for concerns to be noticed and acted upon before they become emergencies.

We need to make asking for help feel less like an admission of failure.

There is another part of the problem that cannot be solved through clinical screening alone.

Mothers need to feel safe telling someone that they are not okay.

That can be difficult when motherhood is surrounded by judgment, particularly for women who fear being seen as incapable, unstable or unfit to care for their children. A mother may worry about what her partner will think, what her family will say, whether her provider will judge her, or whether admitting that she is struggling will change how people see her as a parent.

Those fears can become barriers to care even when services technically exist.

This is why maternal mental health needs to become part of ordinary maternal care rather than something that appears only when a woman reaches a breaking point. Conversations about mood, anxiety, sleep, intrusive thoughts, safety and emotional wellbeing should feel as routine as conversations about blood pressure or physical recovery.

Partners and families also have an important role because they may notice changes before a mother is able to describe them herself. Knowing what symptoms can look like, understanding that postpartum psychosis is a medical emergency, and knowing where to seek professional help can make a meaningful difference when someone's condition begins to change.

Technology has a role, but it cannot replace care.

There is a place for technology in making maternal mental health more visible, particularly in the spaces between clinical appointments, but that role needs to be understood carefully.

An app cannot diagnose postpartum psychosis, replace a psychiatrist, provide emergency treatment or substitute for human connection. What digital tools can do is create additional opportunities for mothers to check in with themselves, recognize changes, find reliable information, track symptoms and know when a concern deserves professional attention.

The goal should not be to put the responsibility for mental healthcare back on the mother through another app or another checklist. It should be to build a more connected layer of support around her, where information can move with her and concerns have a better chance of being recognized early.

That is particularly important in a healthcare system where the traditional postpartum visit is only one point in a much longer period of physical and psychological recovery.

The conversation should be bigger than one courtroom.

The Lindsay Clancy trial will ultimately be decided through the legal process and the evidence presented in court. It would be neither responsible nor fair to use an ongoing trial to make definitive claims about what happened medically, what individual clinicians should have done, or what the final legal outcome should be.

But we can still ask difficult questions about maternal mental health without prejudging that case.

Are mothers being asked often enough about how they are really doing? Are healthcare professionals equipped to recognize the difference between ordinary postpartum adjustment and symptoms that require intervention? Do families know what severe postpartum mental illness can look like? When a screening identifies a concern, is there actually a clear pathway to care? And perhaps most importantly, can a mother say "I am scared by what is happening to me" without immediately feeling that she has failed at motherhood?

These are questions worth asking before another headline gives us a reason to ask them.

Maternal mental health should not have to become visible through tragedy before it becomes worthy of attention. It should be part of the care that surrounds a woman throughout pregnancy and postpartum, with repeated opportunities to check in, recognize changes, access support and escalate care when necessary.

Because the goal of maternal healthcare should not simply be to respond when a crisis becomes impossible to miss.

It should be to build a system in which mothers are seen early enough that fewer crises have the chance to become invisible in the first place.

If you or someone you know is struggling

Maternal mental health conditions are treatable, and asking for help does not require waiting for symptoms to become severe. If someone is experiencing hallucinations, delusions, severe confusion, paranoia, extreme agitation, suicidal thoughts or other signs of possible postpartum psychosis, immediate professional medical assessment is necessary because postpartum psychosis is a psychiatric emergency.

For ongoing concerns about depression, anxiety, intrusive thoughts or emotional wellbeing during pregnancy or after birth, speaking with an obstetric, primary care or mental health professional can be an important first step. Support should begin with being heard, not with having to prove that something is wrong.

Myri can help mothers access evidence-based information, recognize changes in how they are feeling, and understand when professional care may be needed. Myri is not an emergency or crisis service and does not diagnose postpartum psychosis. Whether you have questions about something you are experiencing during pregnancy or postpartum, need help understanding what you are feeling, or are looking for evidence-based information to help you decide what to do next, you do not have to navigate it alone.

Reaching out is not a sign that you are struggling as a mother; it is a way of taking care of yourself, too. <3 

If someone may be in immediate danger or is experiencing suicidal intent, hallucinations, delusions, severe confusion, or other signs of a psychiatric emergency, seek emergency medical care immediately.

Written by Myri Health | Clinically reviewed by Dr. Pinkey Patel, Pharm.D, NASM-CPT

‍

Sources & References

1. Centers for Disease Control and Prevention (CDC). Depression Among Women.
   CDC – Depression Among Women
2. Centers for Disease Control and Prevention (CDC). Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression — United States, 2018. Morbidity and Mortality Weekly Report (MMWR), 2020.
   CDC MMWR – Postpartum Depressive Symptoms
3. American College of Obstetricians and Gynecologists (ACOG). Clinical Practice Guideline: Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum.
   ACOG – Perinatal Mental Health Screening
4. Centers for Disease Control and Prevention (CDC). Timing of Postpartum Depressive Symptoms. Preventing Chronic Disease, 2023.
   CDC – Timing of Postpartum Depressive Symptoms
5. Postpartum Support International (PSI). Postpartum Psychosis.
   Postpartum Support International – Postpartum Psychosis