Note: If you or someone you know is in crisis, please call, text or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.
A Massachusetts woman has been on trial for allegedly killing her three children, one of them an eight-month-old baby. Lindsay Clancy and her defense team don’t deny she killed them. They argue she was suffering from postpartum psychosis at the time, and are pleading not guilty by reason of insanity. The trial started in July and has become a fixture of true-crime social media.
But what deserves more attention than the theories is postpartum psychosis itself, and the fact that it doesn’t exist in isolation. It sits at the extreme end of a much broader spectrum of maternal mental health disorders, conditions that, taken together, are the leading complication of childbirth, affecting 20% of U.S. women, according to the Policy Center for Maternal Mental Health (PCMM).
A condition medicine still doesn’t fully understand
Postpartum psychosis (PPP) is rare — it’s estimated to occur after one to two of every 1,000 births — and dangerous, capable of producing hallucinations, delusions, and thoughts of harming oneself or one’s children, according to the Cleveland Clinic. Similar to more common maternal mental health conditions, including postpartum depression, anxiety, OCD, and PTSD, it’s linked to sleep deprivation and hormonal shifts. Where it diverges is prior psychiatric history: while most maternal mental health disorders are more likely in women with a history of mental illness, the Washington Post has reported that at least half of women who develop postpartum psychosis have no prior history.
Because the onset of PPP symptoms can be unpredictable, it can be difficult to screen for the condition. PPP is also not featured as a standalone diagnosis in the Diagnostic and Statistical Manual of Disorders (DSM), and without that formal recognition, many medical trainees don’t spend much time learning about it.
Clancy had more contact with the mental health system than most people ever get: multiple psychiatrists and nurse practitioners, medication, a disclosure of intrusive thoughts to her family, a call to a suicide hotline, and a psychiatric hospitalization weeks before her children died. Yet the defense argues that inadequate mental health support led to tragedy.
The maternal mental health gap is even wider for women of color
Maternal mental health generally lags, but the gaps in how we support it are widest for women of color. While more than half of postpartum depression cases among women of color go unreported, according to the Maternal Mental Health Leadership Alliance (MMHLA), the data we do have shows that up to 40% of Black and Latina moms experience PPD, twice the rate of their white counterparts.
For American Indian and Alaska Native women, the picture is starker. A 2026 CDC analysis found mental health conditions are the single leading underlying cause of pregnancy-related death in that population, ahead of infection, cardiovascular conditions, and hemorrhage. AI/AN women also report postpartum depression at roughly double the rate of white women, according to PCMM, a gap researchers attribute to historical trauma, chronically underfunded Indian Health Service care, and elevated rates of interpersonal violence.
Women from all three groups additionally deal with overlapping barriers to care, including providers dismissing or minimizing symptoms, a shortage of culturally and linguistically competent mental health care, mistrust of a system with a documented history of mistreating patients of color, and the chronic stress of discrimination itself, which independently raises the risk of depression during and after pregnancy, even after controlling for income and education.
While postpartum psychosis is too rare to be able to generate reliable breakdowns by race, it emerges from the same system that already fails mothers of color at the more common end of the maternal mental health spectrum. So it’s reasonable to think that the same access and bias gaps documented in postpartum depression persist when it comes to PPP.
Maternal mental health matters not just for the health of the mother, but for the health of the family. According to PCMM, untreated maternal mental health disorders are associated with increased risk for preeclampsia, preterm birth, and low birth weight, and can lead to negative early childhood development outcomes. They are also the leading cause of pregnancy-related death, with 20% of such deaths attributed to suicide.
What actually helps
It’s tempting to look at how much care Clancy received and still conclude nothing can prevent a tragedy like this. But the more useful response is asking what closes the specific gaps that failed her and that fail mothers of color even more often at every point along the maternal mental health spectrum. That includes better perinatal mental health training for clinicians, stronger postpartum screening and follow-up protocols, dedicated funding for research into postpartum psychosis, and recognition of it as its own diagnosis. Organizations like Postpartum Support International are already pushing for that last piece, and others, like PCMM, work to advance change through policy makers, providers, and community partners.
Whatever the jury decides about Lindsay Clancy, postpartum psychosis and the broader family of maternal mental health conditions it belongs to will still be here afterward, still under-recognized, and still hardest on the mothers with the least access to care. The verdict deserves focus, but so does what the trial exposed about maternal mental health along the way.
MORE FROM URL MEDIA
- What wildfire smoke does to mental health
- From Clinical to Community: I’m a therapist. Therapy isn’t enough
- What’s missing from the diarrhea lettuce coverage
