What the Lindsay Clancy trial can teach us about postpartum mental health

The Lindsay Clancy trial has drawn national attention to postpartum mental illness. Clancy, a Massachusetts mother, admitted she killed her three young children in 2023, but has pleaded not guilty by reason of insanity due to her postpartum psychosis.

As the case has gained attention, women have taken to social media to share deeply personal accounts of their own postpartum mental health struggles and the barriers they faced when seeking help.

If a new mother hemorrhaged on the delivery table, no one would tell her to wait six weeks for an appointment. We would move heaven and earth. Yet, when a woman’s mind is in crisis after childbirth, we too often ask her to wait, to white-knuckle it or to convince others that she is sick enough before anyone acts.

A postpartum psychiatric crisis is a medical emergency. Treatment should have the same urgency as a bleed, a clot or a seizure.

One of the most damaging myths about postpartum mental illness is that it reflects a mother who is weak, ungrateful or not trying hard enough. The science says otherwise. The days and weeks after birth bring some of the most dramatic biological changes the human body ever undergoes: a sudden collapse in reproductive hormones, shifts in the immune and stress systems, disrupted circadian rhythms and profound sleep loss. In a genetically vulnerable woman, these changes can precipitate real, diagnosable illness.

Most women experience the “baby blues,” which includes mood swings that peak a few days after delivery and fade on their own. But roughly 1 in 7 develop postpartum depression, a serious condition that does not simply lift with time. In about 1 to 2 of every 1,000 births, a woman develops postpartum psychosis, an acute, frightening loss of touch with reality that usually begins within days of delivery, according to the American College of Obstetricians and Gynecologists.

These are not character flaws. They are brain conditions driven by measurable physiology. Like other medical conditions, they should be identified and treated.

If these illnesses are treatable, why do so many women go without care? Research consistently shows that nearly half of affected mothers never reach treatment. Part of the barrier is stigma and shame — the fear of being seen as a bad mother, or of having a baby taken away.

But a larger part is structural. When obstetric providers are surveyed about what stops their patients from getting care, the biggest obstacles are not patient motivation. They are insurance coverage and a shortage of mental health professionals willing and available to see new mothers.

In Minnesota, that shortage is significant. Women in rural counties, women on Medicaid, and BIPOC women receive recommended postpartum care at lower rates than their peers. A mother in greater Minnesota may be hundreds of miles from a perinatal psychiatrist. A mother juggling a newborn, no child care and a tight budget may find that even an available appointment is out of reach.

We have built a system that asks the most exhausted, most vulnerable patients to fight the hardest to be seen.

If you are a new mother and something feels wrong, if the sadness will not lift, if anxiety is constant, if you cannot sleep even when the baby sleeps, if you feel disconnected from your child or yourself, please tell someone. Tell your obstetrician, your family doctor, your baby’s pediatrician or some other trusted person in your life. You are not failing. You are experiencing a medical condition, and it is treatable.

Certain symptoms are emergencies and demand immediate attention. These include thoughts of harming yourself or your baby, confusion, seeing or hearing things others do not, or beliefs that feel real to you but frightening to those around you. These can be signs of postpartum psychosis, which requires urgent evaluation to keep both mother and baby safe. Do not wait. Go to an emergency room or call for help.

Here are two resources every Minnesota family should save: the National Maternal Mental Health Hotline at 1-833-943-5746 (1-833-9-HELP4MOMS), which is free, confidential and available 24/7 by call or text in multiple languages; and the 988 Suicide & Crisis Lifeline for any mental health emergency.

We do not ask mothers to prove they are bleeding enough before we treat a hemorrhage. We should not ask them to prove they are broken enough before we treat their minds.

The biology is real, the treatments are improving and the barriers are ones we built and can dismantle. The Lindsay Clancy trial has put postpartum mental health in the national spotlight. We should use this moment to ask what we can do differently for the next mother who needs help.

Minnesota’s mothers deserve fast and compassionate care without shame. Treating a postpartum psychiatric crisis like the emergency it is would be a good place to start.

Bernice Gyamfi is a psychiatric mental health nurse practitioner and the founder of Minnesota-based Ohana Mental Health.