Lindsay Clancy Murder Trial Puts Postpartum Psychosis in the Spotlight — And Exposes Gaps in America’s Mental Health System

Lindsay Clancy, a former labor and delivery nurse at Massachusetts General Hospital, is standing trial in Plymouth Superior Court on charges of first-degree murder in the deaths of her three children — Cora, 5, Dawson, 3, and Callan, 8 months — who were strangled at the family’s Duxbury, Massachusetts home in January 2023. Clancy has pleaded not guilty. Her defense attorney, Kevin Reddington, argues she was not criminally responsible for the deaths because she was in the grip of a severe postpartum psychiatric crisis and had been dangerously overmedicated at the time.
Patrick Clancy, Lindsay’s former husband and the father of the three children, testified early in the trial. He described Lindsay as a devoted mother, said she had been struggling with her mental health for months after giving birth to Callan, and that he had thought she was improving on the day the children died. He has publicly said he forgives her.
Prosecutors argue Clancy acted deliberately and bears full criminal responsibility. Assistant District Attorney Shanan Buckingham told jurors that people with mental illness commit crimes every day and are still held accountable for them.

What Postpartum Psychosis Is

The trial has drawn national attention to the distinction between postpartum depression and the far rarer and more dangerous condition known as postpartum psychosis. Postpartum depression affects roughly one in eight women who give birth, according to the CDC. Postpartum psychosis is estimated to occur in only one to two mothers per thousand childbirths — but when it does, it constitutes a psychiatric emergency.
The condition typically strikes within the first few days after birth, though it can appear up to six weeks postpartum. Symptoms can include severe insomnia, mania, confusion, delusions, and hallucinations. Women experiencing it may struggle to distinguish reality from what they are imagining, including whether their own child is real. Sleep deprivation, hormonal shifts, and underlying conditions such as bipolar disorder are among the known risk factors. Research suggests that roughly half of women who develop postpartum psychosis have a prior psychiatric history.
Dr. Catherine Birndorf, founder of the Motherhood Center in New York City, told reporters covering the case that the system treats maternal mental health as criminal until proven otherwise — a framing she called deeply problematic. “To me it’s illness until proven otherwise,” she said.

Where the System Falls Short

Mental health experts following the trial have pointed to a structural problem: postpartum psychosis does not appear as a standalone diagnosis in the American Psychiatric Association’s Diagnostic and Statistical Manual. Instead, it gets folded under broader mood disorder categories. That gap has real consequences. Without a formal separate diagnosis, insurers may not cover the specific treatment it requires, clinicians may not screen for it systematically, and defense attorneys face a harder road when building a legal case around it.
Illinois is the only state in the country with a law explicitly allowing undiagnosed or untreated postpartum psychosis to be considered as a mitigating factor in sentencing. Everywhere else, whether a mother in this situation gets appropriate help often depends on where she lives, which doctors she sees, and how quickly someone around her recognizes what is happening.
Clancy had sought care extensively in the months before the killings. She saw specialists in postpartum mood disorders, was placed on multiple psychiatric medications, and checked into a psychiatric hospital. She was discharged 19 days before her children’s deaths.

What This Case Could Change

Maternal mental health advocates say they hope the trial, whatever its outcome, pushes the conversation forward. About one in five mothers experience some form of perinatal mental health disorder, according to Amy Colozzo of Postpartum Support International’s Massachusetts chapter. Many go undiagnosed. Getting treatment early, clinicians say, dramatically improves outcomes — but only if the system is built to catch what it is looking at.
Source: PBS NewsHour, ABC News, WBUR, Psychiatric Times, ABC7 Chicago, AP