The Lindsay Clancy Trial Made me Wonder, ‘What If?’

Since July, our news and social media feeds have been flooded with opinions about the Lindsay Clancy trial. Even if you were trying not to look, as I was, it was hard to escape the hourly updates: the salacious conspiracy theories about her husband; the persistent questioning of her doctors; her lawyer’s fierce defense that Clancy was suffering from postpartum psychosis, which, he argued, should absolve her from a murder conviction.

It’s natural to want to avoid such an upsetting topic — a mother killing her children. (Clancy is scheduled to appear in court again Tuesday, Sept. 29.) But the truth is, we as a society desperately need maternal mental health to be in the headlines more. Not in this particular tragic way, of course, but as a topic we can talk about, out in the open. 

While we may never know exactly what happened in the Lindsay Clancy case, what we do know is that one in five pregnant and post-partum people in the U.S. experience mental health conditions during and after pregnancy. Even more staggering — and damning: Mental health conditions are the leading cause of maternal mortality, accounting for roughly 23% of pregnancy-related deaths, according to CDC reports. Indeed, more than half of all maternal deaths happen during the postpartum period. And still, we look away or keep silent as women’s health issues, including this one, continue to be vastly underfunded and overlooked. 

The instinct to avoid the story of a mentally ill mother is at the crux of the American maternal mental health crisis, according to Dr. Catherine Birndorf, an expert on perinatal and mood and anxiety disorders (PMADs) and a co-founder of the Motherhood Center, which treats individuals with infertility-related, perinatal and postpartum mental health issues. “We as a society want moms to be ‘fine,’ so we struggle to believe that they can have mental illness. But, they’re not fine. That is the foundational problem that underlies everything,” Birndorf says. 

The medical profession is struggling to catch up. In a 2026 letter to the editor published in the New England Journal of Medicine headlined ‘Overdose, Homicide, and Suicide as Causes of Maternal Death in the United States,’ the author(s) posit that “the classic dogma in medical, obstetrical and public health training is that the leading causes of maternal death in the United States are cardiovascular disease, hypertension, hemorrhage and infection.” In fact, as the authors, all experts in health fields at Columbia University, go on to say, the data tells another story. 

Their research, in fact, suggests that the leading cause of maternal death was unintentional drug overdose, with death due to suicide or homicide the second most frequent cause.

Other studies support their evidence: A 2024 study found that mental health conditions including substance use disorders are the leading cause of preventable maternal death, either during pregnancy or in the first year postpartum. Another study, done in 2025, found that the vast majority of maternal deaths, nearly 87%, would have been preventable  with proper screening and care. And yet according to the Association of American Medical Colleges, 75% of women who experience perinatal mental health disorders go undiagnosed or untreated. That treatment gap is, literally, deadly. 

“We don’t have American cultural norms for caring for mothers the way they do in other societies,” says Birndorf. “There’s a uniquely American belief that mothers should be able to do it all and take care of themselves — and that it’s supposed to be easy. If you complain or ask for help, the assumption is that something is wrong — not with the system but with the mother,” she says. 

We badly need a safety net, particularly for pregnant women and new moms, says Birndorf. But first, we have to accept that mothers can and do have mental health struggles. “If we don’t believe that, there’s nothing to talk about,” says Birndorf, who specifically cites the lack of postpartum care after giving birth as the critical phase where so many new mothers fall through the cracks.

This despite the fact that the American College of Obstetricians and Gynecologists recommends that healthcare providers screen all patients for depression and anxiety before, during and after pregnancy. To date, only eight states have legislated mandates for perinatal mental health screenings; a total of 10 states have passed any screening-related legislation at all. And there is still no universal, legally-mandated mental health check for every new mother before they leave the hospital with a newborn baby. 

Instead, hospital staff are more likely to check that women have a carseat (admittedly important) than they are to check that a new mother is mentally well enough to go home with a newborn. Typically, a woman won’t see her OB-GYN again until the six-week checkup, which often focuses on a woman’s physical but not emotional recovery. “We’ve created a system for the new baby where there are check points at one week, two weeks, but we don’t have that for the new mom,” says Birndorf. “That’s bullshit, because if you’re going to have psychosis, you will likely have it in the first few weeks — a period when women aren’t even scheduled to be seen by a doctor.”

By that point, Birndorf adds, the only doctor women have generally seen is a pediatrician — for the baby. If a woman is struggling with mental health issues, says Birndorf: “She’s probably not going to tell them because they’re afraid that their baby will be taken away.” 

I’m a mother of two who has experienced severe postpartum OCD, anxiety and depression — I fell directly into the abyss of the maternal mental health care gap. In 2015, after I had my son, I began experiencing terrifying intrusive thoughts that I might hurt my baby:

What if I let go of the stroller as we crossed our street in New York City? What if a knife accidentally slipped out of my hand and somehow landed on him? What if I wrapped him wrong in his swaddle and he suffocated? 

I have never said these thoughts publicly — until now. Like many other women I was too afraid to share them, tormenting myself with thoughts like: 

How can I have these thoughts and still be a good mother? What if someone takes my baby away for having them? 

Despite my fears, after nearly a month of not being able to eat, barely leaving the house and struggling with the most basic functions while taking care of my newborn — I did confide that I was having obsessive intrusive thoughts to my husband, my mom and my therapist, the latter of whom had treated me through my pregnancy. They urged me to get help from a reproductive psychiatrist. Unlike many women, I had the resources to find one and pay for it – even without insurance, which didn’t cover it. I received a diagnosis of OCD, anxiety and depression, and the doctor convinced me to go back on the medication I’d stopped while pregnant. 

More than a decade later, I have the perspective to see that my frightening thoughts were worthy of a mental health professional’s immediate attention — but they were not  an indication that I had post-partum psychosis and was going to hurt my baby. 

I now know that at least 70% of postpartum women experience intrusive thoughts — and that number is likely an underestimate. And according to the International OCD Foundation, 50% of all new moms have intrusive thoughts specifically about intentionally harming their baby, whether or not they have an OCD diagnosis like I do. “Most mothers will have an intrusive thought such as, ‘What if I drop the baby down the stairs?” says Birndorf. “It’s the fear around seeing harm that could come to your baby and the heightened awareness and anxiety surrounding taking care of a newborn,” she explains. 

While intrusive thoughts are upsetting, it’s important to discern whether they are getting in the way of your ability to function. If they are, Birndorf says, it’s essential to seek out professional mental health support.

And yet, even with the knowledge I now have, even after years of extensive cognitive behavioral and exposure therapy, even with the right dose of medication — those intrusive thoughts came back to me while I followed the Clancy trial. Eventually, they became so upsetting that I had to get off of social media and dedicate multiple therapy sessions to understanding that my case was not like hers. 

In contrast to the intrusive thoughts that I and so many new mothers experienced, the kind of deep postpartum psychosis that Clancy’s attorneys contend she experienced is extremely rare, affecting only one to two in 1,000 people. When it does occur, it indicates a potentially life-threatening psychiatric emergency. Symptoms of postpartum psychosis can include hallucinations, delusions or severe confusion. “With psychosis, you don’t realize that what you’re saying isn’t consistent with reality — you have no insight,” Birndorf explains. 

Yet even for experts, postpartum psychosis can be a challenging diagnosis to make. “You might notice the patient acting out of character or doing unusual things,” says Birndorf, “but they might seem normal in other ways.” That’s why it’s critical for anyone experiencing these kinds of symptoms to get evaluated by a mental health professional.

That’s not always an easy thing to do, and not only because of the shame that can keep people quiet. One of the biggest challenges to getting appropriate care is the lack of mental health experts in the PMAD field. “There are fewer than 500 of us [reproductive psychiatrists] in the country who are trained to really identify postpartum mental health conditions,” says Birndorf. “Yet there are 800,000 new moms who experience a PMAD every year.” 

Short of encouraging a new generation of medical students to pursue a career in reproductive psychiatry, what can be done to help new mothers get the support they need? The answer, says Birndorf, is to keep the conversation going. 

Personally, I’m heartened by new online mini movements like the Breadwinners’ Courage to Confide maternal mental health campaign, that encourages mothers to openly share their struggles and say out loud, “It’s OK to not be OK.” 

And that’s just one reason I’m choosing to share my postpartum struggles here, because I don’t want people to stop talking about maternal mental health once this news cycle ends. Because while the Lindsay Clancy case ended in a mistrial (for now), the entire spectacle is a searing indictment of America’s failure to take care of new moms who suffer from mental health conditions. 

Says Birndorf: “Once [the Clancy] tragedy is out of the spotlight, our instinct as a society will likely be to keep it there, because it’s so hard to hold onto the thought of an illness that could lead to the death of children.” 

“But we can’t succumb to our desire to deny that this happened or that it could happen again — and we can’t look away. We must sit in the discomfort, and believe mothers who say they are struggling.” 

If you or someone you care about is struggling with mental health issues during pregnancy or after, the following organizations can help:

HRSA Maternal & Child Health

The National Maternal Mental Health Hotline is free, confidential, and available 24/7 at 1-833-TLC-MAMA

Post Partum Support International

Call the PSI HelpLine: 1-800-944-4773
#1 En Español or #2 English

Motherhood Center