A key question in a Massachusetts murder trial is whether postpartum psychosis drove a mother to kill her three children.
The case and trial have put a spotlight on an Illinois law surrounding maternal mental health.
On Monday, a jury heard opening statements in the trial of Lindsay Clancy, a former labor and delivery nurse at Massachusetts General Hospital. Both sides agree she strangled her children aged 5 and younger in 2023. But they disagree over whether she should be held criminally responsible.
Clancy and her ex-husband, Patrick Clancy, filed lawsuits accusing her medical providers of failing to properly diagnose and treat her condition.
Awareness of postpartum psychosis has grown in recent years, but maternal mental health advocates said it’s rarely considered in criminal prosecutions. Illinois is the only state with a law allowing for undiagnosed or untreated postpartum depression or postpartum psychosis to be a mitigating factor in sentencing.
If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support.Here’s what to know about the disorder.
What is postpartum psychosis? It’s rare and dangerous
It’s estimated to afflict only 1 to 2 per 1,000 women after delivery. Experts at the Cleveland Clinic describe it as a mental health emergency affecting someone’s sense of reality.
It can happen to anyone after giving birth, but the chances are higher for people with certain mental health conditions. In a journal article on the subject in 2023, researchers at the Medical University of Lublin in Poland said about half of people with postpartum psychosis have a previous history of psychiatric problems and the most common risk factor associated with the condition is bipolar affective disorder, which causes extreme mood swings.
Though most people with postpartum psychosis don’t harm their children, mothers with severe cases may try to do so, and also may try to harm themselves.
Experts say it’s important to seek immediate help if you or your partner or family member show signs of postpartum psychosis.
Signs of postpartum psychosis
Postpartum psychosis usually happens within several days of giving birth but can occur up to six weeks afterwards.
Symptoms may include hallucinations, delusions, paranoia or other behavior changes.
A woman may also have mood changes, such as mania or depression, disorganized thinking or behavior, insomnia, irritability or agitation.
Crime and Courts 5 hours ago911 call from Lindsay Clancy's husband brought tears to the courtroom
Feb 10, 2023‘I Could Have Been Lindsay': Dozens Wrote Letters Supporting Mass. Mom Accused of Killing Her Kids
It’s not the same as postpartum depression or baby blues
Postpartum depression is a mood disorder that can also be dangerous but is much more common. One 2024 study found that U.S. rates reached 19% in 2021. Baby blues is a lot milder and affects about 8 in 10 new moms shortly after delivery.
With baby blues, crying jags and feelings of sadness aren’t enough to interfere with normal life and moms should still be able to care for themselves and their babies.
If sadness lingers for more than two weeks, that can be a sign of postpartum depression. Other signs include intense feelings of despair, anxiety, loss of interest, feelings of guilt and worthlessness, low energy and decreased concentration and appetite. Moms may worry constantly about their babies, be unable to sleep, or stop showering for days. They may even have thoughts of harming themselves.
Postpartum psychosis is the most severe postpartum psychiatric illness.
Treatment for postpartum psychosis
Moms with the condition need inpatient mental healthcare, which can include involuntary hospitalization. Treatments include medications or electroconvulsive therapy, a procedure done under anesthesia in which small electric currents pass through the brain, intentionally causing a brief seizure.
Experts say getting help early increases the odds of a good outcome.
Similar cases have led to insanity verdicts
Possibly the best-known is Andrea Yates, who drowned her five children in a bathtub in Texas in 2001. Her attorneys said she suffered from postpartum psychosis and believed killing her children would save them from hell.
Her initial murder conviction was overturned, and in a retrial she was found not guilty by reason of insanity and committed to a state mental hospital.
Dr. Nicole Cirino of Baylor College of Medicine said women in the grip of postpartum psychosis often believe they are helping their children.
In their own minds, “they may be saving their children from damnation,” Cirino said.
What does Illinois law state?
According to the Policy Center for Maternal Mental Health, Illinois’ Public Act 100-0574, which became a landmark law in 2018, “allows postpartum illnesses like depression and psychosis to be mitigating factors in sentencing.”
“That means mothers who are serving sentences for child neglect or infanticide may apply for a new sentencing hearing if they are serving more than the minimum sentence,” the group stated, “Mothers who can prove they suffered from postpartum mental illness when they committed these crimes can reduce their sentencing.”
In addition, the state in 2025 amended the Illinois Unified Code of Corrections to allow the Prisoner Review Board to consider such factors when decided whether to grant or deny parole or medical release.
“The Board must now evaluate evidence that a petitioner suffered from postpartum psychosis or postpartum depression (as defined by the Code of Civil Procedure), if those conditions were contributing factors to the person’s criminal behavior or participation in the offense,” the police center wrote.
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