Lindsay Clancy trial highlights need to rethink postpartum care, advocates say: “The duty is on the system”
The trial of Lindsay Clancy over the killings of her three young children is driving conversations outside the courtroom about postpartum healthcare — and gaps in the system.
Clancy’s defense says she killed her three children after suffering from postpartum psychosis, a severe condition affecting someone’s sense of reality, while the prosecution argued she planned the killings and knew what she was doing was wrong.
Clancy’s legal team says she tried to get help but was overmedicated and didn’t get the care she needed.
Postpartum psychosis is estimated to affect about one in 1,000 people after childbirth, and the case is resonating with moms across the country — bringing into focus the spectrum of perinatal mood and anxiety disorders and the lack of resources for many women.
Perinatal mood and anxiety disorders are mental health conditions, including depression, anxiety, bipolar disorder and postpartum psychosis, happening during pregnancy and up to a year after giving birth. Overall, they are estimated to affect one in every five to seven women.
Moms have traditionally had a postpartum appointment with an OB-GYN around six weeks after giving birth, where they receive a physical checkup and are screened for mental health issues. But following that visit, there isn’t a standard appointment schedule.
“We can’t just clear a mom at six weeks postpartum and expect her to figure out the rest of what’s going on for the next 12 months,” said Nicole Kumi, a maternal wellness advocate and founder of The Whole Mom, an organization focusing on perinatal transitional coaching.
The American College of Obstetricians and Gynecologists recommends women have contact with a maternal care provider within the first three weeks postpartum and a comprehensive postpartum visit no later than 12 weeks after birth. The organization says care should be individualized and ongoing as needed.
“This is not a ‘one and done’ for our moms,” Kumi said. “She’s going to have physical challenges, she’s going to have mental health challenges, and I think the duty is on the system to revamp, and I feel like this case is going to put the system in a place where they have to act. Changes have to occur.”
The first step for Kumi, a mom herself, is educating women about what postpartum mental health can look like before they are in the thick of it.
“We routinely are expecting our moms to recognize the signs and symptoms that they were never taught to recognize in the first place,” she said. “Then once we identify that something is wrong, we’re expected to navigate this fragmented, if not broken, system while we’re hormonal, while we’re caring for a newborn, potentially other babies, sleep deprived and going back to work.”
Driven by her own experience hiding her mental health challenges during postpartum and hearing from other moms who did the same, Kumi started The 4th Trimester Program to provide education and support to moms. It also aims to create a virtual community of moms to help each other.
A key to filling the healthcare gap is making mental health part of a mom’s treatment plan and ensuring people around her also know the signs of mood and anxiety disorders, Kumi and others say.
“Mental health should be woven into your care before you have a baby, during your prenatal care and especially afterwards,” Dr. Kameelah Phillips, an OB-GYN and founder of a women’s health clinic, said on “CBS Mornings.”
Phillips warned about inadequate funding and a decline in doctors specializing in maternal care that worsened after the Supreme Court overturned Roe v. Wade. One in three U.S. counties is considered a maternity care desert, meaning there are no obstetric clinicians or birthing facilities, according to March of Dimes, a nonprofit that advocates for maternal healthcare.
“I don’t think that America is paying attention to what’s happening in women’s health,” Phillips said. “These women’s health deserts are going to set us up for failure in the near future if we don’t start acting and talking about this really pivotal issue.”
Speaking up about these issues isn’t easy, said Dr. Catherine Birndorf, a reproductive psychiatrist and co-founder of The Motherhood Center, a maternal mental health treatment center in New York.
“There’s a lot of fear around even speaking ill of being a mother, right?” she said. “Society wants us to feel great about it, to be the best thing that ever happened, but in fact, it’s an enormous challenge. It is both/and. It is both wonderful and complicated and challenging, and that nuance is hard to hold and it’s hard to speak about.”
Kumi hopes the more moms who do speak up, the less stigma there will be.
“I think that there’s more of us that are welcoming and understanding of it now than ever before, so I really hope that we can lean into this momentum of driving home change,” she said.
