14 Sep 5 Maternal Mental Health Takeaways From the Lindsay Clancy Trial
If you are a mom, you have likely seen or heard about the Lindsay Clancy trial that took place in Massachusetts in August and September 2026. Lindsay Clancy was on trial for the deaths of her and her former husband’s three children in January 2023. Much of the trial focused on her mental state at the time, including questions about postpartum mental illness, psychosis, psychiatric medications, and reports of hallucinations. The jury was ultimately unable to reach a unanimous verdict, resulting in a mistrial.
I am not here to weigh in on what the verdict should have been or on questions of criminal responsibility. This was an unimaginable tragedy, and I recognize that people have strong and very different feelings about this case. What stood out to me, however, were some of the larger issues the trial raised about how much we still do not fully understand about maternal mental health.
As a licensed therapist with training and experience treating women during pregnancy and postpartum, here are five things I think are worth talking about.
1. Pregnancy and Postpartum Are Unique Biological and Psychological Periods
Even defining “postpartum” is more complicated than it might seem. Different medical and mental health organizations use different timeframes depending on whether they are defining a diagnosis, a period of medical care, or the broader postpartum experience.
We know that pregnancy, childbirth, breastfeeding, weaning, sleep disruption, and the return of menstrual cycles can involve significant physical and hormonal changes. We know much less about exactly how these reproductive changes interact with an individual woman’s mental health and psychiatric vulnerability.
There is promising research happening at institutions including Mass General, Johns Hopkins, and the National Institute of Mental Health. But research does not always translate quickly into the education and training of the clinicians currently sitting across from pregnant and postpartum women. We need that research to reach providers so they can more effectively assess, conceptualize, and treat mental health concerns during these periods.
2. We Still Need Better Research on Medication During Pregnancy and Postpartum
Historically, pregnant and lactating women have often been excluded from medication research because of concerns about potential risks to both mother and baby. While those concerns are understandable, the result is a significant gap in the evidence available to women and their providers when making decisions about psychiatric medications during pregnancy and postpartum.
The Lindsay Clancy trial highlighted some of these limitations. Her treatment involved multiple psychiatric medications and medication changes over a relatively brief period of time. We cannot draw conclusions from a single case about whether a particular medication contributed to what happened. What we can say is that women and their providers deserve better research into how psychiatric medications interact with the significant biological, hormonal, and psychological changes occurring during the perinatal period.
3. Safety Screening Is More Than a Checklist
As a mental health provider, it is my responsibility to regularly assess whether clients are experiencing thoughts of suicide, self harm, or harm toward others. But simply asking, “Are you having suicidal or homicidal thoughts?” does not always give the full picture.
Clinicians trained in perinatal mental health know that unwanted and intrusive thoughts can occur after the birth of a child. Providers need to ask more specific questions about “scary thoughts,” thoughts or images of something happening to the baby or children, and any thoughts or urges involving harm. Just as importantly, we need to build enough trust that a patient feels safe telling us what she is actually experiencing. Mothers may be terrified to disclose these thoughts because they fear being judged or worry about what disclosure could mean for their children.
The nature of the thought matters tremendously. Is it unwanted and frightening? Does the person believe it? Is there an urge or intention to act on it? Does the person believe the thought is coming from somewhere outside of herself, such as a voice giving a command?
These are very different clinical experiences. A good safety assessment requires more than asking the question. It requires creating the relationship in which someone feels safe enough to answer it honestly.
4. Maternal Mental Health Care Cannot Happen in Silos
As a clinician who treats eating disorders, I rely heavily on communication with a client’s larger treatment team, including dietitians, physicians, psychiatrists, and sometimes previous therapists. Maternal mental health should be no different.
A postpartum patient might simultaneously be working with an OB/GYN, primary care physician, psychiatrist, therapist, and other specialists. Each provider may be seeing a different part of the picture.
With the patient’s consent and appropriate attention to confidentiality, communication among providers can reveal patterns that are much harder to recognize in isolation. Changes in sleep, medication, functioning, intrusive thoughts, anxiety, mood, physical recovery, and observations from family members may all be important pieces of the same puzzle.
When multiple professionals are treating the same person, communication is an important part of understanding the whole picture and providing coordinated care.
5. Maternal Mental Health Requires Ongoing Monitoring
Ongoing monitoring is essential when treating any mental health condition, particularly when symptoms or medications are changing.
Earlier in my career, I worked in a residential eating disorder treatment facility where our psychiatrist would not discharge a patient immediately following a medication change. She wanted time to monitor how the patient responded. That experience has always stuck with me. Prescribing a medication is not the end of the intervention. We have to continue asking what happens afterward.
Current perinatal mental health guidelines emphasize ongoing assessment, including the use of validated screening tools to monitor symptoms and response to treatment. Clinical guidance also recommends screening for bipolar disorder before initiating medication treatment for depression or anxiety when it has not previously been done. This matters because antidepressant treatment in someone with an unrecognized bipolar disorder can contribute to mania in some patients, and severe manic episodes can include psychotic symptoms.
Patients need to know which changes or side effects they should report. Prescribers also need systems for following up, reassessing symptoms, and communicating with the other professionals involved in a patient’s care.
What This Case Teaches Us About Maternal Mental Health Care
The Lindsay Clancy case cannot tell us exactly what should change about maternal mental health care. It does, however, give us an opportunity to ask better questions. We still have much to learn about the intersection of reproductive changes, psychiatric symptoms, and medication during pregnancy and postpartum. In the meantime, we can listen more carefully, ask more specific questions, communicate with one another, and make sure that maternal mental health care extends far beyond a single screening or appointment.
If you are struggling during pregnancy or after childbirth, or are concerned about someone you love, please contact me for more support. I can help you think through your concerns, identify appropriate next steps, and connect with professional support when needed.
