Trial of former nurse hinges on whether postpartum psychosis caused child murders

A Massachusetts jury heard opening statements Monday in the case of former labor and delivery nurse Lindsay Clancy, who is accused of strangling her three children, aged five and younger, in 2023. While both sides acknowledge the killings, they dispute whether the defendant should be held criminally liable, citing a possible episode of postpartum psychosis.

Clancy and her ex-husband have filed civil suits alleging that her medical providers failed to diagnose and treat the condition. Postpartum psychosis is a rare mental-health emergency, affecting roughly one to two per 1,000 women after childbirth, according to experts at the Cleveland Clinic. It is characterized by a loss of touch with reality and can include hallucinations, delusions, paranoia, severe mood swings, insomnia and agitation.

"When women are experiencing postpartum psychosis, very, very often they are terrified or suspicious to tell anyone what they're thinking," said Dr. Julia Riddle, a reproductive psychiatrist at the University of North Carolina School of Medicine.

The disorder typically emerges within days of delivery but may appear up to six weeks postpartum. While most sufferers do not harm their children, severe cases have been linked to violent behavior toward both infants and the mothers themselves. Diagnosis is challenging and requires specialized training to recognize the rapid shifts in a woman's mental state.

Postpartum psychosis differs from the more common postpartum depression and the transient "baby blues." Treatment usually involves inpatient psychiatric care, which can include involuntary hospitalization, medication, or electroconvulsive therapy. Early intervention improves the likelihood of recovery.

The trial will examine whether Clancy’s actions were driven by an undiagnosed episode of postpartum psychosis and how that impacts criminal responsibility.