The Lindsay Clancy Case Is About More Than One Mother
Americans have just finished watching the trial of Lindsay Clancy, the Massachusetts mother accused of killing her three children in 2023. Clancy's attorneys argued she was suffering from postpartum psychosis and was not criminally responsible. Prosecutors argued that Clancy acted deliberately and should be convicted of murder. On Friday, the jury came back deadlocked, prompting the judge to declare a mistrial.
At The Motherhood Center of New York, where we provide specialized mental health care to women before, during, and after pregnancy, we see firsthand what can happen when women experience perinatal mood and anxiety disorders—and how critical it is that they can access appropriate care when they need it. Perinatal mood and anxiety disorders (PMADs), often colloquially referred to as postpartum depression, include a range of mental health conditions that can occur during pregnancy and after childbirth, with postpartum psychosis the most severe and uncommon. But the Clancy case has brought renewed attention to the broader question of whether women can get appropriate mental health treatment during pregnancy and after childbirth.
Outside the courtroom, women have been speaking openly about PMADs, especially on social media, sharing stories that previous generations often endured privately. Women gathered outside the courthouse dressed in pink with signs to show support for Clancy, something that would have been unheard of even five years ago. One could argue that the openness about maternal mental illness is progress, as shame and stigma can prevent women from seeking help.
But even as maternal mental health receives greater attention, the healthcare system women rely on when they ask for help is weakening. Maternity units are closing. Maternity care deserts are widening. Specialized perinatal mental healthcare remains scarce. Most insurers inadequately reimburse treatment.
According to the CDC, mental health is the leading cause of pregnancy-related death, and more than one-third of the deaths occurred between 43 days and one year after pregnancy. Eighty-six percent of these deaths were cited as preventable, with contributing factors related to healthcare providers, facilities, communities, and broader systems—not just patients and families.
In addition, women living in states with highly restrictive abortion policies have greater adjusted odds of perinatal depression than women in less restrictive states. At The Motherhood Center, we recognize that PMADs are multifactorial in origin. Most often, no single circumstance explains why one woman becomes ill and another does not, but a woman required to continue a pregnancy she does not want enters the perinatal period already at risk for a PMAD.
Yet identifying women at risk is only part of the problem. Awareness matters only if appropriate treatment is available when a woman asks for help.
Specialized help for PMADs can be remarkably difficult to find. A JAMA Network Open study found that 21 states had fewer than one perinatal psychiatrist for every 5,000 births. More restrictive abortion policies were also correlated with lower densities of these specialists. This means that in the same places where women have fewer reproductive choices, there are often fewer specialists available if they develop a serious maternal mental illness.
And the shortage is bigger than reproductive psychiatry. The 2026 March of Dimes maternity care report found that more than one-third of U.S. counties are maternity care deserts where a woman cannot even get the most basic care during pregnancy and postpartum. These communities also tend to have fewer mental health providers as well as greater economic and insurance barriers than communities with full maternity care access.
Even after overcoming the obstacles to finding treatment, patients still face the question of whether they can afford care—and facilities face the question of whether they can afford to provide it.
The federal budget reconciliation law signed in July 2025 made substantial reductions in projected federal Medicaid spending, which will negatively affect the financing of hospitals, clinics, and providers serving Medicaid patients. In rural communities in particular, reductions in Medicaid financing will put additional pressure on institutions already operating on thin margins. Medicaid finances roughly four in ten births in the United States, making the consequences of changes in the program particularly negative for maternalhealthcare.
Most commercial insurers also provide low reimbursements for therapy and medication management in outpatient settings, as well as for specialized, intensive PMAD treatment. And when women cannot get appropriate treatment early, the consequences do not necessarily end with the postpartum period. Maternal mental illness can affect mothers' long-term health as well as their children's long-term health and development. It also carries significant economic and social costs for states, including lost productivity, absenteeism at work, additional long-term healthcare costs, and strain on public services.
The choice confronting us, then, is not between paying for maternal mental healthcare and paying nothing. Instead, it is between paying for effective care during the perinatal period or absorbing potentially greater human and economic costs later.
This is what the Clancy case should force us to ask: Are our healthcare policies keeping pace with what we now know about maternal mental health and the care women may need?
Every state should have mandatory screenings for women during pregnancy and throughout the first postpartum year. There should be training on PMADs for all healthcare professionals involved in the maternal journey, including pediatricians, OB-GYNs, general practitioners, and mental healthcare clinicians. Maternal mental health treatment should be reimbursed at rates that reflect the expertise, staffing, and clinical hours required. And if governments adopt abortion restrictions that result in more pregnancies continuing, they should account for the maternal healthcare infrastructure those pregnancies require. If federal lawmakers reduce Medicaid spending, they should account for what that means for hospitals and clinicians already serving maternity care deserts.
The Clancy trial may have ended without a verdict, but the questions it raised about maternal mental health cannot disappear with it.
We may be witnessing a genuine change in how women talk about maternal mental health—and this matters. Every woman who tells her story makes it a little easier for the next woman to tell hers. Every family that learns the signs of PMADs, including postpartum psychosis, may recognize an illness sooner.
But telling women to speak up means very little if, when they finally do, there is nowhere for them to go for treatment.
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