A mass discussion has erupted in US society over Lindsay Clancy, the Massachusetts nurse and mother who killed her three children during an episode of postpartum psychosis, highlighting for many the devastating state of perinatal mental health care in this country. After six weeks of trial and seven days of deliberations, the jury could not agree and her case was declared a mistrial.
Right-wing media has feigned surprise and anger that so many people, particularly women, are standing with Clancy. But for the hundreds who rallied in support of Clancy outside the courtroom, and for thousands of women discussing this case in workplaces across the country, there’s nothing surprising about Clancy’s experience of desperately trying to get relief from severe symptoms in a hopelessly discoordinated tangle of providers, clinics, and hospitals. Terrified and pleading desperately for help at every turn, she was prescribed over 13 psychiatric medications that may have even exacerbated her postpartum symptoms. Every ordinary American has had to fight through some version of this nightmarish obstacle course to try and get the mental health treatment they need, or they know someone who has.
A Failure Of The For-Profit Healthcare System
Clancy’s story feels personal to many women who have struggled with postpartum mental health problems. Renee Kimball, an organizer of the rally outside the courtroom said on NPR, “I think that every one of us women believe that could be any one of us, any one of us who have dealt with mental health—anxiety, depression, postpartum.” Some studies estimate that as many as one in five people who give birth in the US suffer from some type of postpartum mental health condition, affecting as many as 800,000 families every year.
Women with severe postpartum depression or psychosis face a dire shortage of options for effective treatment, making it no wonder that the vast majority of cases go untreated. This is especially enraging when the correct medication, treatment, and support can be highly successful in treating postpartum psychosis. And yet successful, comprehensive treatment is out of reach for most women when there are only five inpatient psychiatric units for perinatal care in the entire US to treat the potentially up to 7,000 cases annually of postpartum psychosis. None of the five units allow mothers to be housed with their babies.
Mother and baby units are considered the gold standard for treatment of severe postpartum mental health conditions, where mothers can be treated while they bond with their babies in a safe environment. In the UK, where healthcare is nationalized and most services are free to residents, there are 21 mother and baby units. Most women in the US who have to be hospitalized due to postpartum mental health problems go into general psychiatric units where there aren’t likely to be specialists in perinatal care, nor physical environments that are baby-friendly for visits. In the US healthcare system, no insurer will pay to care for babies who aren’t sick.
Despite the massive spending on healthcare in the US compared to all other countries, women’s health and well-being in the perinatal period is simply not a priority for this system, despite all the risks to new mothers’ mental and physical health posed by pregnancy, childbirth, and postpartum conditions. Where does all the money go? A Yale University analysis found that between 2001 and 2022, $2.6 trillion in income to healthcare companies like pharmaceuticals, insurance companies, and for-profit hospitals was paid out to wealthy shareholders.
Oppression & Healthcare
The medical system has historically treated women’s postpartum health, both physical and mental, with appalling indifference, and it remains totally inadequate today in many respects, as well as deeply unequal. Postpartum depression and the far less common psychosis that Clancy had are under-identified, under-diagnosed, and under-treated for women in general, and the situation for Black women is worse than for white women. The system of capitalism needs women’s reproductive work to create new generations of workers, but the CEOs and major shareholders don’t have any interest in alleviating the suffering of women related to reproduction, unless that alleviation can be made profitable. The oppression of women is deeply embedded in capitalism, and this oppression is mirrored in the healthcare system.
Anti-Black racism in the US drives a vicious double standard in how Black women with mental health conditions are portrayed in the media, compared to the treatment of Lindsay Clancy, whose trial has received intense media coverage, some of which has been sympathetic. In 2022, Latarsha Sanders, a Black woman who also killed her children in Massachusetts, was sentenced to two life sentences without parole. Sanders had been repeatedly hospitalized and given multiple psychotic diagnoses prior to the killings, yet her trial was relatively quick and without widespread national attention. Just last month, Sanders’ conviction was overturned—correctly—when it was determined that her psychiatric records had been prejudicially excluded from evidence. Despite the injustice of her case, it would do women and mothers no service to pit these cases against each other.
Anti-Black racism is another feature of US capitalism that finds its reflection in the healthcare system, and, combined with sexism, has deadly consequences. Postpartum mental health conditions are the leading cause of maternal death in the US, but the maternal mortality rate for Black women is over three times higher than that of white women. A struggle for the healthcare system all women and all working-class people need will require a multi-racial movement fighting for our common interests.
We Deserve Better
Clancy’s children, her now ex-husband, and Clancy herself paid an unthinkably horrific price for the healthcare system’s failures, which are rooted in the system of capitalism and its treatment of women.
Some of the mass anger over Clancy’s charges is being directed at Patrick Clancy, her ex-husband. People are speculating and theorizing that Patrick Clancy didn’t support his wife enough, or even that he himself killed his children or that he orchestrated Lindsay Clancy’s killing of them. With no left-wing political party that represents the working class in this country pointing the finger where it needs to be pointed—at the profoundly broken healthcare system, the CEOs and major shareholders who run it, and the capitalist politicians who allow the situation to continue—an environment of political confusion can be the result.
In a New Yorker profile, Patrick Clancy said, “I wasn’t married to a monster—I was married to someone who got sick.” Indeed, the monsters are the capitalist exploiters whose lives of unimaginable privilege and luxury are made possible, in part, by profiting from illness and misery while they refuse to build the systems of care that would help women when they’re at their most vulnerable. A courthouse packed with supporters of Lindsay Clancy and eleven jurors voting for her acquittal is a small but noteworthy sign that the US working class recognizes the injustice in our healthcare system. What is needed is for the hundreds who protested outside the courthouse, as well as millions across the country, to channel this impulse into an organized fight—one that goes beyond assigning blame to this doctor or that hospital and takes on the billionaires in the necessary task of winning free, universal healthcare.