Postpartum Depression + Psychosis: A Conversation About Postpartum Care We Can No Longer Ignore

Recently, like so many others, I watched the Lindsay Clancy case unfold publicly. It hit a nerve in me.
Not because I believe I can speak to what happened inside another woman's mind or home, I cannot. But because the case brought extraordinary attention to something I have spent the past 14 years working intimately around: the vulnerability of a mother during the weeks and months following birth.
It made me think about how often we wait until something has gone terribly wrong before we begin talking about maternal mental health.
What if we talked more about caring for mothers before they reached a crisis?
What if postpartum planning were considered as important as birth planning?
And what if, when a baby was born, we understood that someone needed to be caring for the mother, too?
This Is Professional for Me... and Personal too!During my 14 years working with postpartum mothers, I have supported women experiencing postpartum depression. I have witnessed exhaustion, overwhelm, isolation and mothers struggling to recognize themselves during this enormous transition.
But I have only witnessed postpartum psychosis up close once.
It happened to my baby sister, who is 15 years younger than I am.
To say that her behavior was completely out of character would be an understatement. I don't know what brought it on, and I would never pretend that I do. What I witnessed was a frightening and profound change in someone I knew extremely well.
She became severely paranoid and believed that someone was going to try to kill her baby.
I acted quickly. We got her professional help.
And it was scary, even for someone like me who was already experienced in caring for women after birth.
That experience has never left me.
It taught me that postpartum care isn't only about beautiful traditions, warm food, belly binding, herbal baths or allowing a mother to rest, although those things can be deeply supportive.
It is also about presence.
Someone is close enough to notice.
Someone asks how the mother is doing rather than only asking about the baby.
Someone notices that she hasn't slept.
Someone notices when fear has become something more.
Someone recognizes when her behavior is profoundly different.
And someone knows when the situation has moved beyond the realm of traditional postpartum support and requires immediate professional medical care.
We Shouldn't Have to Wait for a CrisisPostpartum depression and postpartum psychosis are different conditions, and postpartum psychosis is a psychiatric emergency. Traditional postpartum practices should never be presented as a substitute for appropriate medical or mental-health treatment.
But that doesn't diminish the importance of postpartum care. To me, it makes the conversation about care even more important.
We should not have to wait for a woman to reach a crisis before we surround her with support.

This is where my experience this past August comes back to me.
I worked with a mother from Singapore who came from a culture where the postpartum period was approached very differently. She had arranged for a confinement nurse from Malaysia to come to Los Angeles and help care for her during those precious early weeks.
The preparation wasn't solely for the baby.
It was for the mother.
There was an understanding that she needed nourishment. Rest. Warmth. Practical help. Recovery time. Another set of experienced eyes. Permission to heal.
Her postpartum care wasn't treated as a luxury she had to earn by becoming exhausted enough to need it.

It was part of having a baby.
And that is the conversation I hope cases like Lindsay Clancy's ultimately encourage us to have.
Not a conversation rooted in fear.
A conversation about what happens to women after birth.
About maternal mental health.
About families knowing the warning signs that require medical attention.
About creating support systems before the baby arrives.
About protecting rest and recovery.
About nourishing the mother.
About asking her how she is doing, and staying long enough to hear the real answer.

After 14 years of doing this work, I believe we need to stop treating postpartum care as something optional that a woman receives only when she can afford it, when family happens to be available, or when she is already struggling.

A baby needs to be cared for.
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And so does the woman who just gave birth to that baby.
Perhaps one of the most important questions we can ask during pregnancy isn't only:
“Who will be there when the baby is born?”
It is:
“Who is going to care for the mother once everyone goes home?”