[NOTE: For now, the Clancy case is on hold. But discussions about it aren’t on hold. This post isn’t specifically about that case, however. Rather, it’s about a topic connected with the Clancy case but not specific to it.]

I’ve noticed a great deal of confusion about postpartum depression versus postpartum psychosis. The two are different entities.

Postpartum psychosis is rare and postpartum depression is common. With postpartum psychosis, the sufferer is more likely to be at risk for harming or killing her children even through she has shown nothing but love and caring for them in the past. Postpartum psychosis does not lead to random assaults, when it does lead to crimes. It leads to child harming or child murder, usually under the sway of a delusion of some sort, and often coupled with suicide attempts or completed suicides.

See this:

The postpartum period is the time of highest risk in a woman’s lifetime for the development of a mental illness. Although the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) defines the postpartum period as the immediate, relatively short time following delivery, in research studies this period has been defined as ranging from a few days to 12 months.

Postpartum-onset psychological problems generally fall into one of three categories: so-called baby blues, postpartum depression, and postpartum psychosis. Baby blues affect up to 70 percent of mothers and include mild symptoms of crying and irritability which end by the second week after childbirth. Postpartum-onset depression affects from 7 to 15 percent of mothers and is characterized by sadness, crying, self-blame, loss of control, irritability, anxiety, tension, and sleep difficulties. Factors such as personality, negative feelings toward the infant, marital discord, poor social supports, and ambivalence over parenthood appear to predispose women to the onset of depressive symptoms in the postpartum period.

Postpartum psychosis, the most severe of postpartum mental disorders, occurs in 1 to 2 of 1,000 births and frequently requires hospitalization to stabilize symptoms. … The disorder is characterized by an extended period of loss of contact with reality that may include auditory or visual hallucinations, delusions, or rapid mood swings. The auditory and visual hallucinations may focus on violence toward self or the infant.

Risk factors for postpartum psychosis can be of both biologic and genetic origins. One study found that the rate of postpartum psychosis in mothers with bipolar disorder was 26 percent, with the rate in mothers with bipolar disorder and a family history of postpartum psychosis increasing to 57 percent. …

… [R]esearch supports that postpartum psychosis is associated with prominent cognitive disturbances, ranging from mental confusion and indecision to intrusive and bizarre thoughts. Women with this disorder can appear delirious and disorganized. Second, symptoms can arise and dissipate suddenly, with the woman appearing lucid one moment and psychotic the next. Third, although DSM-IV-TR classifies it as a psychotic disorder not otherwise specified, research shows that the syndrome can have both affective and psychotic components.

It has been estimated that four percent of women with postpartum psychosis commit infanticide. …

The insanity defense is successful in less than 0.1 percent of all criminal trials. However, major population studies, including McKee and Shea, d’Orban, and Bourget and Bradford, found insanity pleas successful in 20, 27, and 15 percent of infanticide cases, respectively. These results suggest that, regardless of the legal or medical guidelines, the law treats women who kill their children with more leniency. Nonetheless, infanticide case outcomes vary extremely. At least two such women have been sentenced to death, whereas some have been released without a prison sentence

That article is from 2012, and the review of cases goes back a ways before that. So we’re not talking about the result of recent internet social media hysteria influencing trials. Most of the data almost certainly predates the ascendance of social media.

You may decide that postpartum psychosis is a myth promulgated by those who wish to avoid punishment for killing their children. I think that underestimates the power of psychosis in general and this type of psychosis in particular. Note also that, as a defense to child murder, it’s most often unsuccessful. It certainly would be far less likely to be a successful defense in cases in which there is no history of deep postpartum disturbance and the seeking of psychological help prior to the murders.

Note also that postpartum psychosis is already very rare, and in that small group 4% go on to murder their children, which makes that phenomenon exceedingly rare indeed. However, I’ve seen people in discussion groups involving the Clancy murders to state that 50,000 women kill their children in the US every year. That bears no resemblance to the actual figures, which are much smaller although still profoundly disturbing:

Between 1976 and 2004, 30 percent of all children younger than five years old who were murdered were killed by their mothers, while 31 percent were killed by their fathers. A study by Brown University showed that from 1976 to 2007, on average, there were 500 cases of filicide a year in the United States.

So that 50,000 figure overstates filicide by a huge factor. Plus, mothers account for about half of the actual figure. This is in marked contrast to the much more lopsided statistics between the sexes for crimes of violence in general.

Nor is the idea of postpartum psychosis as connected with child murder an especially new one:

In the United States, psychiatrists recognized the significance of recent childbirth in acts against infants. In 1927, the field divided infanticide based on whether the mother was still lactating, or breastfeeding. Many cases were attributed to exhaustion or what was then called lactation psychosis, a recognition that hormonal changes and the stress of parenting a newborn could affect one’s well-being.

That article cites a different statistic for filicide in the US – a higher one, although still far short of 50,000 a year:

The Washington Post cites a Brown University study in 2014 that found three thousand filicides occur each year in the United States.

The following are the categories of motivations for maternal filicide (not just for filicide in which the perpetrator claims postpartum psychosis – this is for filicide in general):

Resnick, in his 2016 study, found that mothers who kill their children have one of five motives: altruistic filicide, or the belief that the child is better off dead (usually because the parent intends to commit suicide and does not wish to leave the child alone or because the child has a real or perceived disability); acutely psychotic filicide, or no understandable reason; fatal maltreatment filicide, when a mother abuses the child but does not necessarily intend to kill the youngster; unwanted child filicide, when a mother wants to be free of the child she feels is holding her back (possibly because a new partner does not want stepchildren or the parent seeks a benefit such as insurance money); and spouse revenge filicide, when a mother kills the child to wound the father for actions such as abandonment or infidelity, as in the myth of Medea. Altruistic filicide is the most common—Resnick found that it accounted for 49 percent of the cases reviewed—while spouse revenge filicide is the rarest at 2 percent. Among maternal infanticides, or the killing of a child younger than one year, perpetrators were often unemployed women in their early twenties.

My perception of the Clancy case is that most people who defend Clancy and think she was not criminally responsible believe that her motive was that she was acutely psychotic, period. On the other hand, those who believe she’s guilty of murder tend to believe that her motive was either the first – altruistic suicide – or unwanted child filicide (that she wanted to rid herself of inconvenient children cramping her style in some way).

There are also some Clancy-defenders who believe she didn’t even do it, but that falls into a different category entirely. In addition, there are some people who think Clancy should be found guilty who believe that even if she was psychotic it should not absolve her of any criminal responsibility.

Another high-profile case of maternal filicide and claimed mental illness was that of Susan Smith, in which it seems fairly clear that it was actually unwanted child filicide; Smith was found guilty of murder. She had also distinguished herself by claiming a black man had kidnapped her children:

On October 25, 1994, Smith reported to police that she had been the victim of a carjacking by a black man while driving her 1990 Mazda Protégé sedan with her sons – Michael, aged three, and Alexander, aged 14 months – still in the back seat. For nine days, she made dramatic pleas on national television for their safe return. However, following an intensive investigation and a nationwide search for them, she confessed on November 3, 1994, to letting her car roll into nearby John D. Long Lake, drowning them inside. Her motivation was reportedly to facilitate a relationship with a local wealthy man named Tom Findlay. Prior to the murders, he sent her a letter ending their relationship and expressing that he did not want children. She said there was no motive nor did she plan the murders, stating that she was not in a right state of mind.

Very different fact situation.