I wasn't ready to tell this story. The past year has been an unrelenting nightmare that I still haven't fully processed. Then I watched the trial of Lindsay Clancy unfold, and everything I had worked so hard to suppress came rushing back.
As the public debates whether Lindsay Clancy is a monster or a victim, I find myself asking a different question: "How close did I come to becoming her?" Closer than I ever want to admit.
I write this not only as a survivor of severe antenatal depression, but as a physician. I understand how our healthcare system is supposed to function. I also know what it feels like when that system repeatedly fails someone desperately asking for help. Remaining silent no longer feels ethical.
My story began in the most ordinary way. Like many physicians, my husband and I delayed having children while pursuing our careers. When the time finally came, we required IVF. I began hormonal therapy expecting physical side effects. What I wasn't prepared for was how completely it would consume my mind.
Within two weeks, I transformed from someone who, as a close friend once joked, could "out-Type-A every other Type-A in the room," into someone barely capable of getting out of bed. I cried uncontrollably, couldn't function at work, and became overwhelmed by hopelessness. When I called my fertility clinic asking for advice, I was told to wait a few more days and call the on-call physician if I wasn't better.
By that weekend, I had become passively suicidal.
I called exactly as instructed. After confirming I had no immediate plan to hurt myself or anyone else, the physician asked, "So what do you want from me?"
Advice. Instead, I was offered a choice: stop the hormones or continue treatment. The decision was left entirely to me. I continued.
When I learned I was pregnant, I tried to tell the nurse that I was severely depressed. Before I could finish my sentence, she interrupted.
"You're pregnant! That's all that matters. Congratulations." She hung up.
Over the following weeks, every plea for help seemed to end the same way. I was redirected, reassured, handed a crisis hotline number, or told to find a therapist on my own. Meaningful psychiatric care remained frustratingly out of reach despite repeated disclosures that I was deteriorating.
I began cutting myself. As a physician, I knew what happened to patients who arrived in the ED with psychiatric complaints. Ironically, that knowledge made me even more reluctant to seek care. When my husband found me after another episode of self-harm, he insisted I go to the hospital.
Even there, the response felt procedural rather than therapeutic. My husband had to advocate for me repeatedly before I received obstetric evaluation, and I left without seeing a psychiatrist. I was advised to search online for a therapist.
Weeks passed before a nurse personally intervened and persuaded a therapist to squeeze me into an already full schedule. Only then was I finally started on treatment. The medication dulled the edge of the despair, but it did not erase it.
Depression has a remarkable ability to rewrite reality. I found myself resenting a pregnancy that I had desperately wanted only months before. I begged to be induced early because I believed continuing the pregnancy was psychologically unbearable. My request was denied. Terrified of psychiatric hospitalization, I instead tried to induce labor myself — a decision I have never publicly admitted until now.
Fortunately, I delivered a healthy baby girl, who is now the love of my life. My depression gradually lifted after delivery.
Looking back, what haunts me most is not that I became ill. It is how narrowly catastrophe was avoided. One of the only reasons my story has a happy ending is because my husband refused to stop advocating for me when I could no longer advocate for myself.
That is why I struggle to hear Lindsay Clancy discussed only in terms of guilt or innocence.
None of us can know what was happening inside her mind at the moment she killed her children. That determination belongs in a courtroom. But as physicians, we should be asking a different question altogether: how many opportunities existed before that day to recognize, treat, and prevent catastrophic psychiatric illness? Those are the questions that matter.
Perinatal depression affects millions of women. It is common, potentially devastating, and in many cases, highly treatable. Yet too many patients still encounter fragmented care, prolonged waits for mental health services, and a culture that reflexively reassures pregnant women instead of truly hearing them. We celebrate pregnancies while too often overlooking the suffering that can accompany them.
I am sharing this story despite the personal and professional vulnerability it entails because I know I am not unique. There are countless women silently enduring the same terror, convinced that admitting the truth will bring judgment rather than compassion.
As physicians, we pride ourselves on preventing disease before tragedy occurs. Mental illness in pregnancy deserves that same commitment. Screening alone is not enough if treatment remains inaccessible. We need integrated psychiatric care within obstetric practice, rapid access to perinatal mental health specialists, and a healthcare culture that treats psychiatric illness with the same urgency as any other life-threatening medical condition.
When I hear Lindsay Clancy's name, I don't simply think of one woman or one criminal case.
I think of every missed opportunity. I think of every patient who asked for help and was told, intentionally or not, to wait a little longer. And I wonder how many more Lindsays our healthcare system will create before we decide that protecting the mental health of pregnant and postpartum women is not optional — it is our responsibility.
