State House News Service
The maternal mental health debate sparked by the Lindsay Clancy trial comes amid a years-long surge in state legislation addressing the issue, reflecting the recent fundamental shift in how policymakers approach care for new mothers.
The trial promises to spark even more proposals, including an initiative in Massachusetts, where the trial took place, that Democratic Gov. Maura Healey announced last week.
“To every mom who has struggled with her mental health before, during or after pregnancy, I want you to know we see you — I see you,” Healey said during a visit to Boston’s Beth Israel Deaconess Medical Center. “We need to talk more openly about this.”
Clancy was charged with murdering her three children at her Massachusetts home in January 2023. At the trial, which ended in a hung jury, her attorneys argued that she should not be held criminally responsible because she suffered from untreated postpartum psychosis. Prosecutors alleged that she was depressed but knew what she was doing.
After referencing the numerous women who came forward during the trial to share their own maternal mental health struggles, Healey proposed providing parents of newborns free home visits from nurses and expanding a state program that gives obstetricians real-time access to psychiatric consultations for new moms.
Massachusetts has required providers and insurers to report postpartum depression screening data to the state since 2010. The state Legislature is now considering three separate measures related to maternal mental health, including legislation that would establish new legal protections for mothers experiencing postpartum psychosis. That bill has been tied to Clancy’s case in committee hearing testimony.
"It is unfair to our society and justice system to continue to villainize women for experiencing hormone-triggered mental health crises,” Democratic Rep. James O’Day, sponsor of the House bill, said at a 2025 hearing.
Joy Burkhard, the founder of the national nonprofit Policy Center for Maternal Mental Health, said she expects a spike in similar proposals in the coming year, as the spotlight on the Clancy trial intersects with years of building policy momentum.
“It comes in waves,” Burkhard said, noting that the actions in a couple of states can prompt others to follow suit.
The number of state bills mentioning postpartum depression, maternal mental health, perinatal mental health, postpartum psychosis or postpartum mental health increased from 20 bills across the 2015 and 2016 sessions to 258 across the 2025 and 2026 sessions.
Burkhard’s organization has documented a similar pattern since it started producing annual legislative reports in 2023. The number has increased every year, with a 50% jump in 2025.
“I can only imagine what we're going to see in the next round of legislative sessions,” Burkhard said. “200%? 500%?”
Burkhard credited the shift with several converging developments. The first wave of maternal mental health legislation, starting in New Jersey in 2006, centered on screening and education for postpartum depression, which was the predominant focus of the available research at the time.
Lawmakers drafting those bills were constrained by what Burkhard called the “postpartum cliff,” a six-week cutoff after birth for most maternal healthcare. As a workaround, early policies sought to give new mothers access to screenings at the pediatricians’ office.
“That was an incredible stopgap,” Burkhard said. “Obstetric providers were not in a position, for a variety of reasons, to do robust screening or screening at all throughout the postpartum period.”
Those barriers are starting to fade away, she said. Every state except Arkansas has extended its Medicaid coverage for new mothers to a full year, a federal option first offered in 2021 in response to the COVID-19 pandemic that has since become permanent.
In a separate development starting in 2027, maternal care providers will gain flexibility in how they bill for care under new “unbundled” medical codes. The change replaces traditional global payment packages – which typically ended at six weeks — with itemized reimbursement meant to encourage specialized and extended care.
New research, meanwhile, has shed light on the timing and complexity of maternal psychiatric disorders, spurring efforts to start screening and treatment earlier in pregnancy and throughout the postpartum period.
Heightened public scrutiny has also played a role. Burkhard said lawmakers in New York and Maine are drafting legislation to increase their score on her organization’s maternal mental health scorecards, which it started producing to track state progress in 2023.
In 2025, only five states earned a B, the highest grade awarded: California, Colorado. Michigan, Pennsylvania and Washington. Two states, Alabama and Mississippi, had failing grades.
The Clancy case promises to spark a new round of legislation. Illinois, the first and only state to recognize postpartum psychosis in its criminal statute, starting in 2018, enacted a law last year that allows a sentence to be vacated if postpartum depression or psychosis evidence wasn't presented at trial. New York legislators are considering similar legislation.
“Perinatal mental health conditions are treatable,” Maryland Sen. Dawn Gile said at a February hearing on legislation she sponsored. “The question is whether our system reliably connects mothers to that treatment."
That bill, signed into law in May, expands access to perinatal mental healthcare, primarily through mandatory screening coverage and standing referrals to behavioral health providers during pregnancy and the year postpartum.
