What is Post-Partum Psychosis?

**Brigid Bergen** (0:10)
It's The Brian Lehrer Show on WNYC. Good morning again, everyone. I'm Brigid Bergen, sitting in for Brian today.
A warning for our listeners. This next segment includes discussion of suicide, self-harm, homicide and severe mental illness. So please take care while listening. If you or someone you know is in immediate danger, call 911 or the 988, Suicide and Crisis Lifeline. Pregnant and postpartum people can also call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA.
That's 1-833-852-6262 for free, and that offers confidential support 24 hours a day, seven days a week.
To begin, in Massachusetts, the case of former labor and delivery nurse Lindsay Clancy is bringing media attention to something called postpartum psychosis. For those who haven't heard about the case, she's on trial for the murder of her three children before trying to kill herself. So far, a lot of that trial has focused on the level of care Clancy received after her youngest child was born.
We're not going to focus specifically on that case, but instead, we're going to focus on the conversation it sparked related to maternal mental health. Maternal mental health disorders impact 20% of US women according to the Policy Center for Maternal Mental Health. Despite this number, a 2022 study shows that less than 20% of women are screened for maternal mental health disorders. That's both during pregnancy and after the birth. Joining us today to tell us more is Nikki Sapiro Vinckier. She is an OBGYN physician assistant, health educator and founder of Take Back Trust, a platform helping people navigate reproductive care. She's also the author of We Deserve More, Why Reproductive Healthcare is Broken and What You Can Do About It. She recently wrote a piece for your local epidemiologist called The System Should Be On Trial Too. It's about the ways in which the US healthcare system, in her words, fails new parents in postpartum care. Nikki, welcome to WNYC.

**Nikki Sapiro Vinckier** (2:23)
Thank you for having me.

**Brigid Bergen** (2:25)
And listeners, we're going to be taking your calls about postpartum mental health. Do you have questions for our guest about postpartum psychosis or other related conditions? What resources do you wish you had to manage your mental health postpartum? You can call or text us at 212-433-WNYC.
That's 212-433-9692, again, calls or texts. So Nikki, to begin, let's just define what we're talking about here. What is postpartum psychosis and how common is it actually?

**Nikki Sapiro Vinckier** (2:59)
Yeah, I'm so glad we're talking about it because I think that this trial is really catapulting this into the news. And I think there is so much that remains unsaid about mental health in general. And when we look at the postpartum period, we're really even lacking that much more awareness and support about what these specific things actually are. So let's start with what we actually call it because a lot of times people just say postpartum. And what they refer to as postpartum depression, but they say postpartum, I experienced postpartum. Everyone who's had a child experiences postpartum. That's the window of time that we consider to be one to two years post delivery of that child.
And postpartum depression specifically is the feelings of feeling sad, hopeless, empty most of the day.
We can have excessive amounts of crying, feeling like we're losing interest in the things that we used to like, feeling like we're kind of pulling away from our family and friends, having a hard time bonding or feeling close to that baby. Right. Then we also have postpartum anxiety or panic that people can experience, which is that constant excessive worry about the baby's health, feeling restless, irritable, trouble sleeping or trouble staying awake, right? That like racing thoughts or dizziness, the sudden panic attacks that people can have. Then we kind of, those are on the more common side of things. Before we even get to postpartum depression or anxiety is baby blues. So the baby blues is a little bit more fleeing. Those typically happen to actually the vast majority of mothers, like 90 percent of moms will experience baby blues. So that can really be fleeing within the first few days. But the postpartum depression or anxiety are the ones that can linger on beyond that. Then beyond postpartum anxiety and depression, mothers can experience what we call postpartum OCD, which is disturbing or unwanted thoughts about harm to themselves or coming to the baby. It's really, really common for moms to have kind of these worrying thoughts, intrusive thoughts. And so I think that needs to be normalized because so many people experience intrusive thoughts and then think, oh my god, this is crazy. And I remember postpartum with my kids, I'd be cutting up an apple on the chopping block. And you'd have these thoughts of like, what if the knife flies out of my hand and hits my baby? These things that are very unlikely to happen have never happened before, but all of a sudden starts entering into our brain. That can be very normal. As long as you don't have intent to act on that, that's the difference, right? But postpartum OCD kind of takes those intrusive thoughts to the next step. You're doing repeated actions, like you're checking on the baby constantly. You can't do anything else because you're constantly consumed by the idea that your baby is not taking frequent enough breaths, right? That extreme need and extreme kind of compulsive activity is that postpartum OCD. Then when we lean into postpartum psychosis, which is what we saw unfold with Lindsey Clancy, is almost a little bit more of like a schizophrenia type picture. You're seeing or hearing things that aren't there, so you're having hallucinations. You're believing things that aren't true, so you're having delusions. You may have severe confusion, extreme mood shifts, or strange behavior.