New mothers charged with crimes would get mental health screenings, treatments under bill

Mothers charged with crimes would have to be evaluated for postpartum psychosis and other mental health disorders if a new Massachusetts bill is passed into law.

Advocates and health care providers argue that a small number of mental health crises look like deliberate and intentional crimes, and making the change would prioritize treatment and compassion over punishment.

The bill would affect defendants who’ve given birth in the past year as well as mothers previously sentenced. It would make Massachusetts one of the only states to put those protections into law.

Defendants would have to be evaluated and treated, and those psychiatric evaluations could also be used in their defense in court. Mothers already serving time on charges could ask a judge for a new sentence if their postpartum mental health hadn’t been considered.

Supporters testified in favor of the bill at the Joint Committee on the Judiciary committee hearing Tuesday.

“The bill under consideration is not a free pass,” testified Dr. Lee Cohen, who leads the women’s mental health center at Massachusetts General Hospital. “Its provisions essentially place appropriate evaluation and treatment into the mix.”

Cohen called postpartum psychosis perhaps the most severe form of postpartum psychiatric disorders — including symptoms such as paranoia, delusional thinking and hallucinations.

Postpartum psychosis is rare, occurring one to two times for every 1,000 live births. Cohen said that may not seem like a large number, but the severity of this disorder means it greatly impacts the families of women affected.

“New moms lose touch with reality, placing themselves and their children at risk,” he testified.

Many women who experienced postpartum psychosis — or whose loved ones experienced it — testified that, in that time, they had not been themselves. One compared it to feeling like a marionette being pulled by her strings. Another provider recalled a patient who said her mind got lost in the wilderness.

Meghan Cliffel told lawmakers that, soon after she gave birth, she experienced postpartum psychosis and thought a cult was trying to get to her two young daughters.

After she recovered, she told her husband that she wanted to have a third child.

“He looked at me and said, ‘Meg, what if you kill the kids this time?’” Cliffel said. “I wanted to write it off as just a terrible thing to say, but I know he was voicing a valid fear.”

Katherine Rushfirth, the legislative chair of the Massachusetts affiliate American College of Nurse Midwives, recalled the high-profile case of her former colleague, Lindsay Clancy, a labor and delivery nurse who killed her three children in 2023. Clancy’s case is headed to trial next year.

“Lindsay and I worked for years together on labor and delivery, caring for patients side by side. We also had our babies at the same time. My oldest turned six yesterday and my youngest turns three next month — birthdays that Lindsay’s babies never made,” Rushfirth said. “These stories are hard and they’re full of grief. And certainly some of them ended better than others. But the common theme is how severe, destabilizing and unpredictable these perinatal mood disorders can be.”

Crystal Jaramillo, who had psychiatric complications after having her child, leaned on statistics that show Black and Hispanic women are much more likely to experience severe complications around pregnancy. She says she feels lucky she wasn’t incarcerated.

“As a Black Latina — a person three times more likely to experience perinatal and postpartum mortality than the general population — I stand here before you having survived experiences that [impacted] not just my life but my son’s,” she said. “The last thing our family needed was for me to be criminally involved. I needed care and compassion.”

Sen. Joan Lovely, a Salem Democrat, and Rep. Jim O’Day, a West Boylston Democrat, sponsored the bills in their chamber.

The proposal follows a maternal health law in Massachusetts last year that expands screenings and mental health resources for pregnant and postpartum people.

Illinois is the only state, supporters say, to have a similar policy. Susan Feingold, a clinical psychologist in Illinois who pushed for the law, estimated only about 20 people currently incarcerated in Illinois have petitioned for re-sentencing. She says there is no data about how often it’s being factored into ongoing court cases since it became law in 2018.