Oluwatobi Adu 
ABUJA, Nigeria- What happens when a mother who kills her child is also believed to be suffering from severe mental illness? Recent cases in the United States have brought that difficult question into focus. In this report, Oluwatobi Adu examines what they reveal about warning signs, criminal responsibility and what Nigeria can learn.
Two Cases, Difficult Questions
The cases are different, but both have raised questions about the intersection of severe mental illness and violent behaviour.
In Massachusetts, Lindsay Clancy, a former labour and delivery nurse, was accused of killing her three young children in January 2023.
Her defence argued that she was suffering from postpartum psychosis and was not criminally responsible for the killings. Prosecutors disputed that account. Her trial ended in a mistrial in September 2026 after jurors failed to reach a unanimous verdict.
The case has drawn international attention to postpartum psychosis, a rare psychiatric emergency that can involve hallucinations, delusions, severe confusion, agitation and loss of contact with reality.
Another case in the United States involved a mother accused of killing her toddler. Her lawyer said she had experienced a psychotic episode, again raising questions about severe mental illness and criminal responsibility.
However, the circumstances of the two cases are different. Claims about a person’s mental state cannot be treated as established medical facts without appropriate psychiatric evidence.
The broader question remains: when a mother who kills her child is experiencing severe mental illness, where does medical explanation end and criminal responsibility begin?
What Is Postpartum Psychosis?
Consultant Psychiatrist Dr Ayokunle Felix Akinsade said postpartum psychosis is a severe but relatively uncommon psychiatric emergency. It can develop shortly after childbirth, often within the first few weeks.
A woman experiencing the condition may lose contact with reality and experience hallucinations, severe confusion, bizarre beliefs, delusions, extreme agitation, disturbed sleep or rapidly changing moods. In some cases, Akinsade said, a woman may develop beliefs that her baby or family is in danger or that she must take a particular action to protect them.
But he cautioned against assuming that every mother who harms a child is experiencing postpartum psychosis. “Postpartum psychosis is a severe but relatively uncommon psychiatric emergency that can develop shortly after delivery, often within the first few weeks.”
Other conditions can also contribute to severe psychological disturbance. These include postpartum depression, bipolar disorder, previous psychotic illness, overwhelming psychological stress, severe sleep deprivation, substance use and some medical conditions affecting brain function.
Akinsade stressed that most women experiencing postpartum depression or other postpartum mental-health difficulties do not harm themselves or their children.
The Warning Signs Families Should Not Ignore
Possible warning signs include persistent sadness, hopelessness or severe anxiety, extreme irritability or agitation, inability to sleep even when the baby is sleeping, marked withdrawal, loss of interest in usual activities, feelings of worthlessness or excessive guilt, and statements suggesting that life is not worth living.
More serious symptoms include confusion, disorientation, hearing or seeing things others do not, strongly held unusual beliefs, suspiciousness, bizarre behaviour, severe agitation, rapidly changing moods or talking about harming herself or her baby.
“Families should not wait for a woman to explicitly say, ‘I want to harm my baby.’ Sometimes the earliest indication is a dramatic change in behaviour, loss of contact with reality, severe insomnia, or unusual beliefs,” Akinsade said.
“Early intervention is extremely important because postpartum psychiatric disorders are treatable, and prompt treatment can significantly reduce the risk of harm and improve recovery.”
Akinsade also urged families and society to avoid blaming or stigmatising women experiencing severe mental illness. “The key message for families is: a dramatic change in behaviour after childbirth is a medical warning sign, not something to simply ignore or attribute to ‘baby blues.’ Early recognition, urgent professional assessment and family support can save lives.”
Nigeria’s Hidden Maternal Mental-Health Burden
Nigeria has limited national data specifically on postpartum psychosis. However, available research points to a significant burden of maternal mental-health problems.
A study of 250 postnatal women attending six primary healthcare centres in Lagos found probable postpartum depression in 35.6 per cent of participants.
The World Health Organisation estimates that about 10 per cent of pregnant women and 13 per cent of women who have recently given birth experience a mental disorder, primarily depression.
Studies from different parts of Nigeria, including Ilorin, Bauchi, Lagos, Enugu and Delta, have also reported substantial levels of probable postpartum depression.
However, these studies involved specific populations and healthcare settings. Their findings should therefore not be treated as a national prevalence estimate.
Postpartum psychosis is much rarer. Systematic reviews estimate its incidence at about one to two cases per 1,000 births.
A high prevalence of postpartum depression does not mean that mothers experiencing the condition are likely to harm their children. Likewise, postpartum psychosis does not by itself establish that a woman will become violent.
What Nigerian Mothers Say
For some Nigerian mothers, the psychological demands of early motherhood are less dramatic but still difficult.
Mrs. Rasheedat, a 28-year-old first-time mother and librarian, described pregnancy and early motherhood as periods of fear, anxiety and uncertainty.
Her adjustment became more difficult after a Caesarean section, while caring for a newborn away from her family and familiar support system. “After childbirth, the emotions became more intense. There were times when I felt overwhelmed, lonely, and emotionally exhausted.” She said her husband’s emotional and practical support helped her cope with childcare and recovery. “Support does not always have to be something big; sometimes having someone check on you, listen without judging, help with the baby, or simply remind you that you are not alone can make a huge difference.”
“This does not excuse harming children, and the safety of the children must always come first. However, we should also recognise that a mother who is struggling may need urgent help before a situation reaches a crisis point.”
She called for stronger emotional and practical support for mothers, including access to mental-health professionals, childcare assistance and safe spaces where women can discuss their experiences without fear of judgement.
Mrs. Rukayat Daud, a 45-year-old mother of four and foodstuff trader, said she had encountered a woman with severe mental-health problems who continued to care for her children for years before authorities intervened. “I have seen a woman who was mentally unstable give birth to three children and still protect and take care of those children for several years before the government eventually intervened.”
Speaking about the Clancy case, Daud said she found the reported circumstances difficult to understand based on her own experience. “If a woman develops psychosis after childbirth, she can harm the new baby because she may not understand what she is seeing. But it is difficult for me to understand how she would suddenly turn against older children she had already known and cared for.”
When Does Mental Illness Become A Legal Defence?
Legal practitioner Eromosele Andrew said Nigerian law recognises insanity as a defence. “She can come claiming insanity, but she would have to prove it extensively,” Andrew said.
He explained that Section 27 of the Criminal Code provides for a presumption of sanity, while Section 28 addresses circumstances in which a person may not be criminally responsible because a mental disease or natural mental infirmity deprived them of the capacity to understand what they were doing, control their actions or know that they ought not to do the act.
Andrew said the defence must be supported by evidence relating to the person’s mental state at the time of the offence. The distinction is important: mental illness and legal insanity are not interchangeable, a person can have a diagnosed psychiatric condition without automatically meeting the legal threshold for lack of criminal responsibility.
The cases in the United States do not establish that Nigeria is facing a similar pattern of mothers killing their children. They do, however, raise questions that Nigeria’s health and justice systems must be prepared to answer.
Can Nigeria Protect Children While Treating Mothers In Crisis?
Child safety must remain paramount when there is an immediate risk.
At the same time, mothers experiencing severe mental illness require timely assessment and treatment rather than stigma or neglect.
The central lesson from these cases is not that motherhood itself is dangerous, nor that mental illness explains every tragedy.
It is that a dramatic change in a mother’s behaviour after childbirth should never be ignored.
Recognising warning signs early, seeking urgent professional help and protecting both mother and child can prevent a mental-health crisis from becoming a tragedy.
About the Author
Mirian Gom 