Lindsay Clancy cut her wrists and neck and threw herself from a second-story window, leaving herself paralyzed from the waist down. At her trial, the prosecution questioned the seriousness of her suicide attempt—even this destruction of her body could be construed as a performance. Her detailed schedules for her children’s meals and naps became evidence that she was controlling, manipulative, and therefore sane when she killed her three children, aged 5, 3, and 8 months old. A white woman with access to medical care, herself a labor and delivery nurse (as was her mother), she had sought help repeatedly before killing her three children. What happened in those encounters, and what failed to happen, should trouble us as much as the question of her criminal responsibility. This summer, I sat entranced, watching a spectacle made of a woman on trial when the fact of killing her children was not in dispute.
We watched her face. For grief, vacancy, calculation, remorse. I merged with the courtroom camera that endlessly lingered on her profile. What were we looking for? The face of a mother, a murderer, a madwoman? Something that would allow us to distinguish among them? The media frenzy surrounding the trial, which still continues after its inconclusive end, acquired its own cruelty: Sympathy for Clancy was treated as a betrayal of her children, as though understanding the illness that preceded their deaths meant caring less that they had died. The spectacle offered endless opportunities to judge a mother and remarkably few to consider what keeping her and her children alive might have required. I felt myself in her place—being over-medicated, endlessly diagnosed, denied help for every conceivable reason, desperate in the face of a crying baby and my own mind gone rogue, failing to kill myself adequately, and then mercilessly prosecuted in front of the world, having my devastating actions paraded in front of me.
We have long known that childbirth can precipitate severe psychiatric illness. A detailed case of postpartum illness from as far back as 1551 notes that psychosis can fluctuate, that apparent composure can coexist with danger, and that depression can be a gateway to a deepening psychosis. Yet this knowledge seems to repeatedly desert us when a mother requires care. In Mar García Puig’s book The History of the Vertebrate: On Madness and Motherhood, published in Spain in 2023 and translated into English in 2026, she writes, “On 20 December 2015 I became a mother and I went mad.” That same day, Spain voted, and García Puig was elected to Parliament. Her premature twins were taken to incubators. The book bravely charts these two impossible tasks: navigating her postpartum illness and being elected as a representative of the government in Spain.
“I can’t die anymore,” she tells the psychiatrist who comes to her hospital bed. “I’m a mother.” The state of alarm from that point became endless. Fluid leaking from the site of her epidural becomes, in García Puig’s perception, blood flooding the room. Nurses repeatedly show her a dry dressing. The records document their reassurance and her continuing terror. “I have to be a thousand knives, and this feeling of constant alarm doesn’t give me a moment’s rest. Not even in the brief periods when I manage to fall asleep can I stop keeping track of my children’s heart and breathing rates,” she writes.
Months later, she begins pulling out her hair and eating it. She remembers Snowflake, the gorilla she watched as a child at the Barcelona zoo, tearing out and swallowing his fur before a crowd of spectators. She fears that the hair she consumes will poison the breast milk she pumps for her hospitalized daughter. Arriving with a bottle in a portable cooler, she stops at the threshold and confesses to a doctor. He tells her the milk is fine, recommends that she speak to a psychiatrist, takes the bottle, and leaves. Her psychologist names the behavior: trichophagia. She later reads that captive animals do it to soothe their “imprisoned restlessness.” The pressures of motherhood driven into private domesticity are easily suffocating. But we’ve always known this?
Puig’s book is filled with drawings and photographs of “madwomen.” Photographs were endlessly taken of women confined to 19th-century asylums. Their faces were studied for evidence of madness and recovery, their clothes and poses arranged to make the difference visible. Looking at her own official parliamentary portrait, taken weeks after giving birth, García Puig examines “the position of my mouth and teeth, the angle of my eyes’ openings, the direction of my gaze, the furrows on my brow.” She adds: “Any of it could be used against me.” She searches the archives for women who might help her understand what is happening.
Eliza Gripps, admitted to an English asylum after a difficult birth in 1860, believed the bodily connection between herself and her baby had never been severed. She ate excessively when he was absent so that she could continue nourishing him; she restrained her bowels because she feared she was expelling their lives. During calmer periods she sewed, played chess, and secretly saved food for her son. She died nine years after her admission without seeing him again. Margaret Steele, hospitalized in Edinburgh in 1855, believed the meat she was given consisted of her murdered children. When the children were finally brought to visit, she could not recognize them as living. Another year passed before she could see them without distress.
“The alienists [what doctors working with mentally ill patients were referred to in the 19th century] who treated puerperal insanity faced an enormous challenge,” García Puig writes. “They were not only trying to cure a woman, but trying to cure a family, to have the deranged woman return to her role as mother and wife.” Recovery was measured partly by her willingness and ability to resume that role. The question of what she might need could disappear into the question of when she would be useful again.
One photograph in particular holds García Puig’s attention because the woman in it appears to have three hands. Emma Riches was admitted to London’s Bethlem Royal Hospital in 1857 after the birth of her second child; her first baby had died. In the photograph, one hand rests on her lap, another is partly concealed, and a third grips the first. A subsequent discharge portrait shows a respectable woman holding a book, although her records reveal she could not read. With the help of archivists, García Puig discovers that Emma had three more children, returning to the asylum after each birth. Between her first admission at 25 and her death at 49, she spent only seven years outside it.
Whose hand was it? An attendant’s, perhaps, keeping Emma still for the camera. García Puig imagines “the hand of another madwoman, of her mother, her auntie, her grandmother, the madwomen of history.” What first looks like an anomaly in a photograph becomes the possibility of accompaniment. The History of the Vertebrate is filled with these acts of reaching toward women whose suffering survives in a clinical description, a picture, a few words someone else chose to preserve.
The numbers now being recorded demand another kind of response. A Kaiser Permanente study of more than 442,000 pregnancies in Southern California found that postpartum depression diagnoses doubled between 2010 and 2021, from 9.4 percent to 19 percent. Forty million women are estimated to experience a long-term health problem stemming from giving birth. Comprehensive care requires someone to follow a woman’s changing condition, doctors who speak to one another, attention to sleep and nutrition, practical help with children, and access to someone (preferably well-trained) to talk with regularly. Meaning, actual psychotherapy and not psychiatric check-ins. And help cannot consist of having to assemble that help oneself.
García Puig recalls something shifting in her mind one day when her sister calls the babies her niece and nephew: “They are grandchildren. They are siblings. It’s not all on me alone.” A mother can discover that her children belong to a world in which other people have obligations to them, too. This seems to me a beginning for thinking about care: a mother herself must be able to depend on someone. Puig writes,
“NASA wanted the world to look on with admiration while it conquered the most distant star in the universe. Our leaders wanted a train that connected the capital with the periphery at the speed of light. But Amàlia Alegre and her contemporaries [members of the Radical Party in Barcelona in 1918] just wanted coal so their children wouldn’t freeze to death. Mothers are powerful. We mold the brave, as Napoleon said. But how impotent that mold becomes in the face of powers that mercilessly lay waste to every seed we sow.”
With the U.S. midterms this week, I wonder what it would take to make that dependence a fact of our common life, something we can count on when we can no longer hold everything together. It feels like a miracle that we now have universal 2-K in New York. And yet, that still leaves us with two critical years to arrange care ourselves. Imagine how much more we could provide? I called García Puig to discuss.
Your book starts with you giving birth to twins and being elected to Spanish parliament, where you served for seven years. Let’s begin with how these demands collided and how you navigated that collision. Also, when did you begin writing?
I have always worked on books as an editor and a translator, but I had never written literature before. Both things collided on the same day, which is very poetic, but it’s also reality. An important topic in the book is how the supposedly private spheres and public spheres work against each other in the case of women, especially in the case of mothers. When I gave birth and became a member of the parliament on the very same day, both spheres collided. That made me look at them and realize that these spheres are completely artificial, and this division is a way of perpetuating—[in] the case of women and mothers, especially in politics—a madness. My madness is a consequence of this clash, of this artificial division, because when I’m in politics I’m a mother, and when I’m a mother I’m in politics. Motherhood is not part of the private sphere—or it shouldn’t be—because it’s something social and that has to do with community. Emotions are relegated to the private sphere, but in politics, there’s also a lot of emotion. And I think it’s good that there are emotions in politics.
I started writing after I gave birth and became a member of parliament and I had this anxiety disorder. I started to read a lot about that. I started to research, not knowing I was going to write a book, but when I had a lot of research done, I decided I wanted to write something with all this material.
Perhaps we are the worst in the United States in terms of the absolute artificiality of this division: We don’t have adequate healthcare. We don’t have childcare. We don’t have functional schools. The responsibility for these failures is placed in the private sphere—it’s your fault if you can’t get healthcare, childcare, mental healthcare, education. It seems like we are at the end of this experiment of dividing these domains. We have endless mental health problems.
In Spain, there are so many people that, because of mental health problems, don’t work and have to be paid by the state. But capitalism needs us to work, otherwise we don’t have money to pay for the people that cannot work due to mental health issues. So, the system is breaking because it produces more and more mental health problems that don’t allow us to work, and at the same time we must work to support them—in Spanish, we speak of the fish that eats its tail. Pez que se muerde la cola. At the same time, political forces which are against public health are gaining more and more [traction] in Europe. This division of the private and public spheres is constantly in crisis, and it’s always surviving.
It’s true. It grows another monstrous head. The most recent of which is artificial intelligence, speaking of artificial divisions in life. Did you see the Lindsay Clancy case here in the U.S.?
No, no. I didn’t see it because I found it too painful. I read about it and people told me about it because of the relationship it has with my book and my own experience, but for me it was too painful to see her and all the reactions.
You speak about how the women suffering from postpartum madness you researched didn’t have voices; often all you could find was medical records or legal records or photographs or paintings. We never heard from Lindsay Clancy. We stared at her face the entire summer because the camera was fixated on her. We heard doctors, her nanny, her husband, her mother-in-law, policemen all speak about her, but we never heard from her. The only thing that we had were her acts, whether it was her attempted suicide or her infanticide.
We showed that we don’t understand postpartum illness. Everything that was said, “How can she be insane but also competent as a mother? How can she be insane but understand what her children need for dinner? How can she be insane and still seek help?” They couldn’t put these things together.
I thought a lot about Adrienne Rich and her book Of Women Born, where the last chapter is devoted to a woman who killed, I think, eight children. She had postpartum depression and she was on trial as well, and many feminists, among them Adrienne Rich, defended her, explaining that she had postpartum depression and that postpartum depression is part of patriarchy and so on. When I saw all the reactions to the trial, but also the feminists who defended her, I thought, Wow, from 1976, the year the book was published, to 2026, we’re still in the same place. It’s very sad that during all these years—not even justice, healthcare, media—we haven’t moved, or just a little.
I wonder if we’ve almost gone backwards, if the absolute vitriolic response to Lindsay Clancy would have been allowed then. There was at least a little bit of propriety in discourse, and now with the internet and everything else, the violence that can be expressed against a mother, I found shocking. It was closer to some of the practically medieval cases in your book.
The public judgment has something medieval to it. With the internet and all the media there and people looking at her, it has something of being in the public square. There was a case of a Spanish influencer who made a video on TikTok or YouTube saying, “I kind of understand her.” This influencer had to erase the video because there was such a backlash against her that she was justifying a murder.
Did you face any backlash from your book?
It’s a literary book with a lot of research. It is difficult with a book of this nature to have such a big backlash. When I was in politics, I had a lot of backlash on social media, but I think those people don’t really read this kind of book. Spanish critics have said it’s an “erudite” book. Okay, she’s talking about motherhood. She’s talking about madness. She’s talking about these feminine things and so on, but it’s erudite. She was mad but she’s very bright. I’m not in a lunatic asylum, I’ve written a book: That has kind of stopped the backlash, which is not a good thing.
It feels very close to the same way of dismissing anything that’s intelligent. It’s something like, Oh, those intelligent people. On the one hand, it saves you from madness, on the other hand, it condemns you a second time.
I think maybe in Spain anti-intellectual discourse is not so strong as it is in the States.
It’s very strong here right now. But I also have started to think about it in terms of the way that the left has failed its base to a certain extent. The left has, as much as anybody, sided with corporate interests, with the wealthy. Therefore, their “fancy” language didn’t live up to those it was meant to serve. It’s unfortunate because it becomes the idea that anyone who tries to speak intelligently is secretly a hypocrite. That’s the feeling here. Which might be true.
There’s the [idea that] women, at least women who talk about motherhood, are supposed to [be] very emotional. My book is very emotional, but at the same time, it is encyclopedic. A mother is not supposed to be that.
You don’t talk about it much in the book, but I had the feeling that you received adequate care to help you meet all the challenges of becoming a mother and serving your constituency. Your children were born premature, later a child became sick, you had this new job, you were going back and forth on the train all the time. There’s also the dissolution of your marriage hinted at the end. But you had care and it was important to me also that you pointed to it.
It’s true I had care. I remember I was once with an Argentinian author—and Argentinians are so precise with language—I said something like, “I was lucky.” She said, “No, you were not lucky. It’s a right what you received. This right, to have public mental health care and help with your children and so on, shouldn’t depend on being lucky.” There’s one thing, which I point [out] in the book but I don’t get very much into, because it was not the subject of the book and I felt it was not my experience, which is the fact that I’m a white woman, Catalan from Barcelona, with a network, with my family. I suddenly became a member of the parliament and that helped very much to give me some authority in my madness, but I have received so many comments and feedback from people who were not in this situation, mothers who were alone, racialized migrants, that, maybe, got separated from their children. They got institutionalized.
It was a real moment here in the U.S. this summer for people to question the kind of care that’s offered to women. Lindsay Clancy, I think, saw seven doctors. She was put on 13 medications. The catch-22 was wild because she called the suicide hotline, but she didn’t have a plan, so they wouldn’t speak to her. She went to one place and because she wasn’t on medication, they wouldn’t see her. She went to another place, she was on too much medication, they wouldn’t see her, and so on and so on.
It’s horrible. I think it also hints that medication is not enough. In a sense, we have gone backwards because in the ’70s we had this psychiatry that was much more social, and now it’s all about medication. This case points out very clearly that medication might help but it’s not enough.
I’ve been writing for so long about how disturbing our medicating of mental illness is. The way in which this has led to incredibly impoverished psychotherapy, which is the only place where there’s continuity of care. But at this point it does feel like a privilege for someone who has the kind of authority to ask for what they want and need as opposed to take what’s readily available.
I agree completely.
What did you learn in your time in parliament? Why did you leave?
When I arrived in parliament, it was a very good moment for feminism. It was just before the strike of the 8th of March [in 2018, when Spanish women went on strike to denounce the prevalence of sexism, sexual violence, and wage disparity] and everybody wanted feminists [in] the political parties. It was a good moment to make some changes. I could have a very nihilist stance that institutional politics is detached from society, that it doesn’t serve society, but I was involved in some laws here in Spain which were very important. With sexual and reproduction rights, and on sexual violence as well, we could change some things. But then feminism fell out [of fashion] and everything became so much more difficult. Institutional politics goes very much in waves of what’s fashionable at the moment socially.
I think now that I work politically through literature and through culture, I see the limitations of [the cultural sphere] as well. This complexity—which is so difficult nowadays to defend—makes me still believe in politics. I left politics because I wanted to still believe in politics.
I was listening to a podcast with this famous feminist psychoanalyst, Jessica Benjamin, who was saying, “In my days when you were a feminist, you treated everyone as if they didn’t understand, because feminism was new. You said, ‘Okay, well you don’t understand, and I’m going to teach you.’ Here’s how to be a better person. Here’s how to be a better husband. Here’s how to be more attentive in society. Nowadays, things are really weird because you can’t teach anyone anything. They act as if they understand it all, and yet all the lessons are still the same.” When she listens to women patients nowadays, she finds that they’re in a much more difficult position.
I think it’s true, also because it has become market value feminism. When I worked in publishing, feminism was the fashionable topic. I remember there were books: feminism for children, feminism for men, feminism for little girls, feminism for babies, feminism for all, for my grandma. Everybody wanted to listen to feminists for some years, and now nobody wants to listen to us because “they know everything already.” In the end, it has all been reduced to slogans—very simple, easy sentences used by the markets, but that don’t have this complexity that feminism has.
Watching Lindsay Clancy this summer and then thinking about your book, I had the feeling that the most private transformation, the supposedly most biological forces at play, faced the inability of the social to answer in any way. The need we have to think about a mother, how we take care of a mother who has to take care of children, felt so poignant because we are still so hopelessly lost.
In the case of Lindsay Clancy, it’s not so easy to put yourself in her place. Even though you can understand her, there is a complexity in saying, “I could be her,” this monstrosity of a mother killing her children. Empathy has been reduced to a very simple thing. If we look at empathy as a very complex thing, something you have to work on, something you have to listen to… What you were saying is that we haven’t listened to her: How can you have empathy if you cannot hear her voice?
I’m not the biggest fan of empathy as it tends to be used either, but in this case, in trying to identify with that which feels the most monstrous, I was really moved by it. And to speak about the fact that a woman is never all mother. The ways in which motherhood, and how it’s been depicted, can suffocate you to death—anyone who is a mother would recognize this. Nowadays, with so-called equality between men and women, the expectations on women are horrendous: that you are beautiful, that you have a job, that you make money, that you’re successful, that you are a mother. No woman can do all of this.
Motherhood is a very extreme experience. It’s something that puts you in touch with the fragility of life. I’m taking care of my mother. She’s very old and very ill and that, as well, is very extreme. These experiences change your identity a little bit—when you become a mother, or lose your mother, and you don’t have anyone above you. Now you don’t have anyone to take care of you. You are the one taking care.
A friend of mine and me, we have what we call the Observatory de la Niñophobia, people who have a phobia of children. We always say it’s very connected to madrephobia, motherphobia, because when a child is interrupting something, or they are making noise, everyone always blames the mother. I always say, “Well, try for yourself.”
I like books on motherhood, just like I like books on taking care of old people. I also like books on war, for example, which point to extreme situations in life. Motherhood is an extreme situation in life, and I think people don’t know that. It can make you go mad because it’s extreme.
For further study…
- P Eldridge on the recently published Kate Zambreno book Foam, which traces their pregnancy and postpartum period, along with many writers and artists who work on this liminal foamlike time
- Jessica Grose on Lindsay Clancy, the only article I found that captured why women were watching
- An excerpt from Lynne Tillman’s Mothercare, an excruciating and beautiful book about caring for her dying mother
- On Mary Kelly’s landmark artwork Post-Partum Document, through readings of her texts and images of over 168 artworks
- A fascinating new British project called Contragestive Time looking at how we think about reproductive time, abortion, gestation, conception, in a way that frames these questions for women (including new ways of taking the pill that gets out of the not-pregnant/pregnant dichotomy)
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