What is postpartum psychosis, and why does the media keep getting it wrong?
On this episode of The BADT Roundtable, Sabia Wade talks with clinical psychologist Dr. Ana Arteaga-Biggs and doula, educator and BADT teacher, doula, and educator MaryNissi Lemon. They look at the public reaction to the Lindsay Clancy case and the clinical realities of severe perinatal mood and anxiety disorders (PMADs). Then they turn to the practical side: what birth and postpartum workers can actually do to spot warning signs and get families support early.
In this episode:
Baby blues vs. postpartum depression vs. postpartum psychosis: how onset, prevalence, and severity differ
Intrusive thoughts vs. psychosis: why a parent’s terrifying thoughts are not the same as losing touch with reality
Why the 6-week postpartum checkup often comes too late for families in crisis
How race and class shape whether a parent gets psychiatric care or faces criminalization and CPS involvement
How doulas can use screening tools like the EPDS without stepping into diagnosis
Red flags to watch for during postpartum visits
Building a mental health safety plan with clients before birth
Holding space without taking on trauma: boundaries for birth workers
Building referral networks with perinatal therapists, psychiatrists and support groups, and what to do when a client is in acute crisis
About our guests
Dr. Ana Arteaga-Biggs, Psy.D., is a bilingual clinical psychologist and National Register Health Service Psychologist now based in Barcelona, Spain. Her expertise includes trauma, perinatal mental health, infertility, grief and loss, and race-based traumatic stress. She works with individuals, couples, and families, and she facilitates support groups.
Website: www.doctorarteaga-biggs.com
Instagram: @__.dr.ab.__
MaryNissi Lemon, CD, CLC, CBE, is a birth and postpartum doula, childbirth educator, doula mentor, and trainer. She has more than a decade of experience supporting families. Born and raised in Malawi and now based in Philadelphia, she hosts the Positive Birth Corner Podcast. She is also the author of The Complete Informed Doula Guide for Expectant Families. Her work focuses on making birth education accessible and culturally relevant, especially for Black and immigrant families.
Website: www.positivebirthcorner.com
Instagram/TikTok: @positivebirthcorner
Learn more about BADT programs and resources: www.badoulatrainings.org
Content note: This episode discusses maternal mental health crises, including a case involving the deaths of children. If you or someone you love is struggling, call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262), available 24/7. You can also reach Postpartum Support International at 1-800-944-4773. If someone is in immediate danger, call 911.
Transcript
ES Yo No Se (Instrumental Version) AURA STELLA (00:01) you
Sabia Wade (00:20) Welcome everybody to the BADT Roundtable where we talk the full spectrum of our experiences, the full spectrum of reproductive care, and the full spectrum of reproductive justice. We're finding out our time, our like tagline. We're gonna we're gonna get it together. But you like that one? Okay,
MaryNissi Lemon (00:38) I love this one now. It's perfect. Yes. That was great.
Sabia Wade (00:43) period. So I'm your host, one of your hosts, Sabia.
And I am the founder and CEO of Birthing Advocacy Doula Trainings. Um, I am here also with my co host, which is Mary Nissi. Mary Nissi, you want to introduce yourself?
MaryNissi Lemon (01:00) Yay, I am Mary Nissi. I am this is like the part where it's like, wait, what is it that I am? And what is it that I do?
Sabia Wade (01:06) D
MaryNissi Lemon (01:10) I am uh the founder of Positive Birth Corner, and one of the core teachers here at BADT and also the program manager of BADT. Mm-hmm.
Sabia Wade (01:21) Yes. And also really cute. Love the hair.
MaryNissi Lemon (01:26) I thank you. I think you see my locks up like listen.
Sabia Wade (01:28) Yes,
I know. I was like, okay. Here I am just trying to survive y'all, so y'all get what y'all get. Exactly. And we
MaryNissi Lemon (01:31) Thank you, thank you. Listen, hair, you know, we're gonna talk about another episode about just like, you know, hair
Sabia Wade (01:41) have a very special guest because very special to me for many reasons. Dr. Ana. I'm let you introduce yourself. I won't tell all of our business, but I'll just let you introduce yours yourself first.
Dr. Ana Arteaga-Biggs (01:55) Sounds good. I'm Dr. Ana Arteaga Biggs. Um, I'm a clinical psychologist, um, specializing in a a number of things, but for purposes of today, uh perinatal mental health, uh, women's health kind of across the lifespan, ah things like racial trauma, et cetera. So I'm really excited to join this conversation today. And I know Sabia um personally because she was my doula. Um
With yeah, but my very difficult
Sabia Wade (02:24) Oh me.
Dr. Ana Arteaga-Biggs (02:25) um births and and a long history of infertility. So I found Sabia and she uh was just wonderful. So yeah.
Sabia Wade (02:33) Thank you. Yes, we always bring in these close connections. And so I'm always happy when I can bring someone that I know personally into the space. and I will say too, like if y'all Dr. Ana, like she said, is like it's it's a so much experience, but also I love the way that Dr. Ana brings in her personal experience into the work. So if you have not already, which you will, look up Dr. Ana, look at other podcasts that she's been on, look at all these things that we
We get into it and we in space together, we're like, endometriosis, adenomiosis. We're so like all the things.
Dr. Ana Arteaga-Biggs (03:09) Yes. So we share a lot
of similar yeah, problems, right? Yes.
Sabia Wade (03:13) Yes, yes. We
probably gonna have you back for that episode too, actually. Now that I think about it. Alright,
Dr. Ana Arteaga-Biggs (03:17) Yeah, I'd be happy to uh
Sabia Wade (03:20) y'all. So we have a lot to talk about and we're gonna try to do it in a timely fashion. But we're gonna get into it because I have a lot of feelings. So this is the first episode of the B A D T Roundtable. Um we've been thinking about doing this for some time, but I think things come when it's when it's ready, right? And we
MaryNissi Lemon (03:40) It's opposed to Yeah.
Sabia Wade (03:41) feel ready.
MaryNissi Lemon (03:42) Yeah.
Sabia Wade (03:43) The thing that really sparked this particular episode was the Lindsay Clancy case.
I don't know about y'all, but watching this case unfold as like a birth professional and like as a person who works with people who are in their postpartum raised their postpartum year, let's say like the first year or so, I'm like, this is this is very it's nuanced, right? It's very, very nuanced. And just in my personal opinion, that husband, mm mm.
MaryNissi Lemon (04:22) Yo. Everybody keeps talking about this too.
Sabia Wade (04:23) Mm-mm. Mm-mm.
MaryNissi Lemon (04:25) They
Sabia Wade (04:26) I was like, there's one thing, right? Like, obviously we we all look at postpartum period as a holistic time, right? And yes, it is about the parent, like the birthing parent, and it's also about the support that they have around them, right? And like, I don't know, but I'll just give a brief little to-do about the Lindsay Clancy case. Um
So the Lindsay Clancy case that has been all over television and probably like all over the world, honestly, is about Lindsay Clancy and unfortunately the the death of her children. supposedly, allegedly by her hands, um, in the midst of postpartum psychosis. Um, and so one, I wanna hold space for the children who passed away, because that's
terrible. It's awful. It's something that you never, I feel like in this work, that's like the last thing that you want to get to. and I want to name that there's so much complexity to this. And I'm gonna name that if you are someone who's experienced postpartum psychosis, um, if you're someone who has been helpful to someone who's experienced psych postpartum psychosis, you can probably name the the nuance and the layers that come with this. It takes
It takes time to we get to that outcome that we hate. And I feel like this case really emphasized that. Like how did we get here? And so one of the things I'll emphasize, um, is that Lindsay actually is a nurse, an L and D nurse, labor and delivery. And a big part of this and I think what made this case stand out is that she actually sought out a lot of help. And also had access to it, right? And it
MaryNissi Lemon (06:18) Yeah.
Yeah.
Sabia Wade (06:18) 'Cause not
a lot of people have even have access to what she had access to. Um, so in between going to um psychiatrists, going to a mental health facility, um, utilizing medication, utilizing therapy, like there was a lot in the story that I think was unusual in that case. Usually we hear about at least the things that are publicized, we hear about a lack of that. Right? What we may hear about is child protective services being involved,
MaryNissi Lemon (06:46) Yeah.
Sabia Wade (06:46) but still a lack of care.
honestly, at least
MaryNissi Lemon (06:48) Right. Right.
Sabia Wade (06:49) in my opinion. So this was this was new to see like this this case where all these resources were put in place and we still had this really terrible outcome.
Dr. Ana Arteaga-Biggs (07:02) Well, and on top of that she also had social support within her family, her parents close by who were very attentive and helpful. She was a white woman, so we know she had
Sabia Wade (07:12) Mm-hmm.
Dr. Ana Arteaga-Biggs (07:13) access to a lot more resources. And she also had a nanny uh before allegedly he w she was f let go by the husband, but um she did have a lot of support.
Sabia Wade (07:22) Mm-hmm. Yeah, and that's
like we've never I've never seen a case like that.
MaryNissi Lemon (07:26) Yeah, yeah.
Sabia Wade (07:27) I always see one, your name and Dr. Ana, the intersectionality of it all. Right? Where
MaryNissi Lemon (07:32) Yeah, you know.
Sabia Wade (07:33) it's like usually Black and Brown folks, especially if you're um poor or any of that close to any of that, you don't get all of this. A nanny,
MaryNissi Lemon (07:41) Right. Yeah.
Sabia Wade (07:43) a this, a that, like it's done, right? So I guess I'm gonna go into first like
One, I would just like to hear both y'all's opinions. I said a lot about my thoughts. But I would love to start with you, Mary Nissi, on just a level of like what what you thought about as you were navigating this.
MaryNissi Lemon (08:01) Yeah, yeah. I really struggled. I really struggled like following through the whole story. Um, I had to pause, like I would stop, you know, kinda being on social media. Um, I think it was and I'm I was trying to figure out like w why was this really hard, right? I think it was the aspect of where it was highlighting someone, right? Again, that intersectionality, right, who is privileged, right? Someone who is white, like who has these resources. Um, and when I tell you
the families and the folks that I've personally worked with or that I know of locally, right, who struggle in some way, maybe not psychosis, but like their stories are not, like you don't hear about it. Right. So I think that, like I was just like, oof, I don't know. This feels really hard right now. Right. Like I'm like I don't I don't know that I want to fully enter into this conversation. Um the
Dr. Ana Arteaga-Biggs (08:47) Mm.
MaryNissi Lemon (08:48) other part, as you already know, is that like, you know, not everybody's a birth worker, right? So like neighbors, like I was at a cabin. True story. I was in a cabin
Camping with a bunch of folks and the one person who doesn't even know the work that I do was like very passionate about like how horrible Lindsay is. I can't believe she she deserves, you know, what she gets, right? And I'm sitting here like, holy mother of grace, people are so opinionated about this. I'm like, you're not even educated. Right? Because I was just, I think I it was just bringing out so many emotions for me. Like, I didn't want to enter it. At the same time, I was
Dr. Ana Arteaga-Biggs (09:21) Yeah.
MaryNissi Lemon (09:22) very angry about this like extreme opinions of like.
Just everybody around you know, around me of kind of like those like this two sides, right? Like polar opposites of like what she deserves. And
Dr. Ana Arteaga-Biggs (09:33) Mm-hmm.
MaryNissi Lemon (09:33) I'm thinking, This is so much more complicated than like what you believe she deserves, right? So I think it was just like a very hard space for me, um, to enter in. And, you know, with all the hats that I wear, right, as a birth worker, you know, as a community member, as a Black woman, right? As someone who's very much aware of kind of like what this like postpartum season looks like as a mom. ah
Just felt like there was not a lot of conversation around the nuance of it all. Um, so I kinda like was like,
Dr. Ana Arteaga-Biggs (10:06) Yeah.
MaryNissi Lemon (10:06) I'm like, we're camping right now. I can't really go into it. You know, like it
Dr. Ana Arteaga-Biggs (10:11) Yeah.
MaryNissi Lemon (10:12) might not end well, right? Um, yeah, so I think I really struggled. And I was like really, you know, I've been really looking forward to kind of like having this conversation together. Cause I think this is honestly the first time that I'm actually like fully
talking about all of this, you know, kinda like the nuances of it, right? Of like what that means, you know, for us, what that means for birth workers. Um and really glad for you, Dr. Ana to be here as well. So I'd love to hear hear from you.
Dr. Ana Arteaga-Biggs (10:35) Thank you. Yeah. I gosh. Okay. So I have to preface this by saying this this case happened for me adjacent to a uh completely brand new move across the world for me. I moved from San Diego to Barcelona, Spain for political reasons. Um and so navigating this really complicated move of extraordinarily stressful move that actually
brought me back to a similar state that I felt when I was postpartum. That's how I've described it to people. And they're like, well, how are you? I I feel like a new mom in some
MaryNissi Lemon (11:11) Mm-hmm.
Dr. Ana Arteaga-Biggs (11:12) ways because I feel so confused and out of sorts and lost and just not myself, right? So I was kind of already in this state. And then I was of course tuning in to this trial um because this is the work that I do, not the postpartum psychosis
MaryNissi Lemon (11:26) Mm-hmm.
Dr. Ana Arteaga-Biggs (11:27) so much, but just perinatal
mood disorders, right? And um working
MaryNissi Lemon (11:31) Okay.
Dr. Ana Arteaga-Biggs (11:32) a lot with pregnant and postpartum uh people. And
MaryNissi Lemon (11:35) Mm-hmm.
Dr. Ana Arteaga-Biggs (11:37) I I personally struggled with pretty severe postpartum depression with my second. I don't know if you
MaryNissi Lemon (11:43) Mm-hmm.
Dr. Ana Arteaga-Biggs (11:43) knew that, Sabia. I don't know if we had talked about it much, but it was pretty, pretty bad actually. And I I think that so much of that time of my life I felt very alone.
And a lot of the ways that I was feeling the things I was thinking, especially as an infertile person, it is ex it there's even less space for you to voice any displeasure with being a mother because you were only allowed to be grateful and um, you know, enjoying every single second and these kinds of things.
MaryNissi Lemon (12:13) Yeah.
Dr. Ana Arteaga-Biggs (12:14) And I was just not feeling those things at all. And it wasn't my fault. Um
MaryNissi Lemon (12:17) Okay.
Dr. Ana Arteaga-Biggs (12:18) and so I was I w
During this trial, I felt like an intense emotional experience for for weeks. I I I
MaryNissi Lemon (12:28) Yeah.
Dr. Ana Arteaga-Biggs (12:28) was losing sleep because of it. I was remembering things with my my son that I had kind of let myself forget intentionally because they're so painful. and I was really, really aware of a couple of other things. So one is just the very few women that I have worked with who suffered from.
Postpartum psychosis. And those thankfully happened when I was under training. So I I was under the supervision of a licensed psychologist at the time when I wasn't. So I had a lot of support around navigating these really, really painful cases. But those are the ones that have stayed with me the most in my career in these really painful ways where I feel like I wasn't able to help in the ways that I wanted to. And I was also thinking about this white woman receiving.
all of this like love and care. I mean, she's also gotten villainized horrendously and it makes me sick. But there's also been this uplifting and all of all these moms around the world that have, you know, that have supported her, which is beautiful and she deserves that. But I just think of how many Black and Brown women, like Latasha Sanders, is, you know, one out of I'm sure many examples of names that I haven't even heard of, they don't even show up on my screen, right? And so
I was just very aware of that piece of things too. And that's just uh it it's to your point, it's so uh multifaceted and so nuanced and so complex and so there's a million different feelings swirling around, but on a personal level, just as a as a woman, as a mother who had postpartum depression, this case just rocked me emotionally.
Sabia Wade (14:12) For sure. I think definitely it it's I I can't emphasize enough how it is to be in the work and not just be talking around the work. Right? Because I'm like, this sounds maybe more Black and white if you're just around it, if you haven't sat with birthing people, if you haven't been at the birth, you haven't been in their postpartum period, you haven't had those conversations.
Seen those difficulties, navigated what it what it feels like to have a child and also have other children on top of that. That's a whole nother thing, right? Like it's one thing, granted, everything is a challenge and a journey, but wow, when somebody's bringing home a new baby amongst other children already, the demands of that, right? The relationship demands, right, between you and your partner, the way that things change, the way that you're trying to identify yourself.
where you're trying to identify your children, you're trying to identify your partner. Who were we at one kid? Who were we at two kids? Who are we at three kids? Right. Like there's so many things that like me personally I've never had a child. And sometimes I'm like, being a doula maybe it made me even more clear about not being a parent. Because I'm like, I don't think I have the mental faculties. Right. I'm like, I don't think I personally have the mental faculties.
To handle it. Like, and that's just being honest, right? But not many people, including birthing people, learn about postpartum mood disorders prior to getting pregnant. If anything, they learn about it in between like when they're pregnant, right? If they go to childbirth
Dr. Ana Arteaga-Biggs (15:56) Thank you.
Sabia Wade (15:57) education, if they go to something like that. But generally speaking, people don't learn about
MaryNissi Lemon (16:02) Okay.
Sabia Wade (16:02) pregnancy, postpartum, this, that, and the other until they are already in it.
MaryNissi Lemon (16:07) Mm-hmm. Mm-hmm.
Sabia Wade (16:08) Right. And that's already like,
I feel, uh, a problem in our in our society to begin with. However,
MaryNissi Lemon (16:13) Yeah, yeah.
Dr. Ana Arteaga-Biggs (16:13) Right.
Sabia Wade (16:15) I want to move us forward and I think it's really important because a lot of what we're talking about, postpartum psychosis, depression, da-da-da-da. A lot of these things I learned are not even like in the official like diagnosis book for how we navigate mental health.
Dr. Ana Arteaga-Biggs (16:35) Mm-hmm.
Sabia Wade (16:37) And so Dr. Ana, I would love to just hear about um one, what are P mads?
Dr. Ana Arteaga-Biggs (16:42) Mm.
Sabia Wade (16:42) Right. And then two, why aren't they listed in the books and stuff?
Dr. Ana Arteaga-Biggs (16:50) So I can't the systemic issues of my field, we that's a whole separate episode of just the DSM in general. Um, to be fair, I I stopped going through that the way that I did in my training just because I think working with so many Black and Brown people, that book became a little less useful to me unless, you know, I really needed it for
more like clinical purposes or you know diagnosis related issues that I was concerned about. But um I mean this is a controversial take. So people will listen to this and and have feelings about me saying that. But I I personally I I mean people that have worked with me clinically know that I'm not I'm not looking at them from the lens of that book so much as I'm looking at all of their circumstances.
So I can't speak to why it's not in the DSM or why things are that maybe shouldn't be in the DSM as disorders. That's a whole episode on in and of itself. But um what PMAD stands for is perinatal mood and anxiety disorders. Um and there's a multiple different ones. And what's tricky when you're seeing uh a clinician in this space, the the mistake that I see people make is they work with
just their regular therapist thinking that that particular person can help when they're pregnant or postpartum. And sometimes that's true, but it's very, very specialized training. Extremely specialized. And even within that world, you have people that are specialists in part of that and people who are are not experts in other aspects of it. So when you look at the array of disorders, I'm I'm using air quotes, um, in that there's there are some, for example,
If I were to get a call from someone who was experiencing um postpartum OCD or postpartum psychosis, that would be an immediate referral out for me. I would be supporting as needed until I got them to proper care because I don't consider myself an expert in that. I consider myself an expert in depression, postpartum depression and anxiety. But those other two are they're just more they're they're
Some I mean postpartum psychosis specifically is a medical emergency, right? I mean, that's requiring medication, that's requiring hospitalization. And so if you don't have a lot of experience with psychosis, which I do not, then you could miss this and you could create and cause a lot of harm, right? And so that's the other piece is when you're looking for providers, you want to make sure if you're helping a loved one or one of your clients, for example, is doulas is that you're actually looking for someone who says.