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Postpartum Support International (PSI) PSI is the global champion for perinatal mental health (PMH), connecting individuals and families to the resources and support needed to give them the strongest and healthiest start possible. For 35 years, PSI has been leading the effort to address PMH disorders, working with experts and families to boost scientific knowledge and emotional understanding to develop and deliver effective interventions for all perinatal individuals and families.

Perinatal psychosis occurs after childbirth in approximately 1-2 of 1000 births, although occasionally psychosis can begin during pregnancy or after pregnancy loss. Of that number, 4% of those involve infanticide. Symptoms of perinatal psychosis most often begin within the first 2 weeks after birth, and might include delusions, hallucinations, delirium, and paranoia. At times the person loses complete touch with reality. Psychosis is a medical emergency that requires immediate care and thorough assessment, intervention, and treatment. Although the symptoms of psychosis are severe and present great risk, perinatal psychosis is treatable and individuals are capable of full recovery. Perinatal psychosis is a temporary illness that needs to be looked at differently than chronic psychiatric disorders. This difference must be understood as individuals are assessed, defended, and evaluated for alleged crimes committed during a temporary and treatable delusional state. Legal insanity definitions can be misleading, because the individual experiencing perinatal psychosis can at moments be able to differentiate right from wrong, yet in the delusional state be influenced by extreme compelling delusional beliefs, hallucinations, or commands which might instruct them to harm their baby.

In a very small percentage of cases individuals experiencing the extreme symptoms of perinatal psychosis act on hallucinations that result in harm, neglect, or infanticide. Perinatal psychosis is too often unrecognized, ignored, or inadequately treated. PSI advocates for a complete mental health assessment and clinical evaluation when an individual is alleged to have committed a crime during the perinatal period (pregnancy or postpartum). While many countries provide compassionate investigation and legislation, in the United States individuals often face lengthy and sometimes lifelong incarceration. It is the intent of PSI to promote positive change and justice, and advocate for improved knowledge among attorneys, judges, law enforcement, health care providers and the public about perinatal mental health disorders including psychosis, and to help change outdated legislation where possible. PSI works to increase public and professional understanding that perinatal psychosis, while it presents a serious and immediate potential for harm, is treatable and temporary.

PSI cannot provide psychiatric or legal evaluation in individual cases. We do have resources available for affected individuals, families and professionals.

Here are some resources:

Through education, advocacy, and providing resources for prompt and proper treatment, PSI endeavors to prevent crises related to perinatal psychiatric illness and the risk of tragic outcomes. We strive to increase informed mental health coverage on these topics, including fair and equitable coverage for all individuals and families.