Clancy looked up suicide methods, bipolar disorder and insomnia at the end of December 2022 and, in January, went in search of information on postpartum depression. She also wrote a detailed note in October 2022 expressing doubts about her parenting choices, second-guessing her decision to stop breastfeeding her 8-month-old, and reconsidering plans for a fourth child.

The defense says she was in the grip of bipolar disorder and postpartum psychosis, a rare condition that can alter a woman’s sense of reality after childbirth. A forensic psychiatrist diagnosed Clancy with those conditions following the killings.

In her note, the 36-year-old former labor and delivery nurse seemed most concerned with not being able to give her youngest child the same attention as her first two, ages 3 and 5.

“I’m terrified of something happening to my kids or doing something wrong to mess up their development,” Clancy’s note read. “Our generation is inundated with information about every aspect of parenting. … It’s insane. For the last five years, I’ve just filled my mind with all things parenting and it’s just unhealthy.”

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EDITOR’S NOTE: This story includes discussion of suicide. If you or someone you know needs help, the national suicide and crisis lifeline in the U.S. is available by calling or texting 988.

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Clancy has pleaded not guilty to murder charges in the deaths of Callan, Dawson and Cora Clancy. Their father found the children in the basement of the family’s home in coastal Duxbury, south of Boston. Their mother was lying in the yard after jumping out a second-story window, and remains paralyzed from the waist down.

Text messages with her then-husband, Patrick Clancy, show them juggling the routines of parenthood. Massachusetts State Police cellphone forensics expert Tim Chiappini read aloud texts between them from the day of the killings. They checked in on each other and Lindsay Clancy expressed relief that one of their children’s kidneys were OK. There were also photos of the children.

“You’re a good mamma,” Patrick Clancy texted, prompting Lindsay Clancy to respond with a heart and smile emoji.

Clancy’s livestreamed trial has generated intense public interest, with journalists and spectators packing the courtroom as online audiences pore over the details of the tragedy.

Clancy’s attorneys do not dispute that she killed the children. But they say the jury should not hold her criminally responsible because she was mentally ill, believing she heard voices ordering her to take their lives and her own.

Prosecutors argue she was an intentional killer who contrived to get her husband out of the house by sending him to get takeout and to the pharmacy on Jan. 24, 2023, then strangled the children with exercise bands.

Prosecutor Shanan Buckingham has urged jurors not to view the trial as “a public debate about women’s mental health and how the medical system treats women.”

If convicted of murder, Clancy faces life in prison without parole. If found not guilty due to a lack of criminal responsibility, she would be committed to a state mental health facility.

Her attorneys say Clancy did everything she could to seek help: She turned to multiple outpatient providers, tried various drugs they prescribed, called a suicide hotline, went to an emergency room, and approached but wasn’t accepted into a hospital-based, full-day treatment program for women with postpregnancy mental health problems. Clancy even checked herself into a psychiatric hospital for several days.

Rather than improving, her condition worsened on the ever-remixed cocktail of psychiatric medications, some of them problematic for bipolar patients, her attorneys and family say.

Prosecutors aim to show that Clancy had access to a range of mental health services but sometimes ignored doctors’ advice and stopped taking certain medications. They’ve brought several of her medical providers who testified she never talked about having a plan to harm herself or her children. They say she never showed signs of psychosis or mania, although she did say she was having suicidal thoughts.