Jury selection begins Monday in the trial of a Massachusetts mother who strangled her three children while undergoing medical treatment for psychiatric problems that developed after she gave birth.

Lindsay Clancy has pleaded not guilty to murder charges in the deaths of her children Cora, 5, Dawson, 3, and Callan, who was 8 months old when the siblings were killed on Jan. 24, 2023.

Clancy, now 36, threw herself out a window after killing the children and was paralyzed in the fall. She is being held at a state hospital.

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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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The trial is expected to explore the complicated and rare phenomenon of postpartum psychosis, which afflicts a very small percentage of women who develop delusions and sometimes hallucinations after giving birth. Clancy's lawyers β€” and her husband β€” say she was not responsible for her actions.

Prosecutors say the killings were intentional and well planned, not the work of someone who had lost control.

On the day it happened, Clancy, a former labor and delivery nurse at Massachusetts General Hospital, asked her husband, Patrick Clancy, to go out for takeout food and pick up something at the pharmacy. Then, she used exercise bands to strangle her children in the family's home in Duxbury, about 30 miles (48 kilometers) south of Boston.

Eighteen jurors, including six alternates, are expected to be chosen over several days. The trial is expected to last several weeks.

Clancy's attorney, Kevin Reddington, doesn't dispute that she killed the children but plans to raise an insanity defense.

"This whole case is an extreme tragedy," he said.

Clancy and her husband filed lawsuits earlier this year accusing her medical providers of failing to properly diagnose, treat and monitor for her for a "severe postpartum psychiatric condition."

Lindsay Clancy's lawsuit detailed how she was depressed, having trouble sleeping and repeatedly hearing voices urging her to harm her children and herself. She spent several days at a psychiatric hospital just weeks before the killings.

"Lindsay Clancy did everything a mother in her situation could do. She recognized something was wrong with her. She sought medical treatment. She went to emergency rooms. She called crisis hotlines. She admitted herself to hospitals. She took the medication prescribed to her. She communicated her worsening symptoms to her providers. She told them the medications were making her worse," the lawsuit said.

On the day of the killings, Clancy said she heard voices saying, "This is your last chance. Kill the children so you can kill yourself."

Both sides have Clancy's husband on their list of witnesses. He has said in interviews that he forgives his wife.

In a post on GoFundMe several days after the killings, Patrick Clancy wrote that the "shock and pain is excruciating and relentless," but he urged the public to see Lindsay Clancy as he did before the killings.

"The real Lindsay was generously loving and caring toward everyone β€” me, our kids, family, friends, and her patients. The very fibers of her soul are loving. All I wish for her now is that she can somehow find peace," it said.