Reproductive Psychiatry 101
At the intersection of mental health, pregnancy, and childbearing.
Updated April 17, 2025 | Reviewed by Lybi Ma
As a reproductive psychiatrist, I specialize in the mental health treatment of pregnant and postpartum women with mood and anxiety disorders. Reproductive psychiatrists also help women on psychiatric medications optimize their treatment before becoming pregnant, during pregnancy , and while breastfeeding.
The field of reproductive psychiatry has grown significantly throughout my career . Twenty years ago, many pregnant women were advised by their obstetrician-gynecologists to stop all psychiatric medication before pregnancy. Unfortunately, this often led to significant depressive symptoms or anxiety resurfacing during pregnancy. A growing body of clinical research studies now provides reassuring safety data for most psychiatric medications during pregnancy and breastfeeding. Women taking selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), escitalopram (Lexapro), and fluoxetine (Prozac) for anxiety or depression , can stay on their medication throughout pregnancy and breastfeed. However, there are exceptions; for example, the mood stabilizer valproic acid (Depakote) is known to cause birth defects and is avoided in reproductive-age women.
Pregnancy and the first year postpartum are vulnerable times for women, with hormonal shifts, sleep deprivation, and the stress of caring for a newborn creating a perfect storm for depression, anxiety, and bipolar disorder to emerge.
A typical day in my practice might include:
There is very good news for individuals preparing for pregnancy: awareness of perinatal mood and anxiety disorders (PMAD) has increased, stigma around treatment has decreased, and more treatment options are available. As numerous celebrities have publicly disclosed their experiences with postpartum depression, more women feel comfortable speaking about their struggles as new mothers.
Brooke Shields paved the way for destigmatizing postpartum depression when she wrote her memoir Down Came the Rain: My Journey Through Postpartum Depression in 2005. More recently, Chrissy Teigen has shared her experience with postpartum depression and the benefits of therapy. Additionally, Chrissy Teigen and John Legend have raised awareness about pregnancy loss after the passing of their son Jack in 2020, highlighting the importance of honoring their son’s memory .
Over the past 20 years, several new aspects of women's mental health have emerged. Advances in reproductive endocrinology have enabled women to freeze eggs and postpone childbearing into their forties and beyond, which can present unique psychological challenges. These challenges include:
Additionally, the influence of social media on new parents' mental health has become a significant concern. The growing number of " parenting experts" on TikTok and Instagram can make parenting feel overwhelming and confusing. Furthermore, climate anxiety and fears about bringing new life into an uncertain world have become increasingly prevalent issues for many.
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Judy Greene, M.D., is a board-certified psychiatrist specializing in women’s mental health in New York City. Dr. Greene completed training in psychiatry at the Harvard Longwood Psychiatry Residency Program.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.