Take our Authoritative Parenting Test

Find a therapist near me

The lack of a formal reproductive psychiatry subspecialty results in too few skilled practitioners.

Only about 500 reproductive psychiatrists are practicing in the United States today.

Efforts are underway to establish an accredited reproductive psychiatry fellowship.

Awareness of perinatal and postpartum mental health issues is growing dramatically. Yet there remains no formal reproductive psychiatry certification for medical school residents. The lack of training means that only about 500 reproductive psychiatrists nationwide care for the roughly 800,000 women in the U.S. who experience maternal mental health complications each year.

Approximately 13 percent of pregnant women take selective serotonin reuptake inhibitors (SSRIs), but about 80 percent of women are prescribed these SSRIs by OB/GYNs, Dr. Maria Muzik, a professor of psychiatry and obstetrics and gynecology at the University of Michigan and the medical director of its Perinatal Psychiatry Clinic, told me recently in a sit-down interview. This lack of a formal reproductive psychiatry subspecialty means “[many psychiatrists] might have never heard about reproductive psychiatry,” Muzik said. “They might never have treated pregnant people adequately.” The result is a dangerous lack of specialized care.

What Happens When Expertise Is Missing

These statistics aren’t abstract to me. In 2020, trying to prepare for a potential pregnancy, I began a taper on a selective-norepinephrine reuptake inhibitor (SNRI) associated with a small, increased risk of heart defects in a baby. My husband and I had consulted a reproductive psychiatrist about my medication regimen’s safety in pregnancy, but this specialist’s recommendations had gotten lost in the shuffle between her and my regular psychiatrist. I ended up communicating them to the latter according to memory. My psychiatrist told me that we’d start a taper on the SNRI—at a rate she thought safe, not what the specialist had suggested.

Six to eight weeks later, I was a wreck: episodes of wild sobbing, deep depression, even suicidality. One day, as I was standing at the kitchen counter making dinner, my mind kept flashing to the safe upstairs, where I keep my medication—I knew it was unlocked. I pictured pouring........

© Psychology Today