20 myths women are still told about their mental health.
Plus a chance to AMA about maternal mental health and get an answer that won't harm you.
Right now, I think there is no end to the ways we are failing women.
This shows up so often in my clients’ therapy sessions, it now seems like part of my intake process – tallying up the misinformation and harm women endure from their doctors, healthcare systems, and the internet.
I’ve been at the work of being a therapist for almost 20 years now, and perinatal therapy for about 10. Most of us in this field understand it is viciously uphill work, and that the learning is constant.
Learning how to not drown in the chaos of medical and health insurance systems. Learning how to know our value while trying to offer equitable care to those who need it. Learning how to navigate the racist, capitalist, and patriarchal structures we all live in – both inside and outside the therapy room.
There’s also the deeper clinical learning about how to listen, hold, and remain present with clients in enormous pain.
Most of us understand that while clinical training is essential, the greatest learning comes from our clients. For perinatal therapists, who are often perinatal women themselves, our clients offer an uncomfortable reflection, mirroring back some of our own deepest battle scars.
I still remember sitting in my first online class with PSI, weeping with relief-grief at what I was hearing1 and the connection the maternal mental health community offered. That moment catapulted me into a frenzy of study, training, supervision, and eventually certification in perinatal mental health.2
Over time, as I’ve crashed through my own seasons, my therapy practice has grown to include the entire reproductive lifespan – pre-conception through to menopause, with every tricky turn in between. And I can safely say that women are failed at every step along the way. Those who live in marginalized identities most of all.
There are some truly incredible writers and thinkers out here talking all about this3 – about WHY women are failed so profoundly. I won’t try to replicate their brilliant work, but I’ll give you this spoiler: it involves the overall culture of violence toward women that is currently leading us even deeper into a collective demise.4
The more I learn from my clients, the more I understand that something truly nefarious is going on.
For a long while, I kept a mental list (and an actual list on my phone) of the toxic, misinformed messages my clients have received from the providers they work with during pregnancy, loss, infertility, postpartum, and perimenopause. This is a common point of bewilderment and commiseration among colleagues. In Facebook groups for perinatal therapists, we fill up impassioned WTF threads, trying to understand how so many providers could still be getting it So Wrong.5
Maybe I’m jaded, but it seems to be getting worse. Or the advice is getting more harmful. Or maybe it’s just that as my small Southern city grows, there are even more women exposed to it.
The other day, after meeting with a newly pregnant mom who had received some especially harmful and false information from her OB-GYN, I found myself thinking for the millionth time, “Someone needs to make a list of every bullshit thing women are told by experts.”
Thankfully, I now have a Substack. So I guess that somebody will be me.
Here are 20 harmful and totally false things providers* have told my clients about maternal mental health.
(*Primarily OB-GYNs and pediatricians, though there are some psychiatrists and therapists in the mix here too.) Maybe in a future post I’ll pick some of the most egregious of these apart and review the data that proves them wrong. We’ll see.
Please add to this list from your own experiences or those of others in the comments!
Postpartum depression is the only mental health issue moms experience.
Postpartum depression and/or anxiety present immediately after birth only.
Breastfeeding will protect you from postpartum depression and anxiety.
Ingesting placenta will protect you from postpartum depression and anxiety.
It is not safe to take medications for depression and anxiety while pregnant or breastfeeding.
You should wean off all medications in the third trimester to protect your baby from withdrawal.
All mothers fall in love with their babies immediately; if you don’t, you have a mental illness.
If you’re depressed or anxious when you are pregnant or postpartum, it must be because you have a hormonal or chemical imbalance.
Intrusive thoughts mean you will try to harm your baby.
You can’t have a traumatic pregnancy or birth if you and your baby are alive and healthy.
All new mothers are tired; it’s normal to not sleep.
Sleeping with your baby is child abuse.
Leaving your baby to sleep alone in a crib will cause psychological harm.
Motherhood is hard and it’s natural to put your own needs last.
Postpartum is only for 3 months – you should feel normal after that.
Mental health issues cause infertility.
You’ll get pregnant when you relax and have fun.
Your stress, depression, or anxiety caused your miscarriage.
You should resolve all your trauma and be 100% healthy before becoming pregnant.
Only people who give birth to full-term living babies can experience perinatal mental health issues.
When I thought about sharing this list, I felt pretty self-conscious.
I understand there is no shortage of content about everything wrong with health care, mental health care, and women’s health. And for good reason.
I have a part who is always concerned that I have nothing new to add to the conversation, or worse, that I’m Just Complaining.
But there’s another part who takes care of this concern by encouraging me to offer something in return for my redundancy and complaints. And so, here is that offering, which can hopefully fuel more productive/informative future posts:
If you have questions about maternal or perinatal mental health, or mental health across the reproductive lifespan, please ask them here.
You don’t have to share your name. You also don’t have to be shy, embarrassed, or concerned that you’ll shock me. If I don’t know the answer, I will always admit that and help you find it.
If I do know the answer, I will answer it in my newsletter with data to back it.
Again, I definitely do not know everything there is to know. But I do know where to look and where not to look. I do know the harm googling, social media, and so many providers themselves can do. And I have a deep passion for undoing that.
So ask away, my friends. I hope to hear from you.
I recently talked about the ways my self-imposed immersion into perinatal mental health helped heal me – in this chat with Beth Kelsall.
I strongly recommend PSI’s Components of Care training for anyone who is interested in learning about maternal mental health – you don’t have to be a therapist to benefit. For therapists, Karen Kleiman’s trainings are worth their weight in gold. For reading recs, check out my Bookshop.
See: Elinor Cleghorn, Mikki Kendall,
, , , , Dani McClain, Jessica Grose, , , , Alexis Pauline Gumbs, Minna Dubin, Allison Yarrow, and just to name a few. More to read at my Bookshop.Again, there is no emphasis strong enough for how disproportionately this affects women who are Black, queer, disabled, undocumented, poor, or uninsured.
I should clarify that I am in no way faultless – I have been part of the problem. I absolutely cringe thinking about things I said to clients in my greener years and the misinformation I readily regurgitated without checking myself. The ways I dodged difficult, painful conversations. The safety of whiteness, class, and privilege I’ve hid behind. I have made plenty of mistakes and will continue to. Sharing this post is, in some ways, an attempt to repair that.
It's all so much, and you write about it so beautifully. This space and the people in it are so fortunate that you're here 🤍
Ooof. I felt so many things reading this. Memories catapulting back of these messages and then me internalizing them even though “I knew better.” I’m so glad you compiled the list.