When Kira S. discovered she was pregnant in 2012, she was optimistic at first. Kira, now 43, had great insurance coverage, a committed partner, and a long, trusting relationship with her ob/gyn. But there were difficulties, too, that weighed on her mental health. There was her previous miscarriage, which left her fearful. There was her high blood pressure, which developed into preeclampsia. There was her placental abruption, a rare condition where part of the placenta separates from the abdominal wall, which led to bed rest. And there was a sinking feeling in her gut as she realized her partner wasn’t who she thought he was, so she needed to leave.
Still, Kira was fortunate in that she had a level of prenatal care that often isn’t reserved for black women. Her ob/gyn, also a black woman, was “invested,” Kira tells SELF. “My ob/gyn sent me to a million other doctors” like a pregnancy cardiologist for a better chance at comprehensive care, Kira says. Even with the attention and care she received, Kira, like far too many other black women, went into preterm labor.
As SELF continues to explore black maternal mortality—black women are three to four times more likely to die from pregnancy-related complications, according to the Centers for Disease Control and Prevention (CDC)—it is important that we look at the structures in place to support maternal mental health. Of course, general therapy can be helpful when people have the financial and logistical resources they need to make it work. But when it comes to the intersection of parenthood and mental health, reproductive psychiatry and psychology are especially vital to this conversation. They both aim to focus on the mental wellbeing of pregnant and postpartum people, along with anyone dealing with reproductive issues like infertility.
There aren’t currently industry-wide training requirements that outline exactly what a doctor or mental health expert needs to do in order to describe themselves as a reproductive psychiatrist or psychologist. The field is still pretty young and only really began to gain momentum in the mid-90s as more people became aware that hormonal fluctuations could increase the chances of psychiatric disorders from before a person’s first period through menopause and beyond, according to a 2015 paper in the American Journal of Psychiatry.
As a baseline, a reproductive psychiatrist does need to have an M.D. or D.O. degree, as does any other type of psychiatrist. Reproductive psychiatrists may have gotten their expertise through specialty training during their residencies (like in women’s mental health, which usually encompasses reproductive health), post-residency fellowship programs, “on the job” training, research, or a mix of these avenues, per a 2017 Academy Psychiatry paper. (The paper identified 12 women’s mental health fellowships nationwide.) But since reproductive psychiatry isn’t recognized as a subspecialty by the American Board of Psychiatry and Neurology, as a 2017 paper in Archives of Women’s Mental Health explains, no standardized curricula exist across training programs.
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