More than a Phase: Navigating Women’s Mental Health From Pregnancy to Midlife
Oversubscribed Newsletter
Season: Q3 2026
Summer Rhythms
Article by Amanda McGovern, PhD & Megan Hughes, PhD
More than a Phase: Navigating Women’s Mental Health From Pregnancy to Midlife
There are certain times in a working woman’s life when mental health challenges may be more likely to arise. In this article we’ll discuss the stages of getting pregnant and pregnancy, postpartum conditions, and perimenopause and menopause. We’ll provide information about mental health conditions that can arise during those three stages as well as interventions to help women get back on track. We are covering a lot of ground here, so we’ll provide a quick overview of each stage and then resources for where to learn more. And please note that while we are focusing here on birthing parents, non-birthing parents also are at risk for increased symptoms in the post-partum period.
Since we’ll be talking about depression, please note that there are important resources available for immediate support.
If at any time you are experiencing thoughts about harming yourself or others, it is important to seek out professional support. There are excellent, effective psychotherapy and medication treatments available to help things improve. There are also a range of crisis services that are available immediately:
988 Suicide & Crisis Lifeline: 988
Crisis Text Line: Text TALK to 741741
Resources Database: SpeakingOfSuicide.com/resources
Emergency Services: 911
Maternal Mental Health Hotline: https://mchb.hrsa.gov/programs-impact/national-maternal-mental-health-hotline
Stage: Getting Pregnant & Pregnancy
Many mental health challenges can arise during the process of trying to conceive and carry a pregnancy to term. Trying to get pregnant can be physically and emotionally taxing, especially if a person has experienced infertility, pregnancy loss, or other challenges along the way. Women may experience grief, trauma reactions to medical interventions, depressed mood, and anxiety as they are navigating this process. In addition to the emotional effects that may impact a person’s functioning, there are the logistics to account for as well. Assisted reproduction comes along with doctors visits and monitoring appointments can be time-intensive and difficult to schedule outside of working hours. In all, it is important to prioritize women’s mental health and functioning during the prenatal phase.
Coping Ahead for Managing Mental Health While Trying to Conceive and Pregnancy
The prenatal phase leads to additional vulnerability to mood and anxiety symptoms (Huo et al., 2026). Therefore, all women–and especially those who have a history of anxiety and depression–can create a cope-ahead plan to protect their mental health in this phase of life. For individuals with pre-existing bipolar disorder or psychotic disorders, it will be important to continue to manage treatment under the care of a psychiatrist.
Elements to Consider for a Prenatal Mental Health Cope Ahead Plan:
Mindfulness practice (free with the Oxford Mindfulness App)
Yoga (free videos from the Prenatal Yoga Center)
Low-to-moderate intensive aerobic exercise
Psychotherapy, including:
Interpersonal Psychotherapy Interpersonal psychotherapy (IPT) for PMADS targets four key areas: interpersonal conflict, transition in role, grief and deficit in relationship, and addresses them by using different techniques like clarification, communication, supportive listening, role play and encouragement.
Cognitive Behavioral Therapy Cognitive-behavioral therapy (CBT) focuses on identifying and modifying unhelpful thoughts and behavior patterns.
Mindfulness-Based Stress Reduction MBSR is a science-backed intervention that teaches individuals to engage in a regular mindfulness practice.
Plan ahead for parental leave. Consider the Mindful Return course to help think through your leave and return to work within a supportive community of other new caregivers.
Research your local new parent and baby groups. You can find them on your local community Facebook groups, Meetup.com, local libraries, and local play spaces. Parent and baby groups can be a helpful place to talk with other parents of newborns about the identity changes that come along with parenthood.
Where to Learn More About Prenatal Mental Health:
If you have an hour, listen to this podcast:
On Perinatal Mental Health: Navigating Pregnancy and Postpartum
If you have more time, check out this workbook:
Expecting Mindfully (Dimidjian & Goodman, 2019)
Stage: Pregnancy and Postpartum
Perinatal or postpartum mood and anxiety disorders (PMADS) represent a range of treatable mental health conditions that arise anytime during pregnancy and up to a year after childbirth. They are the most common complications of pregnancy and childbirth, affecting one in every five to seven birthing individuals. PMADS include perinatal or postpartum depression, anxiety, OCD, panic disorder, psychosis, and post-traumatic stress disorder. For more thorough information of the different symptoms of these conditions, refer to About Perinatal Mental Health | Postpartum Support International (PSI).
Coping with PMADS
Cognitive-behavioral psychotherapy (CBT) and interpersonal psychotherapy (IPT) have been shown to be effective, first-line interventions for PMADS. For instance, individuals with postpartum depression may have thoughts related to harming their baby or not being a good mother. As part of CBT, cognitive restructuring techniques will help individuals challenge this thinking and generate a more rational response (e.g., “I am having a scary thought because I want to keep my baby safe”, “I’m learning a new role and I’m doing the best that I can every day”). Furthermore, the behavioral component of CBT will help individuals increase their daily pleasurable activities. In IPT, navigating the interpersonal difficulties of the postpartum period remain the focus of treatment. For instance, IPT may help individuals navigate conflict with partner or extended family (interpersonal disputes), loss of social/work relationships (role transition), and losses associated with the birth (grief).
Medication: Selective Serotonin Reuptake Inhibitors (SSRIs), including sertraline (Zoloft) and escitalopram (Lexapro), are generally considered first-line treatments for perinatal depression and anxiety. Furthermore, Zuranolone (Zurzuvae), a fast acting neurosteroid, is a first-of-its-kind oral pill taken once daily for 14 days to treat postpartum depression, showing improvement in as little as 3 days.
Social support system: Whether joining a mother/baby group or prioritizing interpersonal relationships, one’s social support system is essential during the postpartum period.
Self-care: Ensuring sleep and rest, being active, getting adequate nutrition, practicing self-compassion, and setting boundaries when needed.
Where to Learn More About PMADS:
If you have an hour, check out an episode from one of these podcasts:
If you have more time, check out these workbooks:
The Pregnancy and Postpartum Anxiety Workbook (Wiegartz, Gyoerkoe, & Miller, 2009)
Postpartum depression workbook (Burd, 2020)
Stage: Midlife
Biological Changes in Perimenopause and Menopause
Perimenopause is a transitional stage that happens before menopause and is characterized by fluctuations in hormone levels, primarily estrogen and progesterone. Menopause is officially diagnosed when a woman has not had her menstrual period for 12 consecutive months. Perimenopause and menopause are frequently accompanied by mental health symptoms, including anxiety, depressed mood, restlessness, irritability, tearfulness, mood swings, and feelings of hopelessness.
Midlife Identity Changes and Transitions
Beyond the impact of hormone changes connected with perimenopause and menopause, there are multiple other transitions that can impact women’s identity in mid-life. These include:
Changing relationships
Caring for aging parents and the loss of parents
Preparing children for independence
Empty nest
Changes in adult friendships as your children’s social life is no longer the driver of your social life
Transitions in primary relationship such as navigating empty nest or separation and divorce
Changes in identity related to one’s own aging
Loss of fertility
Appearance changes with aging
Health changes with aging
Career changes
Career advancement vs stalling
Changes in career priorities as the demands of family life decrease
Ageism in the workforce
Seeing this list written out, no wonder this can be a challenging stage of life. And yet, in middle age, women have much more life experience to draw from and examples of pivoting and growth through transition. Here are some strategies to consider when meeting middle age life transitions head on.
Elements to Consider for a Mid-Life Mental Health Cope Ahead Plan:
Menopause Hormone Therapy: Formerly known as hormone replacement therapy (HRT), menopause hormone therapy (MHT) stabilizes hormones, including estrogen, progesterone, and sometimes testosterone, that are dysregulated from perimenopause and menopause. See our book review of The New Perimenopause.
Meaning-making: Although parenting older teens and young adults is certainly not emotionally easier than raising younger kids, it may be less time-consuming. In the case that you find more time on your hands, consider leaning into new activities that provide a sense of meaning and/or well-being. If you don’t have any ideas, check in on areas of life that you neglected during the intensive parenting years.
Taking care of yourself with more exercise, mindfulness, or time outside.
Leaning more into your career now that you have more time for work travel or evening commitments
Volunteering for an organization that you really believe in.
Starting a new (or long-lost) hobby.
Connecting with new friends through shared hobbies and interests.
Reconnecting with old friends.
Where to Learn More About Perimenopause and Menopause:
If you have an hour, listen to this podcast:
If you have two hours, listen to this podcast episode:
If you have more time, check out these books:
Final Thoughts:
Women may face heightened risk for mental health conditions during key life transitions. These include when trying to conceive, pregnancy, postpartum, perimenopause, and menopause, among others. These vulnerable periods are driven by a complex mix of hormonal shifts and other biological changes, identity transitions, and unique life stressors. All women deserve accurate information and access to resources to support their well-being at every stage.
References:
Huo, L., Yu, X., Ma, Y., Yang, L., & Li, X. (2026). Effects of prenatal psychotherapies and psychosocial interventions on depressive symptoms, anxious symptoms and stress: A systematic review and network meta-analysis. Frontiers in Psychiatry, 16, Article 1624924. https://doi.org/10.3389/fpsyt.2025.1624924