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In 2017, Dr. Funda Bachini, a psychiatrist based in Phoenix, Arizona, welcomed her third child. But soon, she noticed something was amiss—crying spells, intrusive thoughts, and sleepless nights left her feeling unrecognizable to herself. “I was crying a lot, and I was anxious,” she recalls. Despite her expertise in treating mental health conditions, Bachini attributed her symptoms to work stress and the demands of parenting three young children. It took her nearly a year to realize she was grappling with postpartum depression (PPD) and postpartum anxiety (PPA)—two underreported and underdiagnosed mental health conditions affecting countless mothers, including physicians.

For mothers in medicine, these conditions may be even more prevalent. A 2022 survey at the American College of Obstetricians and Gynecologists (ACOG) conference revealed that nearly 25% of physician mothers experience PPD—double the rate observed in the general population. The risk of postpartum depression is amplified in a profession that demands unwavering resilience, leaving many physicians to privately battle symptoms they might easily diagnose in their patients but struggle to acknowledge within themselves.

A Hidden Crisis in Medicine

Despite progress in mental health awareness, perinatal mental health, encompassing PPD, PPA, and rarer cases like postpartum psychosis, remains poorly understood. In the U.S., 60% of postpartum depression cases go undiagnosed, and half of those diagnosed do not receive adequate treatment. Among physicians, the barriers to care can be even more daunting, with stigma, fear of professional consequences, and demanding schedules often preventing them from seeking help.

In recent years, tragic incidents have highlighted the acute need for better support systems. In 2023, oncologist Dr. Krystal Cascetta and her infant died in an apparent murder-suicide. A similar fate met Dr. Radhika Lal Snyder and Dr. Gretchen Wenner Butler, both physician mothers who died by suicide within months of childbirth. While most mothers with perinatal mental health conditions do not face such severe outcomes, suicide remains one of the leading causes of maternal death in the United States, underscoring the need for systemic change.

Medicine’s Culture: No Room for “Self”

Many physicians contend that the culture of medicine is inherently incompatible with family life. Medical training involves years of high-stress workloads, sleepless nights, and relentless pressure, conditions under which many doctors also begin building their families.

“There’s no room for self in the culture of medicine; it doesn’t allow for or promote self-health,” notes Dr. Catherine Birndorf, co-founder of The Motherhood Center, a facility focused on perinatal mental health. She explains that while self-care may be encouraged in theory, actual policies for maternity leave and parental support are often inadequate. For instance, an analysis of top U.S. hospitals showed that birthing parents received an average of only eight weeks of paid leave, far below the 18 weeks recommended by the World Health Organization. Additionally, a 2024 Medscape survey found that 33% of female physicians reported no access to paid maternity leave.

Dr. Jessica Vernon, an OB/GYN, recalls the pressure to return to work shortly after childbirth, with implicit expectations communicated by her colleagues. This culture pushes many physician mothers to prematurely return to work or to forgo necessary mental health care.

The Struggle to Self-Diagnose

For many physicians, self-diagnosing mental health conditions can be challenging, as symptoms often diverge from clinical presentations seen in patients. Dr. Vernon, who experienced postpartum obsessive-compulsive disorder (PPA and OCD), initially dismissed her symptoms as typical new mother anxieties. “I couldn’t multitask. I started to feel like a computer whose hard drive was crashing,” she describes. Her initial thoughts were not about her mental health but possible thyroid or autoimmune disorders.

This “high-functioning” presentation of perinatal mental health conditions is common among physicians, says Dr. Pooja Lakshmin, a perinatal psychiatrist. Many healthcare providers continue to work through symptoms, glossing over signs like isolation, chronic exhaustion, or difficulty managing work, which are often indicative of a larger issue.

Systemic Barriers to Seeking Care

The stigma surrounding mental health, coupled with the unique pressures faced by physicians, prevents many from seeking help. “Physicians are up against the idea that they’re supposed to be the caretakers, not the patients,” Dr. Birndorf explains. In some regions, physicians fear that admitting to mental health issues could lead to professional consequences or board investigations, further discouraging them from seeking support.

Moving Forward: Advocating for Change

Experts suggest a multifaceted approach to address the issue. Advocacy for improved maternity leave policies, affordable childcare, and greater accessibility to mental health resources are vital steps. Federal laws like the Pregnant Workers Fairness Act offer some protections, but cultural change within healthcare systems is essential. “We need physicians in leadership to normalize taking leave so that others feel comfortable doing the same,” says Lakshmin.

Increased education on perinatal mental health conditions and expanded training for identifying risk factors could also empower physicians to recognize their own symptoms. Initiatives like the National Curriculum in Reproductive Psychiatry are equipping physicians with skills to discuss mental health during and after pregnancy, aiming to normalize conversations and improve patient care.

Resources such as Postpartum Support International offer directories for specialized providers and support groups, but awareness within the medical community is still lacking. Furthermore, in 2023, the FDA approved zuranolone, the first oral medication specifically for postpartum depression, signaling promising advancements in treatment. Yet, the medical community must stay informed of such options to ensure that providers are aware of all available avenues for help.

A Call to Reshape Medicine’s Approach to Parenthood

The stories of Dr. Bachini, Dr. Vernon, and countless other physician mothers are reminders of the urgent need to reform how medicine approaches mental health and family life. As Dr. Vernon aptly puts it, “Residency trains us to treat ourselves like robots… But with babies, the job is never done.” A shift toward a more supportive, inclusive medical culture is essential to protect not only the well-being of physician mothers but also the lives they work tirelessly to save.

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