Therapy for Black Girls – Session 450: Reproductive Psychiatry
Date: February 11, 2026
Host: Dr. Joy Harden Bradford
Guest: Dr. Mimi Sanders, Board-Certified Psychiatrist (Reproductive Psychiatry)
Episode Overview
This session explores the specialized field of reproductive psychiatry, focusing on the unique mental health needs of women across the reproductive lifespan—menstruation, fertility, pregnancy, postpartum, pregnancy loss, and menopause. Dr. Joy Harden Bradford and Dr. Mimi Sanders discuss common challenges, the importance of culturally responsive care for Black women, medication management in reproductive transitions, and how to advocate for yourself with healthcare professionals.
Key Discussion Points & Insights
Dr. Mimi Sanders’s Journey to Psychiatry
- Initially interested in pharmacy, Dr. Sanders shifted to medicine after exposure to osteopathic medicine and primary care.
- A pivotal moment during her psychiatry rotation, observing racial disparities in mental health care, motivated her to represent and support the Black community.
“I really want to be a representative of that Black community as a psychiatrist. We necessarily don't have to see someone in crisis... We can have that representative as an outpatient and really work on what is proactive in my own mental health.” (09:05)
The Birth of Her Practice: Inter Community Health
- Dr. Sanders started her practice during COVID-19, responding to an overwhelming need among women juggling remote work, family, and self-care.
- Her own experiences with pregnancy loss, work transitions, and searching for culturally aware support informed the welcoming, empowering environment she wanted to create.
What Is Reproductive Psychiatry? [13:30]
- This specialty follows women throughout their reproductive lives, addressing mental health needs related to:
- Menstruation
- Infertility and pregnancy loss
- Pregnancy and postpartum transitions
- Menopause
- Focuses on how hormonal changes and life transitions impact emotional well-being.
When Do Women Seek Out Reproductive Psychiatry? [14:45]
- Many women don’t realize reproductive psychiatry exists.
- Education and awareness are crucial—helping women understand symptoms like brain fog or anxiety can be related to hormonal transitions like perimenopause.
- Resources include therapy, medication management, and support groups.
Mental Health and Reproductive Health Diagnoses [15:39]
- PCOS, endometriosis, and other ovarian disorders impact self-esteem, introduce guilt, shame, and anxiety—especially around family planning.
“That uncertainty of me wanting to have a child... what are these medications that my OB-GYN has put me on—can cause mood swings. We see you, we understand what you may be going through, there’s resources here.” (16:52)
Medication and Fertility Journeys [17:37]
- Clients are often apprehensive about medications interfering with fertility or pregnancy.
- Dr. Sanders individualizes recommendations, working closely with OB-GYNs to balance medications and manage risk.
“It’s a team effort… at the center of the team, it’s you as the client and the patient.” (19:37)
Medications and Breastfeeding [20:09]
- SSRIs, like sertraline, are commonly used and considered safe during lactation.
- Regular monitoring and open communication are essential.
“There’s research saying that, hey, staying on this medication is good for you and the baby, especially if you have experienced depression in the past prior to pregnancy.” (21:36)
Stigma, Shame, and Womanhood [25:20]
- Dr. Sanders helps clients challenge beliefs tying womanhood to fertility and motherhood.
- Seeking medication or therapy is not a sign of weakness.
“You take a medication does not mean that you are weak… It just means that, hey, this is the right treatment option for me in this season.” (26:19)
Postpartum: Beyond Depression [27:39]
- Postpartum anxiety and separation anxiety are common and under-discussed.
- Challenges include preparing to return to work, safety concerns, and feeling responsible for all aspects of a child’s well-being.
- Strategies include developing postpartum plans and checking whether anxiety interferes with self-care and daily functioning.
Technology and Parental Anxiety [32:57]
- Baby monitors and smart devices can sometimes increase anxiety instead of alleviating it.
“We have to make sure that we are not exacerbating our anxiety with all these developments in technology…” (33:17)
Supporting New Mothers [34:33]
- Importance of developing a postpartum plan with family and partners before birth.
- Partners can help monitor for signs of anxiety and depression.
- Support must balance encouragement with recognition when to escalate care.
Resources for Partners [37:39]
- Postpartum Support International offers directories and support groups, including options for partners.
Perimenopause and Menopause [41:58]
- Common symptoms: mood swings, irritability, hot flashes, insomnia, brain fog, low libido.
- All mood and cognitive changes are treated similarly, regardless of cause—individualized plans may involve hormone replacement therapy or psychiatric medications.
“It’s biological, it’s psychological, it’s got social aspects. So it’s like a biopsychosocial treatment plan.” (45:04)
Navigating Mental Health in Midlife [45:55]
- Women should seek support, even if they haven’t needed it before. Life transitions and changing resilience are natural.
“We have never been this particular age before. Really giving yourself that grace… I may not have needed that help when I was 30. However, I have gone through a lot of things between 30 and 45.” (46:36)
Advocating for Yourself with Medical Professionals [47:27]
- Don’t be afraid to voice your needs or preferences with OB-GYNs—role-playing difficult conversations in advance can help.
“You can really advocate for yourself… Tell me more about my birth control options… advocating and showing up for yourself and having that voice.” (48:12)
Mindfulness and Self-Care [49:34]
- Mindful eating, breathwork, and slowing down are valuable tools, especially for high-achieving women.
“We are, perhaps at an age now where we have poured out enough and let’s sit back… and let’s allow others to pour into us.” (51:00)
Notable Quotes & Memorable Moments
-
On representation in psychiatry:
“I really want to be a representative of that Black community as a psychiatrist.” — Dr. Mimi Sanders (09:05)
-
On building a safe space:
“I wanted to create a space that I know that I would want to go to, that I would feel comfortable.” — Dr. Mimi Sanders (12:55)
-
On team-based care:
“At the center of the team, it’s you as the client and the patient.” — Dr. Mimi Sanders (19:37)
-
On postpartum anxiety:
“I see more postpartum anxiety in my clinic… That separation anxiety that the new mom has with her baby.” — Dr. Mimi Sanders (27:55)
-
On advocating for reproductive choices:
“No, you can really advocate for yourself and just say, ‘Hey, please tell me more about my birth control options.’” — Dr. Mimi Sanders (48:09)
-
On mindful wellness:
“Slowing down your movement, slowing down your mind, so you really can practice being in that present moment.” — Dr. Mimi Sanders (50:07)
Timestamps of Key Segments
- 05:21 — Dr. Sanders discusses her journey and career pivots
- 13:36 — What is reproductive psychiatry?
- 15:57 — Mental health challenges with PCOS and reproductive diagnoses
- 17:37 — Medication and fertility/infertility management
- 20:09 — Medication use during breastfeeding and postpartum
- 25:20 — Addressing stigma and redefining womanhood
- 27:39 — Under-recognized postpartum experiences, especially anxiety
- 32:57 — Technology and its impact on parental anxiety
- 34:33 — Partners’ roles and support plans in the postpartum period
- 37:39 — Resources for partners (Postpartum Support International)
- 41:58 — Perimenopause/menopause: mental health symptoms and treatment
- 45:55 — Self-advocacy and seeking help in midlife transitions
- 47:27 — Tips for advocating with healthcare providers
- 49:40 — Mindfulness interventions and self-nurturing
Resources Mentioned
- Dr. Mimi Sanders’ Practice:
- Inner Community Health (intercommunityhealth.com)
- Instagram: @drmimicare
- Postpartum Support International:
- Support groups for women and partners, provider directories
This episode is a comprehensive primer on reproductive psychiatry, centering the emotional and cultural nuances Black women face. It’s packed with relatable stories, practical advice for navigating medical systems, and empowering guidance to seek support across all reproductive milestones.