Redefining Service in Healthcare
When we talk about service in healthcare, we often think about access, affordability, or follow-through. And those things matter. But to me, being of service starts somewhere more foundational: with listening. Deeply listening.
For mothers, especially those in the perinatal period, being truly heard can feel radical. Many come to our initial appointment feeling dismissed, labeled, or overlooked by systems that moved too fast to ask the right questions. Sometimes the deepest need isn’t for a new medication or referral, but for someone to pause, and ask “Tell me about your story. About your journey to motherhood.”
Because psychiatric care that actually serves moms doesn’t start with a checklist. It starts with connection.
Mental Health Care That Honors the Story, Not Just the Symptoms
What looks like anxiety might actually be vigilance—an alert, primal scanning for threats to a tiny life they grew inside their body for 40 weeks. It might be hesitance—not about love, but about stepping into connection with a brand-new human who feels at once familiar and entirely unknown.
What appears as anger could be grief for the birth she imagined but didn’t get to have. Beneath the rage, there might be years of quiet self-abandonment—people-pleasing, accommodating, pushing down needs—that now erupt under the weight of postpartum demands. There’s a friction between who she has always been and who she is becoming—a mother practicing boundaries in a new way, not just for herself but to fiercely protect what is hers.
The Complexity of Joy
Joy, too, is layered. It may show up as awe—an enchantment with this tiny being, with her own capacity to endure, nurture, soften, and rest. She may feel proud—of her resilience, of her body, of surviving what felt unsurvivable. And maybe, in rare and sacred moments, she feels validated. Not for what she accomplishes like she has worked for in the past, but for simply being. In those moments, she is centered. Empowered. Capable.
Even something as simple as “I don’t feel like myself” or “Today was a good day” deserves more than a checkbox—it deserves curiosity. Because beneath every feeling is a story, and mothers deserve space for their full humanity to be seen, heard, and honored.
The Clinical Necessity of Time and Space
When I meet with patients, our longer appointment times aren’t just a luxury—they’re a clinical necessity. They create room for what’s not on the intake form:
- their feelings about the changing nature of their relationship with their partner
- the intrusive thoughts no one wants to admit out loud
- the unprocessed trauma that’s resurfacing in the early hours of new motherhood
- The moments when they watch their child experience challenges at the same age they recall experiencing something similar.
When we take the time to hear the full context, our treatment plans become not just more accurate—but more human.
Walking Alongside: A Personal Reflection
Everything I’ve shared here comes from years of listening—really listening—to mothers: my patients, my colleagues, my friends and family, and stories from other women that sit on my bookshelves. Their stories, their fears, their quiet joys, and their unspoken griefs have shaped the way I practice and the way I understand motherhood.
I’m currently pregnant with my first child. And while I bring to this moment the lens of a psychiatric provider, therapist, and lactation counselor, I also know: I may know the theory, but motherhood is something you live. No one is exempt from the vulnerability of becoming.
Since sharing my pregnancy with patients, I’ve often heard, “Oh, you’ve got this—you know all of this already. You’re [fill in the blank with the degrees or roles listed in my email signature]” And my answer has remained the same: “No one lives through motherhood without being transformed–and deeply humbled.”
So I offer these reflections not as someone speaking from the other side, but as someone walking alongside—bringing my own layered story of femininity, fertility and conception, loss, and hope. I carry the education, yes—but more importantly, I carry the willingness to keep becoming.
Psychodynamic Roots: Hearing the Unspoken
My background as a therapist shapes everything about how I practice psychiatry. I was trained to listen not just to the words, but to what’s beneath them. A flat affect might hide exhaustion, or grief, or protective detachment. A quick “I’m fine” often signals someone who has learned that their needs won’t be met, so why even name them?
When a mother says, “I’m just overwhelmed,” I hear that. But I also ask: What kind of overwhelm? Is it the kind that comes from lack of sleep and decision fatigue—or the kind that comes from feeling invisible in her own life?
This is the work of listening deeply: tracking not just symptoms, but meaning. Holding space for the mother’s inner world—not just her role, her function, or her diagnosis.
In doing so, we help her reconnect with the parts of herself that may feel buried under the weight of motherhood.
Honoring the Full Emotional Landscape of Motherhood
One of the greatest disservices in maternal mental health is the pressure to keep things tidy. The smiling baby photos, the “you’re so lucky,” the subtle messaging that any deviation from joy is a personal failing.
But motherhood is vast and contradictory. It holds love and fear, joy and grief, hope and rage…sometimes all before breakfast.
At Praxis Mental Health, I work to create a space where mothers can speak their full truth. Where they can say, “I love my baby, but I miss my old life,” or “I kind of like being back at work; does that make me a ‘bad mom’ ?” and not be judged. Where they can cry over a traumatic birth, or feel disconnected from their partner, or admit that breastfeeding makes them feel trapped. Where they don’t have to rush to fix it or make it sound okay.
Because emotional honesty is not pathology. It’s humanity.
When we honor the full range of emotion—without minimizing or overpathologizing—we invite real healing. We remind mothers they are allowed to be whole.
Listening as a Radical Act of Service
Listening sounds simple. But in a system that rewards speed and output, deep listening is a radical act.
It means slowing down in a culture of urgency. It means presence in a field often shaped by productivity. It means being willing to hear the messy, nonlinear, emotional truth—without rushing to clean it up.
And it changes everything.
When a patient feels heard, she opens up. She shares the real story. She’s more likely to engage with the treatment plan we create together. She’s more likely to believe in her own capacity to heal. The medication may be the same, but the outcome is different—because the relationship is different.
Rooted in Service: A Model That Honors, Not Silences
If we want to serve mothers, we must listen to them.
We must build systems that allow for nuance, complexity, and emotional truth. We must create spaces where mothers are not treated as vessels or patients to be managed, but as full human beings in a sacred and often overwhelming transition.
This is what being of service looks like in maternal mental health. Not just offering treatment, but offering ourselves—our time, our attention, our presence.
And it starts with listening first.
