Women & Maternal Mental Health Deserves More Than a One-Size-Fits-All Approach
For a long time, women’s mental health has been discussed as though anxiety is simply anxiety, depression is simply depression, and stress affects everyone in more or less the same way. But our emotional wellbeing does not exist separately from our bodies, relationships, identities, responsibilities, hormones, or the social environments we live within.
Women can experience mental health challenges at any stage of life, but there are certain experiences that deserve particular recognition: fertility struggles, infertility treatment, pregnancy, pregnancy loss, traumatic birth experiences, postpartum adjustment, breastfeeding, sleep deprivation, becoming a mother, caregiving, changing relationships, perimenopause, menopause, and the often invisible emotional labour of caring for others.
Recognizing these experiences is not about suggesting that every difficulty a woman experiences is hormonal or biological. In fact, reducing women’s emotions to hormones can be dismissive in its own way. Rather, women-centred mental health care recognizes that biology, psychology, relationships, culture, identity, and social expectations can all intersect at the same time.
The Public Health Agency of Canada, for example, now recognizes perinatal mental health as an important area of care extending through pregnancy, postpartum, and the first year after childbirth. Approximately one in five people experience a perinatal mood, anxiety, or related disorder, which may include depression, anxiety, obsessive-compulsive symptoms, trauma responses, or, more rarely, postpartum psychosis.
Yet mental health during pregnancy and motherhood can still be surprisingly difficult to talk about.
There is often an assumption that pregnancy should be joyful, that becoming a mother should feel instinctive, or that having a healthy baby should somehow cancel out fear, grief, overwhelm, anger, resentment, loneliness, or sadness. When a woman’s actual experience does not match that expectation, shame can quickly enter the picture.
A mother may love her baby deeply and still miss her old life. She may be incredibly grateful for her child and still feel depleted. She may have desperately wanted a pregnancy and still experience anxiety or depression once she becomes pregnant. She may have a medically uncomplicated birth and still experience it as frightening or traumatic.
Two things can be true at once.
Fertility, Infertility and the Emotional Weight of Trying to Conceive
Fertility challenges can affect far more than the hope of becoming pregnant. They can touch identity, sexuality, relationships, finances, body image, friendships, and someone's imagined future.
Appointments, waiting periods, testing, medications, procedures and repeated cycles of hope and disappointment can begin to make life feel organized around fertility. Pregnancy announcements that once brought uncomplicated happiness may suddenly bring grief alongside that happiness. Relationships can become strained when partners process the experience differently. Sex can shift from something intimate to something scheduled, medicalized, or associated with disappointment.
In Canada, Fertility Matters Canada estimates that approximately one in six Canadian adults needs access to fertility care. The organization offers education, support communities, support groups, and a directory of fertility and family-building professionals across Canada.
Therapy cannot remove the uncertainty of fertility treatment, but it can create somewhere to put everything that accompanies it: the grief, anger, jealousy, fear, decisions, relationship changes and exhaustion that can otherwise feel difficult to say out loud.
Pregnancy Loss Is Still a Loss
Miscarriage and pregnancy loss are remarkably common, yet many women describe feeling unprepared for how deeply they grieve.
One of the particular difficulties of pregnancy loss is that other people may not have known the pregnancy existed. There may be no visible reminder of the person or future that was lost, and the surrounding world can move forward remarkably quickly while the woman experiencing the loss feels that something enormous has happened.
Sometimes well-intentioned reassurance such as “you can try again” or “at least you know you can get pregnant” unintentionally skips over the grief that exists now.
Pregnancy loss can bring sadness, anger, guilt, anxiety, fear about future pregnancies and changes within a relationship. Fertility Matters Canada similarly recognizes recurrent miscarriage as an experience that can have a significant emotional and relational impact and encourages people to seek support when needed.
Therapy after pregnancy loss does not require someone to “move on.” Often, it means having somewhere that the significance of the experience is allowed to exist.
Pregnancy, Birth and the Postpartum Period Can Change Your Entire Inner World
Pregnancy and postpartum involve extraordinary physical changes, but there can also be enormous psychological ones.
Sleep changes. Relationships change. Bodies change. Sexuality can change. Independence changes. Family relationships can suddenly become more complicated. Old experiences from childhood can resurface as someone begins thinking about the kind of parent they want to become.
For some women, birth itself can be traumatic. A medically necessary intervention can still feel frightening. Feeling ignored, powerless, exposed, rushed, separated from a baby, or afraid that either mother or baby might die can leave a lasting emotional imprint even when everyone ultimately leaves the hospital physically healthy.
And then comes postpartum.
The cultural image of early motherhood frequently centres snuggles, tiny clothes and a glowing new parent. The reality may also involve feeding difficulties, physical recovery, pain, isolation, intrusive thoughts, identity changes, relationship tension and profound sleep deprivation.
The Canadian government now explicitly recognizes that perinatal mental health conditions are treatable and that treatment can include psychotherapy, peer support, medication, sleep interventions and other individualized supports. Canada also released its first national clinical practice guideline addressing perinatal mood, anxiety and related disorders in 2025.
For women looking for additional information, CAMH's perinatal mental health resources also provide education and links to pregnancy and postpartum supports.
Motherhood Can Be Beautiful and Still Be Exhausting
Not every struggling mother meets criteria for postpartum depression or anxiety.
Sometimes what a woman is experiencing is the cumulative weight of caregiving.
The planning. Remembering. Feeding. Packing. Scheduling. Anticipating. Cleaning. Night waking. Medical appointments. School forms. Emotional regulation. Household management. Work responsibilities. Maintaining friendships. Maintaining a relationship. Trying somehow to care for herself within whatever remains.
That emotional and cognitive workload can become maternal burnout.
Many women eventually arrive in therapy saying something similar to: I don't even know who I am anymore.
That sentence matters.
Motherhood changes identity, but becoming a mother does not require someone to disappear entirely inside the role.
Therapy can become a place to explore questions that may otherwise feel selfish to ask: What do I need? What happened to the person I was before becoming a mother? What parts of myself do I want back? Where are my boundaries? Why do I feel responsible for everyone? Why am I so angry lately? Why does asking for help make me feel guilty?
These aren't signs of being a bad mother. They are meaningful questions about identity, relationships and emotional wellbeing.
Perimenopause and Menopause Are Mental Health Conversations Too
Women’s mental health does not stop being relevant once the reproductive years begin to change.
Perimenopause and menopause can involve shifts in sleep, mood, anxiety, concentration, confidence, irritability, energy and emotional regulation alongside physical symptoms.
Unfortunately, women are not always prepared for that connection.
The Menopause Foundation of Canada reports that 46% of women surveyed felt unprepared for perimenopause and menopause, while 95% reported experiencing symptoms. Mood-related symptoms can include anxiety, depression, low mood, irritability, changes in confidence, low motivation, crying spells and panic symptoms.
For some women, this stage also arrives at an already demanding point in life. They may simultaneously be caring for children, supporting aging parents, managing careers, navigating relationship changes and beginning to notice changes in their own bodies.
When anxiety suddenly increases at 43, sleep changes at 46, or someone who previously felt emotionally steady begins saying, “I just don't feel like myself anymore,” it deserves curiosity rather than dismissal.
The Menopause Foundation of Canada offers evidence-based education along with a useful menopause symptom tracker and care resources that women can bring into conversations with their health-care providers.
Women Are More Than Their Hormones
At the same time, women's mental health cannot be understood through reproductive health alone.
Women live within families, workplaces, relationships, cultures and communities that shape emotional wellbeing.
The Public Health Agency of Canada's work on mental health inequalities recognizes that mental health in Canada is influenced by interconnected factors including sex, gender, sexual orientation, race, income, employment, discrimination, social connection, access to care and experiences of violence.
A woman may be navigating motherhood while also being an immigrant building a life in a new country. She may be caring for children while experiencing relationship distress. She may be queer and navigating systems that do not always reflect her family. She may carry experiences of trauma alongside fertility treatment. She may be supporting everyone around her while privately struggling with depression.
Good therapy makes room for the whole person.
You Don't Have to Wait Until Things Become Unmanageable
Health Canada’s national perinatal guidance was published in 2025, CAMH currently describes perinatal mood and anxiety disorders as affecting roughly 10–20% of pregnant women and new mothers, Fertility Matters Canada reports that 1 in 6 Canadian adults are affected by infertility, and the Menopause Foundation of Canada provides Canadian-specific data on menopause experiences.
There is a persistent idea that therapy is something we seek only once something has gone terribly wrong.
It doesn't have to be.
You can seek therapy because you're overwhelmed.
Because you're grieving.
Because pregnancy after infertility feels terrifying instead of exciting.
Because you don't recognize yourself postpartum.
Because you love your children and simultaneously feel completely depleted by motherhood.
Because your relationship has changed since becoming parents.
Because you're entering perimenopause and wondering why everything suddenly feels harder.
Or simply because you need one place in your week where nobody needs anything from you.
At Tender Roots Therapy & Wellness, we support women through the emotional, relational, identity and hormonal changes that can occur throughout different stages of life. Our therapists work with women navigating fertility and infertility, pregnancy, pregnancy loss, perinatal mental health, postpartum depression and anxiety, birth trauma, motherhood, maternal burnout, relationship changes, perimenopause, menopause and the many experiences that exist alongside them. We offer in-person therapy in Halifax and virtual counselling throughout Nova Scotia.
You don't need to know exactly what is wrong before reaching out. Sometimes therapy begins simply with the feeling that something has changed, something feels heavy, and you don't want to carry it alone anymore.
If that sounds familiar, you can book a free 15-minute consultation with Tender Roots and we can help connect you with a therapist who feels like the right fit.
References & Canadian Resources
Canadian Centre on Substance Use and Addiction / Centre for Addiction and Mental Health (CAMH). Perinatal Mood and Anxiety Disorders. CAMH notes that perinatal mood and anxiety disorders can arise during pregnancy or within the first year postpartum and affect approximately 10–20% of pregnant women and new mothers.
Learn more from CAMH
Fertility Matters Canada. Fertility 101: Fertility Fundamentals. Fertility Matters Canada reports that approximately 1 in 6 Canadian adults will be affected by infertility during their lifetime and provides education, advocacy, support programs, and information about fertility and family building across Canada.
Visit Fertility Matters Canada
Government of Canada. Mental Health During and After Pregnancy. Public Health Agency of Canada information on perinatal mood, anxiety, and related disorders, available treatment options, and Canadian guidance for mental health during pregnancy and the postpartum period.
Read the Government of Canada resource
Health Canada. Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety and Related Disorders. Canada’s national clinical practice guidance addresses the identification and treatment of depression, anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and other mental health conditions occurring during pregnancy and postpartum.
Learn about the Canadian clinical guideline
Menopause Foundation of Canada. The Silence and the Stigma: Menopause in Canada. National Canadian research examining experiences of perimenopause and menopause, including mood, anxiety, sleep, cognition, workplace impact, stigma, and access to information. The foundation reports that 46% of women surveyed felt unprepared for menopause and 95% experienced menopausal symptoms.
Read the Menopause in Canada research
Menopause Foundation of Canada. Menopause Essentials. Evidence-informed Canadian education about the physical, cognitive, sexual, and psychological symptoms that may occur during perimenopause and menopause, along with information to help women advocate for appropriate care.
Explore Menopause Essentials
Additional Support
For women and families looking for further information and support, Fertility Matters Canada provides fertility and family-building resources across Canada, while the Menopause Foundation of Canada provides Canadian education and advocacy related to perimenopause and menopause. The Centre for Addiction and Mental Health also offers extensive information on perinatal mental health.
For individualized mental health support in Nova Scotia, Tender Roots Therapy & Wellness offers compassionate counselling for women navigating fertility and infertility, pregnancy, pregnancy loss, perinatal and postpartum mental health, birth trauma, motherhood, maternal burnout, relationship changes, perimenopause, menopause, and other significant life transitions.
If you are wondering whether therapy might be helpful, you can book a free 15-minute consultation with Tender Roots Therapy & Wellness to connect with a therapist and talk about what support could look like for you.
