Perinatal & Postpartum Psychiatry in Alexandria, VA and Across Virginia, Maryland & DC
Expert psychiatric care for pregnancy, postpartum, pregnancy loss and fertility challenges, from psychiatrists trained in reproductive mental health. Telehealth across the region, with in-person visits in Old Town Alexandria.
This Isn't What I Expected to Feel
Pregnancy and new parenthood are often thought of as happy times. For as many as 1 in 5 women, they also bring anxiety, depression or intrusive thoughts that don't go away on their own. You might be thinking:
"I love my baby, but I feel nothing, or I feel like I'm failing."
"I can't stop worrying that something terrible will happen."
"I have scary thoughts I'd never act on, and I'm afraid to tell anyone."
"I'm exhausted, but I can't sleep even when the baby does."
"I was doing well on my medication. Now I'm pregnant and don't know if I should stop."
"After our loss, everyone expects me to be moving on."
These experiences are common and treatable. They are not a sign that you're a bad parent, and you don't have to wait until things get worse to get help.
What We Help With
We care for women from preconception planning through the first years after birth, including:
Postpartum depression and anxiety, including symptoms that start during pregnancy
Perinatal OCD and intrusive thoughts
Planning medication before and during pregnancy, whether you're starting, continuing or adjusting a medication
Medication decisions while breastfeeding
Bipolar disorder in pregnancy and postpartum, including relapse-prevention planning before delivery
Pregnancy loss, stillbirth and infant loss
Fertility treatment and infertility distress, including IVF
Birth trauma and fear of childbirth
Identity shifts and returning to work after having a baby
How Care Works
1. A free 15-minute call with Jeni, our intake coordinator, to talk through what's going on and match you with the right psychiatrist.
2. A two-visit initial evaluation. Two 50-minute visits give us time to understand your history, your pregnancy or birth, your support system and your goals, not a rushed 20-minute snapshot.
3. A plan built with you. At your second visit, we talk through options together: therapy, medication, or both. When medication is on the table, we walk through the benefits and risks for you and your baby, including the risks of leaving symptoms untreated.
4. Follow-up that fits your life. Telehealth means you can join from home, with your baby in the room if needed.
We work with your whole care team. With your permission, we reach out to your OB/GYN or midwife, primary care doctor and any therapist you already see. We share our evaluation and are available whenever they want to talk, so you don't have to repeat your story or carry messages between providers.
Our Perinatal Psychiatrists
Both of our psychiatrists have specialized training in reproductive psychiatry. Jeni will help you choose based on where you live, availability, and what you need.
Dr. Jacqueline Smyth
Dr. Smyth works with adult women experiencing anxiety, depression, bipolar disorder, OCD, PTSD, and stress, with special expertise in reproductive psychiatry, including pregnancy, postpartum, infertility, PMDD, and perimenopause. Her whole-person, integrative approach looks at sleep, nutrition, movement, and therapeutic support, with medication used as one tool among many.
Licensed in Virginia.
Telehealth only.
Ages18-64.
Psychiatrist
Dr. Emily Rosen
Dr. Rosen works with accomplished, high-functioning women facing anxiety, depression, and burnout, bringing specialized training in reproductive psychiatry when PMDD, pregnancy, postpartum, or perimenopause is part of the story. She combines thoughtful medication management with ACT, IFS-informed, and psychodynamic approaches.
Licensed in Virginia, Maryland, and Washington, DC
Telehealth and limited in person in Alexandria.
Ages 22+.
Founder & PsychiatristFrequently Asked Questions
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Many medications can be used during pregnancy and breastfeeding, and the right choice depends on your history and your symptoms. Untreated depression and anxiety also carry real risks for you and your baby. We go through the evidence with you so you can make an informed decision, not a fearful one.
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Please don't stop on your own. Stopping suddenly can cause withdrawal/discontinuation symptoms or a relapse. Talk with your doctor or schedule an appointment with us, and we'll help you weigh your options.
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Yes. A preconception visit is one of the most helpful things you can do if you take medication or have a history of depression, anxiety, bipolar disorder, or other mental health conditions. We'll make a plan before you're facing decisions under pressure.
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Your OB/GYN manages your pregnancy and physical health. A therapist provides talk therapy. A perinatal psychiatrist is a medical doctor who specializes in diagnosing and treating mental health conditions during pregnancy and postpartum, including medication decisions. We work alongside both.
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There's no cutoff. Many women don't seek help until months after delivery, and that's okay. Symptoms that began after birth are worth treating whenever you're ready.
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Yes. Feeding, rocking or a fussy baby in the background are all welcome.
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We're an out-of-network practice. We provide a superbill after each visit that you can submit to your insurer for possible reimbursement.
Ready to Feel More Like Yourself?
Schedule a free 15-minute call with Jeni. She'll answer your questions, explain fees and help you choose the right psychiatrist. See our fees page for current rates.