Reproductive Mental Health: The Weight Women Carry, and Why AOC Is Talking About It

Picture a woman in a television studio dressing room. Her makeup is done. In a few minutes she will walk out and talk about elections and foreign policy on live TV. But first she opens a lunchbox, lays out a row of syringes, and injects herself with fertility hormones.

That woman is Rep. Alexandria Ocasio-Cortez. Last weekend, she chose to show the whole thing to the world. She is freezing her eggs, and she is doing it out loud.

If any part of that image made your chest tighten, you already understand something the headlines are only starting to catch up to. Reproductive mental health is not a side topic. The reproductive journey is a mental health journey as much as a physical one. We know this because we sit inside it with women in the therapy room every single week.

At a Glance

• What this covers: Why the reproductive journey (fertility, miscarriage, birth, postpartum, and the decision itself) is one of the most under-supported mental health experiences in a woman's life, and what actually helps.

• Who it's for: Any woman carrying grief, anxiety, or trauma tied to fertility, pregnancy loss, birth, or new motherhood, and questioning whether her pain is "big enough" to deserve support.

• Read time: About 9 minutes

• Key takeaway: The pain you feel is real, it is common, and it is shaped by a system that was not built for you. Feminist, trauma-informed therapy can help you put down the shame and find your footing again.

Why AOC Doing This in Public Is a Big Deal

Most public figures keep this kind of thing private. Ocasio-Cortez decided not to. She said she had weighed the decision for a long time and saved for it, and that there simply is not enough honest information out there for women who are considering it.

Her words were direct. She described it as "a choice that I am making to feel more in control of my life," and added, "I feel empowered by this decision." She talked openly about the part that stressed her out the most, which was the money.

Here is what she shared about the cost. She is paying roughly eight to nine thousand dollars out of pocket for this round. Her medication alone runs about thirty-five hundred. Storage will cost her around twelve hundred dollars a year, every year, for as long as her eggs stay frozen. And in her own words, "My insurance does not cover one penny of this."

Then she named the part that so many women feel and rarely say. "This is just not something that men deal with," she said. Men run for office and interview for jobs, and no one sits in the back of their mind wondering how old he is or whether he wants to start a family.

That is the whole point. When a woman with a national platform injects herself on camera and tells you exactly what it costs, she is not oversharing. She is using her power to pull a private, expensive, exhausting experience into the light so the rest of us do not have to carry it in secret. That is feminist advocacy in action, and it matters.

The Reproductive Journey Is a Mental Health Journey

We treat women every day who are somewhere on this path. Some are trying to decide whether to become mothers at all. Some are desperate to conceive and cannot. Some are raising babies they love while quietly falling apart. The reproductive journey is not one experience. It is a dozen different heartbreaks and hopes, and almost none of them get the support they deserve.

The Grief No One Lets You Name

Miscarriage is common. It affects somewhere between 15 and 25 percent of recognized pregnancies. And yet women are often left to grieve it completely alone.

There is a name for this in the research. It is called disenfranchised grief, a term coined by grief expert Kenneth Doka. It describes a loss that is not openly acknowledged, publicly mourned, or socially supported. Miscarriage fits it exactly, because the loss so often happens before anyone else even knew about the pregnancy.

The grief is not small. One review found that complicated grief after perinatal loss can run nearly three times higher than after other kinds of loss. Nearly a third of women show signs of post-traumatic stress a month after a miscarriage.

Think about what that looks like in real life. A woman miscarries at home, in her own bathroom, often with her body doing the very thing she prayed it would not do. There is no bereavement leave. There is no funeral. There is no casserole on the doorstep. She is expected to show up to work on Monday as if her whole world did not just quietly end. So the grief goes underground, and it stays there.

When Birth Itself Is the Trauma

For the women who do carry a pregnancy to term, the finish line is not always relief. Many arrive in therapy carrying a birth they never got to process.

Birth trauma is real and it is measurable. Postpartum PTSD affects 3 to 4 percent of all women after birth, and jumps to 15 to 19 percent for women who had complications or a preterm birth. Postpartum depression is even more common. The CDC has found that nearly 1 in 8 women experience symptoms of it after a live birth.

Here is the part that should make us angry. Unlike depression, postpartum PTSD is still not routinely screened for in most maternity care. So a woman can go through a terrifying birth, be dismissed when she says her pain is not normal, and then be sent home to recover with no one checking whether she is okay.

And "recover" is a generous word. She is healing from one of the most intense physical events a human body can survive, on almost no sleep, often with no real support, and frequently back at work before her body has even mended. When there is no money and no leave, that pressure lands right on her mental health.

Becoming a Mother Before You Were Ready

There is another version of this we see often, and it starts much earlier. Many of the women who come to us became mothers long before they were ready, and not because they made a reckless choice.

They were never taught how their bodies work. They were never taught that they were allowed to say no, or what a respectful relationship should feel like. Without that education, an early pregnancy is not empowerment. It can be the beginning of a much harder road.

Becoming a parent before you know yourself is its own kind of grief. It can tie a woman for life to a partner who is not good for her. It can end an education before it starts and lock a whole family into poverty, because a woman who never got the chance to build a career has fewer ways out. That is not a personal failing. That is a predictable outcome of a system that refused to prepare her.

When the System Itself Is the Problem

Notice the thread running through all of this. The pain is not just biological. It is built.

Go back to what Ocasio-Cortez said about cost. Freezing your eggs, one of the few medical tools a woman has to protect her ability to choose when she becomes a mother, is almost never covered by insurance. It is thousands of dollars, out of pocket, on your own.

Now ask an honest question. If men had to pay out of pocket to protect their own reproductive timeline, would it be covered? Of course it would. This is the same logic as the "pink tax," and it is a close cousin of what sociologists call the patriarchal dividend. Men's health and reproduction are treated as standard care. Women's are treated as an optional luxury they can fund themselves.

The gaps do not stop there. There is no bereavement leave for a miscarriage. There is no routine mental health screening after a traumatic birth. And over the past few years, reproductive rights have been actively rolled back, so the small amount of ground women had gained keeps slipping away.

This is why inaccessibility is itself a mental health issue. When a woman cannot afford the procedure that would give her more control over her own life, that is not a neutral inconvenience. It produces grief. It produces a quiet, corrosive shame, a sense that her options were taken and she was supposed to be fine about it. Shrinking a woman's choices always has a psychological cost, and we see that cost every day.

What Actually Helps: Therapy for Reproductive Grief and Trauma

Here is the good news, and it is real. This pain is treatable. You do not have to white-knuckle your way through it, and you do not have to do it alone.

Grief-focused therapy is usually the most direct fit for reproductive loss. It is built to address exactly what makes this grief so hard, the invisibility, the way others minimize it, the absence of shared memories, and the loss of a future you had already begun to picture. It gives the loss a name and a place, which is something the outside world almost never does.

For the trauma and PTSD pieces, CBT and EMDR are both well-established, evidence-based options. In fact, leading clinical guidelines recommend CBT or EMDR for trauma symptoms after a loss. Approaches like mindfulness, ACT, and somatic (body-based) work can help too, especially when the trauma lives in your body and not just your thoughts. At Her Time Therapy, our clinicians are trained in trauma-informed and EMDR-based care for exactly this reason.

But the piece that changes everything for so many women is feminist counseling. A feminist therapist does something a symptom checklist never will. She helps you see the power dynamics at play. She helps you understand that your body did not betray you, and that the crushing weight you feel was not designed by you or for you.

This matters more than it sounds. So many women in this season are trapped in a shame spiral, convinced that their body let them down, that they waited too long, that they should have wanted it more or wanted it less. Feminist counseling gently interrupts that story. It moves the blame off your shoulders and onto the system where it belongs. And from that steadier place, it helps you find the control and agency that are still yours, wherever they can be found.

That work can happen in more than one room:

• Individual therapy gives you a private space to name what you have been carrying, sometimes for the first time out loud.

• Couples therapy creates room to be understood by a partner who loves you but does not fully get it. This is especially powerful when a woman is grieving next to a male partner who processes it differently, or barely seems to process it at all. A good couples session can turn a lonely grief into a shared one.

• Group therapy puts you in a room with other women who are standing exactly where you are standing. Research shows that connecting with others who have lived the same loss is one of the most powerful ways to break isolation and rebuild a sense of empowerment. You stop being the only one. That alone can be a turning point.

However you do it, the goal is the same. You put down the weight you were never meant to carry alone. You name the grief and, yes, the rage. You understand the bigger picture so it stops feeling like a personal failure. And from there, you get to move from silence toward voice, whether that means speaking openly about your own journey or walking into a voting booth with a clearer sense of what you deserve.

Frequently Asked Questions

Is struggling with fertility a mental health issue?

Yes. The emotional toll of fertility struggles, pregnancy loss, and reproductive decision-making is well documented and can include depression, anxiety, and post-traumatic stress. Research shows that complicated grief after perinatal loss can run nearly three times higher than after other kinds of loss. At Her Time Therapy, our Colorado-based clinicians treat fertility-related distress as the real and significant mental health concern that it is, using grief-focused and trauma-informed approaches rather than telling women to simply stay positive.

What is disenfranchised grief after a miscarriage?

Disenfranchised grief, a term coined by grief expert Kenneth Doka, is grief that is not openly acknowledged, publicly mourned, or socially supported. Miscarriage is a classic example, because the loss often happens before anyone else knew about the pregnancy, so there is no funeral, no bereavement leave, and often no recognition at all. This lack of acknowledgment is part of why miscarriage grief can become so heavy and so stuck. Therapy at Her Time Therapy gives that loss a place to be named, honored, and grieved out loud, which is something the outside world rarely offers.

Can therapy help with birth trauma or postpartum depression?

Yes, and it works. Postpartum depression affects nearly 1 in 8 women, and postpartum PTSD affects 3 to 4 percent of all women after birth, yet PTSD is still not routinely screened for in maternity care. Evidence-based treatments like CBT and EMDR are effective for processing traumatic births and reducing symptoms of postpartum depression and anxiety. The feminist, trauma-informed therapists at Her Time Therapy specialize in supporting women through perinatal and postpartum challenges, all through convenient online sessions across Colorado.

Does insurance cover egg freezing, and why does that matter for mental health?

In most cases, no. As Rep. Ocasio-Cortez shared, egg freezing is frequently paid for entirely out of pocket, often eight to nine thousand dollars or more per cycle, plus yearly storage costs, with insurance covering nothing. This matters for mental health because when a woman cannot access the tools that would give her more control over her reproductive future, it produces real grief, shame, and a sense of lost choice. At Her Time Therapy, we treat that experience of blocked access as a legitimate source of distress, not something a woman should simply accept quietly.

How do I find a therapist for fertility or reproductive grief in Colorado?

Look for a therapist who names perinatal, fertility, or reproductive mental health as a specific area of focus, and who practices from a trauma-informed and, ideally, feminist perspective. Her Time Therapy is a group practice of licensed therapists offering online therapy for women across Colorado, with clinicians who specialize in fertility challenges, pregnancy loss, birth trauma, and postpartum support. You can schedule a free consultation and be matched with the therapist whose focus fits your situation, so you are not left guessing on your own.

Related Reading from Her Time Therapy

• Grief and Loss Counseling — For the grief that follows miscarriage, infertility, and pregnancy loss, and the space to finally name it.

• Women's Empowerment and Feminist Counseling — Learn how a feminist approach helps lift self-blame and restore your sense of agency.

• Online Group Counseling for Women — Because sometimes healing starts the moment you realize you are not the only one.

You Do Not Have to Carry This Alone

If you are somewhere on this journey, trying to conceive, grieving a loss, recovering from a birth that frightened you, or simply weighing what you want your future to look like, please know that your pain is real and it deserves support. You are not too much, and it is not too small.

At Her Time Therapy, we specialize in the reproductive mental health of women, including fertility grief, miscarriage, birth trauma, and postpartum struggles. We hold this work with a feminist, trauma-informed lens, which means we will never leave you carrying the shame that was never yours to hold. When you reach out, we will match you with the therapist whose focus fits exactly where you are.

Schedule a free consultation whenever you are ready. There is no pressure here, just an open door and a place to put the weight down.

About the Author

Meagan Clark, MA, LPC, NCC, BC-TMH is the Founder, CEO, and Clinical Director of Her Time Therapy, a group practice specializing in online mental health counseling for women. She is a Licensed Professional Counselor and clinical supervisor in Colorado and Georgia, a National Certified Counselor, and a Board Certified Tele-mental Health provider. Meagan specializes in women's mental health and employs a feminist therapeutic approach. She is passionate about helping women heal, build self-trust, and create fulfilling lives. As Clinical Director and supervisor, she oversees and mentors a team of therapists at Her Time Therapy, ensuring care across the practice is aligned with a feminist, trauma-informed, and integrative approach to women's mental health.

About Her Time Therapy

Her Time Therapy is an integrative group counseling practice comprised of licensed therapists in Colorado who specialize in providing convenient and empowering online therapy for women. We recognize that women experience a unique set of biological, environmental, economic, and social challenges that have a real impact on mental health, and that you deserve specialized, feminist-informed support. Schedule a free consultation to get started.

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Disclaimer: This blog does not provide medical advice. The information contained herein is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a licensed health provider before undertaking a new treatment or health care regimen. If you are in crisis, please contact the 988 Suicide & Crisis Lifeline by calling or texting 988.