Between middle-of-the-night feedings and early-morning diaper changes, new mothers are famously exhausted.

Sleep deprivation might seem like an inevitable part of parenthood, but for some it can have serious consequences, creating or worsening mental health conditions, including postpartum depression, says Nicole Leistikow, clinical director of the Johns Hopkins Reproductive Mental Health Center.

“Everyone just kind of shrugs their shoulders about women and sleep in the postpartum,” says Leistikow, who began the job July 1. “Women and families are so willing to sacrifice for their kids.”

Leistikow says conversations with her postpartum patients made her realize “we had been thinking about this all wrong,” she says. “We wouldn’t take a patient with a broken leg and constantly put stress on that injury and expect it to get better. We need to change the culture and the discussion to help parents see that their mental health is really foundational.”

While a fairly new field, reproductive psychiatry considers conditions that are as old as time: the mental health risks that women experience during periods of reproductive transition, including pre- and postpartum, and during perimenopause. Conditions that experts in the field study and treat include premenstrual dysphoric disorder, a particularly intense version of premenstrual syndrome, and postpartum depression.

Though it’s not yet a board-certified specialty, Leistikow believes it will become one within the decade.

The Reproductive Mental Health Center, located at The Johns Hopkins Hospital, provides individualized care to women at all stages of their reproductive life.

Leistikow first encountered it during a rotation there as a third-year Johns Hopkins psychiatry resident. “I became really interested in women’s mental health, in reproductive psychiatry,” she says.

Johns Hopkins established its leadership in the field early on, when Jennifer Payne, assistant professor of psychiatry and behavioral science, founded the clinic in 2006. Until recently, it was known as the Johns Hopkins Women’s Mood Disorders Center.

Liisa Hantsoo, the center’s director of research, studies premenstrual dysphoric disorder, as well as perinatal and perimenopausal mental health, adverse childhood experiences, and polycystic ovary syndrome (PCOS). The group is working to strengthen collaborations with the Division of Maternal-Fetal Medicine and with researchers in the Johns Hopkins Bloomberg School of Public Health.

As the field gains prominence, Leistikow is leading efforts to increase clinician knowledge.

She is part of the leadership of the National Curriculum in Reproductive Psychiatry founded in 2013 by then-Hopkins faculty member Lauren Osborne, which provides standardized education for psychiatry residency training programs.

Leistikow also notes that Johns Hopkins offers a particularly strong reproductive psychiatry experience. “Residents see their patients longitudinally for six months, and I provide the supervision and teaching so that by the time they finish they hopefully feel some level of confidence and competency in treating this population,” she says.

“There’s a small and growing network of reproductive psychiatrists in the area,” Leistikow says. “The goal of both our residency program and the national curriculum is to expand that pool, and to ensure that adult psychiatrists have a certain basic level of competency in treating women across times of reproductive change.”

Leistikow majored in English at Yale University, earned a master’s in literature at the University of Oxford, and then worked as a freelance journalist and high school English teacher before going to medical school.

“It’s very humbling to be in the clinic where I learned so much from Dr. Payne and Dr. Osborne, who are national and international leaders in reproductive psychiatry,” she says. “And I’m thrilled to bring my teaching background into this field that I feel passionate about.”