“How Come No One Told Me?”

The Emotional Guide to Pregnancy and The First Year of Motherhood.

Coming Spring 2019, from Simon and Schuster.


Becoming a mother is a dramatic identity shift called “matrescence,” a time of hormonal shifting, body morphing and identity transition that’s as stressful and transformative as adolescence.

During this transition, many women find themselves feeling lost somewhere between who they were before motherhood, and the picture-perfect but unrealistic image of who they think they should be now. Too many women are ashamed to speak openly about the ups and downs of their experiences for fear of being judged. Many worry that they are “going crazy”, or destined to be bad mothers, when they’re simply experiencing universal challenges.

As Reproductive Psychiatrists, we specialize in helping women navigate their emotions before, during, and after pregnancy. Our phones are ringing off the hook, but the majority of the women who call us don’t really need us. What they need is the truth about how their moods, hormones, and identities change during matrescence, together with some practical ways of helping themselves. It’s time for women to stop feeling so guilty, disappointed, competitive, frustrated, ashamed, angry and afraid about their normal transitions to motherhood. After years of repeating that very information to thousands of women and hearing them say “How Come No One Told Me?” we decided to write this book, an emotional guide from the first trimester of pregnancy, through the first year of motherhood.

Read Alexandra sacks' viral New York Times article:

About the Authors

Alexandra Sacks, MD

Alexandra Sacks, MD is a Reproductive Psychiatrist, advanced candidate at The Columbia University Psychoanalytic Center for Training and Research, New York Times Contributor. Her article “The Birth of a Mother” was the #1 most read article of 2017 for the New York Times Well-Family Section and has been featured in Time Magazine, Elle, Slate, and Manrepeller. She serves on advisory boards for the American Psychoanalytic Association and Columbia Psychoanalytic to advance communication about mental health with the media, and TendLab to advance the success of mothers in the workplace. With 15 years of experience in writing about medicine, she served as the Benjamin Rush Scholar in the DeWitt Wallace Institute for the History of Psychiatry at New York-Presbyterian Hospital/Cornell and the Humanities and Medicine Program at Mount Sinai School of Medicine via Amherst College. She has specialty Fellowship training in Reproductive Psychiatry from New York Presbyterian/Columbia.

Catherine Birndorf, MD

Catherine Birndorf, MD is a Reproductive Psychiatrist and Clinical Associate Professor of Psychiatry and Obstetrics/Gynecology and founding director of the Payne Whitney Women’s Program at The New York Presbyterian Hospital/Cornell. She is co- founder/medical director of The Motherhood Center, and the founder of the Women’s Mental Health Consortium, a New York area network of women’s mental health clinicians and researchers. A Smith College graduate, Dr. Birndorf attended Brown University Medical School and did her psychiatry residency at New York Presbyterian Hospital/Cornell. She has appeared on The Today Show, Good Morning America, CNN and for 10 years was a regular mental health columnist for SELF Magazine. In 2010 she co-authored the New York Times bestseller, The Nine Rooms of Happiness. She has won numerous awards and serves on boards of several medical organizations including the President’s Advisory Council of Postpartum Support International.