Dr Miranda believes mental health support should begin before conception. “It’s the one time in life where everything feels out of your control,” she explains. “That loss of control—trying to conceive, staying pregnant, becoming a parent—can be very triggering, especially for women with anxiety or perfectionist tendencies.” She starts conversations about mental wellbeing during preconception consults to help women build awareness and identify potential risks early.

While many hospitals and midwives use formal mental health screening tools, Dr Miranda prefers a conversational approach. She takes time to explore how a woman is really coping, digging beyond standard questionnaires. “I ask about background mental health, emotional wellbeing, and how things are going day-to-day,” she says. This helps uncover concerns that might otherwise go unnoticed—especially in women who’ve never experienced mental health issues before.

Interestingly, Dr Miranda notes that many women with a history of mental health issues often do better during pregnancy. “They usually have good insight, established support systems, and they’re emotionally prepared,” she explains. However, she keeps a close eye on all patients, as the perinatal period is a vulnerable time for everyone—whether or not they have a prior diagnosis.

Dr Miranda encourages patients to combine Mental Health Care Plans with the Medicare Safety Net for the most accessible care. Once a family reaches the safety net threshold, appointments that may normally cost hundreds can drop significantly in price. “I’ve had women do a whole day here, including lunch and ongoing support, for around $250 once they’ve hit the safety net,” she shares.