• Center for Epidemiologic Studies Depression Scale - Revised (CESD-R) [ Time Frame: 6 Weeks Postpartum ]
  Self-reported depressive symptoms over the past two weeks. There are 20 items, each scored from 0-4. The total score range is from 0-80. Total score will be used, with higher scores indicate more depressive symptoms.
• Emotion Regulation Questionnaire (ERQ) [ Time Frame: 6 Weeks Postpartum ]
  Self-report of emotion regulation skills. There are two primary subscales, cognitive reappraisal (range: 6-42) and expressive suppression (range: 4-28). Outcome will be total score on the cognitive reappraisal scale. Higher scores for reappraisal indicate better emotion regulation.
• Stroop Task [ Time Frame: 6 Weeks Postpartum ]
  The classic Stroop task is a robust measure of cognitive control. Participants will view a color word in a different color ink, naming the ink color. A control condition is included with neutral words. Interference score will be calculated using reaction times.
• Brain activation during an emotion regulation task [ Time Frame: 6 Weeks Postpartum ]
  An emotion regulation task will be completed during a functional magnetic resonance imaging (fMRI) scan in order to examine whole-brain functional activation. Individuals will view negative and neutral pictures from the International Affective Picture System. For some pictures, they will just view the images. For some negative pictures, they will be asked to regulate their responding using a distancing technique that has been introduced to them.
• Brain activation during the Stroop task [ Time Frame: 6 Weeks Postpartum ]
  The Stroop task will be completed during a functional magnetic resonance imaging (fMRI) scan in order to examine whole-brain functional activation when cognitive control must be exerted.

• Rate of Postpartum Depression [ Time Frame: 6 Weeks Postpartum, 6 Months Postpartum ]
  Presence of a major depressive episode will be used to determine the presence of postpartum depression. Major depressive episodes will be assessed using the Mood Module of the Structured Clinical Interview for the Diagnostic and Statistical Manual, Fifth Edition (SCID-5).
• Emotion Regulation Questionnaire (ERQ) [ Time Frame: 6 Months Postpartum ]
  Self-report of emotion regulation skills. There are two primary subscales, cognitive reappraisal (range: 6-42) and expressive suppression (range: 4-28). Outcome will be total score on the cognitive reappraisal scale. Higher scores for reappraisal indicate better emotion regulation.
• Stroop Task [ Time Frame: 6 Months Postpartum ]
  The classic Stroop task is a robust measure of cognitive control. Participants will view a color word in a different color ink, naming the ink color. A control condition is included with neutral words. Interference score will be calculated using reaction times.
• Infant Behavior Questionnaire - Revised (IBQ-R) [ Time Frame: 6 Months Postpartum ]
  A 193 item self-report measure completed by mothers about specific temperament-related behaviors displayed by their infant over the past two weeks. There are 14 sub-scales derived, each ranging from 0-7. A negative emotionality composite will be derived from the fear, sadness, and distress to limitations sub-scales.

• Maternal Psychological Distress
• Postpartum Depression
• Prenatal Stress

• Experimental: Mindfulness Based Cognitive Therapy
  Mindfulness Based Cognitive Therapy (MBCT) adapted for pregnancy includes 8 sequential, weekly 2-hour group sessions co-led by two master's level therapists. Sessions include: 1) introducing new mindfulness skills through in-session practice, 2) reviewing mindfulness practices and troubleshooting barriers to practice, 3) reinforcing mindfulness skills through in-session practice and debriefing, 4) learning about how thoughts influence feelings and behaviors (not all sessions), 5) providing psychoeducational information to support skills, and 6) encouraging the establishment of social support.
  Intervention: Behavioral: Mindfulness Based Cognitive Therapy
• No Intervention: Treatment as usual (TAU)
  All participants will receive routine prenatal care from an identified medical provider, which they have initiated on their own. They will be able to engage in any services recommended by their primary medical provider or that they voluntarily initiate. For ethical reasons, they are not prohibited from engaging in any type of therapeutic, complementary, or medication treatment (after enrollment). The TAU group will be offered a delayed treatment option, after the 6 month follow-up. This will be a 2 hour mindfulness psychoeducation session, offered between 6 and 9 months postpartum. Several core mindfulness concepts included in the full MBCT curriculum will be taught and participants will complete several brief mindfulness activities.

Inclusion:

1. female who is currently pregnant (8-22 weeks gestational age (GA) at time of screen)
2. 21-45 years old
3. single gestation
4. fluently speak English
5. be available and physically able to attend scheduled group meetings
6. have a prior history of at least 1 major depressive episode (as determined through psychiatric interviewing).

Exclusion (at enrollment):

1. Magnetic Resonance Imaging (MRI) contraindication (e.g., metal in their body)
2. major neurological or medical illness (e.g., diabetes, multiple sclerosis)
3. history of head trauma (loss of conscious > 2 minutes)
4. Intelligence Quotient (IQ) < 80
5. uncorrectable vision or hearing impairments (including color blindness)
6. use of psychotropic medications, corticosteroids, insulin, or any other medications that might impact the central nervous system
7. current illicit drug use or diagnosis of a current substance use disorder
8. current diagnosis of an eating disorder
9. current depressive or manic episode
10. diagnosis of a neurodevelopmental disorder (Autism, Intellectual Disability)
11. any history of psychosis
12. current active suicidality and/or homicidality, or interpersonal violence
13. prior history of engaging in mindfulness-based psychotherapeutic interventions (e.g., Mindfulness Based Cognitive Therapy (MBCT), Mindfulness Based Stress Reduction (MBSR), Dialectical Behavior Therapy (DBT))
14. known congenital, genetic, or neurologic disorder of the fetus (e.g., Down syndrome, fragile X)
15. pregnancy-specific medical conditions or complications that significantly increase risk (e.g., placental separation, placenta previa)
16. History of meningitis or seizures (except infantile or febrile)