Perinatal & Postpartum Therapy/Maternal-Infant Mental Health

The process of family building is one of the most intense periods in one’s life. When trying to conceive, during
pregnancy and following birth, major changes occur for women physically and emotionally, as well as in their
lifestyle and relationships.

Women are more likely to have difficulty coping in the first year after childbirth than at any other time in their
lives. Even when conception, pregnancy and childbirth are smooth, the transition to parenting your new baby may
be rocky. If becoming pregnant, the course of your pregnancy and/or childbirth did not go as planned, you may be
suddenly faced with a variety of unexpected stresses, losses, and challenges.

How does infertility affect psychological well being?
The long term inability to conceive a child can evoke significant feelings of loss. Coping with the multitude of
medical decisions and the uncertainties that infertility brings can create great emotional upheaval for a significant
number of couples and individuals.

What are some common experiences described by new parents?
Many new parents have some difficulty adjusting to the birth of a baby. During the first months with a newborn, it
is normal to feel intensely focused on the baby. Many mothers describe feeling overwhelmed by the demands of an
infant and worried about whether they are providing all the “right things” for their child. They may find important
family relationships shifting suddenly—relationships with their spouse, their own parents, and older children begin
to change unexpectedly. Many mothers say that they are surprised to feel sad and anxious after the birth. They
worry that something is wrong with them for feeling this way. Mothers often have worries during pregnancy as
well, and are concerned about how they will make these adjustments.

Sometimes, these feelings last only a couple of months and resolve with support, understanding and guidance from
friends and family. Other times, symptoms do not go away and may even become worse. Mothers often feel
ashamed when this happens—they expect to feel more joy and ease with the birth of a baby. If you are concerned
about your feelings, thoughts, behaviors or adjustment, therapy can help you through this difficult period. By
seeking therapy, you not only help yourself, but also your baby and your family.

When pregnancy and/or childbirth is complicated…
If you had difficulty becoming pregnant, or had complications during pregnancy or childbirth, you are faced with
some unexpected losses and challenges on top of the typical adjustments to a new baby. You may be surprised to be
feeling loss, grief, anger, guilt, fear, isolation and confusion. Instead of joining easily with other parents of
newborns, you may find yourself struggling to figure out where to find others who will understand you. If you have
been faced with issues such as infertility, difficult pregnancies or deliveries, losses in pregnancy, premature birth or
newborn complications, your feelings about your pregnancy, baby and yourself as a parent are likely to be mixed.
You are trying to adjust to your new situation, yet your circumstances may leave you feeling alone, uncertain, and
not sure who could understand and help.

Could you benefit from therapy?
In general, if you believe you might benefit, you could. If your doctor is worried about how you have been
feeling, s/he may recommend therapy. You might also consider therapy if you are experiencing difficulty with:

Overwhelming feelings:
• being unable to “shake” sadness
• feeling enraged
• feeling inadequate or like a failure
• feeling hopeless or helpless
• feeling constantly exhausted or empty
• frequent tearfulness
• feeling guilt, shame or worthlessness
• feeling confused, worried or panicky
• fears for the baby or because of the baby
• fears of being alone or of going out.

Distressing thoughts:
• trouble concentrating & remembering things
• disturbing images
• difficulty thinking clearly or making decisions
• fear of rejection by your partner
• thoughts of suicide or harming the baby
• thoughts of running away

Disruptive behavior:
• insomnia or excessive sleep
• nightmares
• change in appetite/eating patterns
• isolating yourself from others
• difficulty keeping up with self-care
• low energy and motivation
• difficulty keeping up with routine tasks
• pervasive loss of interest/pleasure in usual activities (including sex)

Why seek therapy? Why not wait it out?
Getting help adjusting to the challenges of parenthood is not a luxury. By addressing these difficulties soon,
you not only reduce the chances of the symptoms worsening, but you also can quickly focus on creating the
best possible relationship with your child. Your emotional health directly impacts your baby’s cognitive and
emotional development. Taking care of yourself is taking care of your family. While the symptoms you feel
are common, many mothers fear discussing them because they think that others will criticize them. Therapy
may be the first place where you can openly discuss all of your thoughts, freely express your emotions and
create a plan to make things better.

If the path you imagined was very different from the path your pregnancy actually took, you may be trying to
figure out how to feel “at peace” with how things went. You may feel distant from your baby, or worry that
you’re overly protective. You might find yourself overwhelmed with sudden memories of treatments, the
pregnancy, delivery, or events after delivery. If becoming pregnant, pregnancy, delivery or the newborn period
did not go the way you had planned, you have many losses to mourn, and adjustments to make. These may not
be easily recognized by your friends and family; leaving you feeling even more alone and upset.

What Happens in Therapy?
In therapy, you can:
• tell your story to someone who is skilled in listening.
• receive the extra support you need and deserve during challenging times.
• recognize realities about yourself and your life, with someone who does not have an investment in your
being or acting in a particular way.
• allow yourself to feel all the different and difficult feelings that may be flooding you.
• examine the thoughts that come along with those feelings.
• gain insight into your reactions, & develop ways of handling new situations so you can move forward.

Therapy can take place with you individually or together with your partner. The number of sessions is up to

Remember, therapy gives you a chance to make peace with yourself. It helps you to develop additional skills
for handling stress. It gives you a chance to mourn your losses, and come to grips with what faces you. It
allows you to examine the ways in which these experiences have touched you, and to find yourself again.