Why We All Need Therapy During Pregnancy & Postpartum

I remember when my eldest daughter was about two months old, there was a period where she was not sleeping at all. We tried everything. Army crawling out of the bedroom many a night, worried our footsteps might suddenly rouse her after she had finally fallen asleep… Holding her while bouncing on an exercise ball, while my husband turned on the hairdryer to create loud ambient noise (this was clearly before MamaRoo’s and fancy sound machines) … Going for long walks and car rides to attempt to lull her off to dream land…During that time in our early parenting journey, none of it seemed to work. To top it off, our daughter was super cranky (go figure) during her waking hours, and we suspected she might have colic. My husband and I were exhausted, overwhelmed, and stuck in an endless loop of Groundhog’s Day. We were also far from family and didn’t have the support network of fellow parents that we do now.

 

Our experiences with pregnancy and the postpartum period vary greatly. I know many women who experience pregnancy and young babies as exciting and joy-filled; others experience them as a phase of life filled with challenges and destabilizing shifts (in their bodies, identities, lifestyles, careers, relationships, etc.). I imagine most parents would say that how they feel varies greatly, changing almost daily, and exists on a wide spectrum of completely understandable reactions to this massive transition. Due to these significant emotions and all that they entail, I would argue that anyone who is pregnant or who has a new child would benefit greatly from therapy, particularly one that specializes in these issues. Here are some topics to being exploring with your therapist, just to get you started.

 

Topics to Address in Therapy

 

Transitions/Change:  Before children, how did you handle change? What were your typical defense mechanisms (e.g., attempts at control, ways of distracting/avoiding/numbing, etc.)? With any change, we typically experience a “hello” to something new, and a “goodbye” to something old. How do you handle having to say goodbye or letting go?  With pregnancy and new babies, many people feel a deep sense of loss for their old life, while at the same time experiencing excitement and anxiety about the future. How ever you experience change, transitions bring a lot of emotions to the surface, and a therapist can help you process them in an effective way, offering tools and strategies for coping with the inevitable stress that comes with such a massive change.

 

Big emotions and old narratives/past memories. Pregnancy and postpartum periods are full of highs and lows, from happiness to fear, joy to doubt. You will most likely find yourself experiencing a wide range of emotions, sometimes all in the same day. For some, this can also bring up unresolved issues from the past—childhood experiences, family dynamics, or unresolved grief. It’s not uncommon for these periods to dredge up long-buried feelings or memories that you might not even realize are still impacting you. Therapy can offer a safe space to explore these emotions, helping you understand what’s coming up for you and why.

 

Bodily changes. The changes in your body can’t be ignored either. Pregnancy and childbirth bring dramatic physical changes, and for many, this can be a really tough adjustment. Our culture’s fixation on “bouncing back” after childbirth doesn’t help, leaving many new parents feeling disconnected from or highly critical of their bodies.  Working with a therapist can help you reconnect with your body, fostering acceptance and gratitude for the incredible work it’s doing. For those with a history of disordered eating or body image struggles, this time can be particularly tricky, making therapy an essential tool in maintaining recovery.

Self-care & maintaining your sense-of-self. Taking time to explore your own identity outside of parenthood allows you to reconnect with your body, process changes, and develop coping strategies for the challenges that arise. Nurturing yourself isn’t selfish or a waste of time—it’s crucial. Therapy provides a supportive space to cultivate self-compassion, establish healthy boundaries, and create routines that honor your well-being, benefiting both you and your family in the long run.

 

Hormones. Lastly, hormones play a huge role in how we feel during pregnancy and postpartum. The hormonal fluctuations during these stages can lead to mood swings, anxiety, and even more serious conditions like postpartum depression or anxiety. Therapy can be crucial in helping you recognize the signs of these conditions early on and providing support as you navigate them.

 

Pregnancy and the postpartum period can be beautiful, challenging, and unpredictable. You don’t have to go through it alone. Remember, our ancestors birthed and raised their babies in villages, surrounded by love and support. This is how we are wired. Therapy can provide this support; it’s a space to process the immense changes you're going through, manage your many emotions, and find balance as you adjust to your new life. It's not about being unable to handle it or “not up for the job”—it’s about giving yourself the support and compassion we all need during this major life change.