Common concerns related to fertility, pregnancy & postpartum

  • The decision to have a child as a single or partnered person

  • Getting pregnant or concerns about your own (or partner’s) fertility

  • Mixed emotions during pregnancy or in reaction to major life changes

  • Birthing parents (or partners) experiencing significant anxiety or depression during pregnancy or postpartum (e.g., PMADs)

  • Relationship with food, body, weight, and sex during pregnancy or postpartum

  • Complicated feelings or triggers about your parents or caregivers while pregnant or expecting

  • Changing roles or relationships with partner, co-parent, friends, family, in-laws, or colleagues

  • Grief or isolation after a miscarriage or perinatal loss

  • Painful or difficult emotions if struggling with infertility

  • Undergoing fertility treatments or artificial reproductive technology (e.g., going through rounds of IVF)

  • Decision to freeze eggs or embryos

  • Unresolved pregnancy-related trauma or birth trauma (e.g., high risk pregnancy, unexpected birth complications, NICU care)

  • Decision making re: career vs stay at home, child care, parenting approach, living situation, finances, and future

  • Impossible parenting expectations: having an immediate bond with your baby, perfect maternal instinct, or being a happy/fulfilled/saintly parent in the “fourth trimester” & beyond

  • Matrescence or complex transition into new parenthood, questions of “who am I now”

Supporting real and honest experiences of fertility, pregnancy, and postpartum

Trying to get pregnant, being pregnant, having a baby, and becoming a parent can be one of the biggest life-changing, joyful, dramatic, and exciting adventures you take on. Yet strong social pressures and idealized myths are also tied to this time period. Especially when it comes to what it means to have a smooth family planning journey, healthy pregnancy, or be a good enough parent. This often leaves little room for real talk about the honest, complicated emotions or exhausting challenges that come with family planning, pregnancy, postpartum, and parenthood. Unfortunately, many hopeful or expecting mothers, birthing parents, and partners end up assuming that their own experience is abnormal, when part of it may be more common than they think. Or they may be completely shocked at all of the things “no one told me” and feel lost and alone. Others may have an unexpectedly difficult journey trying to conceive, be grieving pregnancy loss, or discovering that new parenthood isn’t quite what you expected. The reality is, everyone’s experience is unique and there are many paths to having a baby and becoming a parent that are wonderful. What’s true for most is how incredibly helpful it is to receive support so you can invest in your emotional wellbeing while embarking on this next chapter.

“While there may be many “nobody ever told me” moments, you don’t have to face them alone. You can navigate them with complete support in therapy.”

What’s the perinatal period and what are PMADs

Generally speaking, the perinatal period is defined as the time between pregnancy through the first year post-delivery. According to Postpartum Support International, perinatal mood and anxiety disorders, or PMADs, are the top complication for pregnancy and childbirth, affecting up to one in five women and one in ten men during the perinatal period. PMADs does include what’s commonly known as postpartum depression, but also includes anxiety during pregnancy and other types of mood disorders.

Although research continues to show that untreated PMADs affect the likelihood of premature births, parent-child attachment, and later learning or behavior difficulties for a child, only about 25% of those affected receive professional guidance. PMADs can occur due to the significant hormonal changes related to pregnancy, but also occur as a result of the many stresses and changes during this time on a mental, emotional, relational, and environmental level. So what prevents people from receiving care? A lack of knowledge, stigma, and silence can keep many people in the dark, trying to muscle through without adequate support. The good news is that if identified and addressed, PMADs are treatable with therapy and professional help.

How can therapy for fertility, pregnancy and postpartum-related concerns help me?

Since family planning and the perinatal period is so multifaceted and unique to each person, therapy is tailored to your needs and journey. Often therapy for any related concerns starts with education and normalizing the many thoughts and feelings that accompany this special context. Being supported to slow down, process, and experience compassionate care when going through an uncertain or vulnerable process helps. Validating and helping you plan for the rapid physical, hormonal, and neurobiological changes of pregnancy and postpartum can encourage self-kindness and proactive adjustment of expectations rather than feeling disoriented or self-critical. In session, a perinatal therapist can teach you how to manage new anxieties with coping skills. Or a therapist can hold safe, nonjudgmental space to discuss what’s being stirred up for you during whatever your experience is. Sometimes this journey can come with unwanted twists or setbacks in your imagined timeline. Sometimes there are complex medical procedures - and it can feel like there is no time for you to make sense of what’s happening before you’re swept up in the next step. If you’ve had a pregnancy loss, therapy can be a place where you grieve and heal, especially if no one knew you were pregnant and it’s too exhausting or complicated to bring it up now. Discussing who you were then versus who you are now, what it’s like to return to work after parental leave, and your evolving needs for social support are a key part of pioneering the postpartum year in ways that make sense for you. While there may be many “nobody ever told me” moments, you don’t have to face them alone. You can navigate them with complete support in therapy.

Fathers and partners of birthing parents are often relegated to the periphery during family planning or the perinatal period, even though they are equally deserving of emotional support as they undergo their own life-altering identity, relationship, and role changes. You may want to focus on finding ways to connect with a partner as what worked for you before isn’t realistic now. Your therapist may also assist you in problem solving and taking practical steps that remind you of what you have control over as a non-birthing person. You may be encouraged to assertively express your needs with your OB/GYN or consider building additional supportive relationships, such as with a doula, reproductive psychiatrist, endocrinologist, or support group. Whatever brings you to therapy, this period is a time where many feel overwhelmed, alone, and unsure about nearly everything. Having a dedicated space to support your emotional wellbeing can make all the difference.

Finding a fertility therapist or perinatal mental health specialist in NYC - we’d love to help

Whether you are trying to conceive, are expecting, or have just become a new mother, father, birthing person, or partner, this process comes with unique challenges that affect you on a deeply personal level. Our team of psychologists at Manhattan Therapy Collective are trained in a number of therapy approaches that support mood changes and role transitions, such as Cognitive Behavioral Therapy and Interpersonal Therapy. We encourage you to reach out for support - we’d love to connect and be there for you through this beautiful, wild, uncertain, exhausting, and demanding moment in your life. Don’t buy into the myth that somehow you’re automatically “supposed to know” what to do, that you must be perfect or that there is a perfect storyline, or that you’re only allowed to feel blissfully happy and excited while everything in your world changes. Feeling stress, ambivalence, and sadness about what is unexpected or different that your imagined experience is normal. We believe there are many healthy paths to trying and having a baby - and becoming a good enough parent - and we’re here to walk with you in whichever one you take.

Common concerns about therapy for fertility, pregnancy, or postpartum concerns

 

  • Absolutely not! We understand that this unique period of time may mean juggling medical appointments, physical pain or discomfort, or childcare. Teletherapy is a wonderful option that we offer, giving you the flexibility you may want to meet with your therapist.