Specialist Therapy for Pregnancy, Birth and transitioning to Parenthood
Prior to working privately, I helped establish specialist NHS Maternal Mental Health services in Oxfordshire. A core part of my work has been supporting women and birthing people affected by birth trauma, pregnancy loss, fear of childbirth, and other mental health difficulties related to parenthood. I’ve seen first hand the difference compassionate, evidence-based therapy can make.
I care deeply about advocating for women and families, and it’s this commitment that’s drawn me to specialise in perinatal mental health. Alongside my therapeutic work, I’ve had the privilege to shape wider service development in this area. This has included contributing to the Birth Trauma Inquiry and developing mandatory training that has been rolled out to all maternity staff in Oxfordshire.
Birth Trauma (including Post Traumatic Stress Disorder)
Sadly, research shows that one in four births are experienced as traumatic. It’s important to know that birth trauma isn’t just about what happened during delivery, it’s about how the experience felt to you. Even when the outcome was medically okay, the emotional impact can be deep and long lasting.
Birth trauma can affect your mental health in many ways during the post natal period. You might experience symptoms of:
- Postpartum anxiety or depression
- Postpartum OCD
- Difficulties with bonding or feeding your baby
- Challenges in physical recovery from birth
These difficulties can sometimes bring feelings of guilt or shame, especially if you feel you “should” be coping better. It is not your fault if you are struggling to manage the impact of birth trauma, you are not alone in feeling this way.
One commonly associated condition is post-traumatic stress disorder (PTSD). With PTSD, distressing memories of the birth continue to intrude, making you feel as though you are reliving the trauma. You might feel unsafe or on edge, even though you know rationally the danger has passed.
The good news is that birth trauma is very treatable. Therapies such as Eye Movement Desensitisation and Reprocessing (EMDR) and Cognitive Behavioural Therapy (CBT) have a strong research base and highly effective for treating birth trauma.
Tokophobia (fear of birth)
It is estimated that fifteen percent of people experience severe fears of birth during pregnancy. The term used for this is tokophobia. The experience of tokophobia varies greatly from person to person. Symptoms can include high levels of anxiety, disgust, avoidance and struggling to bond with the baby. Sometimes people can delay conceiving due to these fears, or terminate a much wanted pregnancy. Tokophobia is usually categorised into two types:
- Primary tokophobia – a fear of childbirth that exists before any personal birth experience.
- Secondary tokophobia – which develops after a traumatic or difficult birth, miscarriage, or pregnancy related experience. Often people with secondary tokophobia will report symptoms of post traumatic stress disorder (PTSD)
For some, non birth related traumas can heighten anxiety around pregnancy and birth. This can include experiencing medical trauma, sexual trauma, or previous experiences where you have felt a loss of control.
Neurodivergence (such as autism, ADHD, or sensory processing differences) can also contribute to heightened fears. Challenges around sensory sensitivities, communication needs, and navigating complex systems can make the idea of giving birth feel particularly overwhelming.
Therapy can help address the underlying fears and if needed to treat traumas maintaining anxieties. It also is very helpful to consider how to navigate maternity systems and prepare practically. This may include going through previous birth notes, considering birth choices and creating a psychologically informed birth plan. This can help you to feel safer, more informed and empowered during pregnancy and birth.
Adjusting to becoming a parent
Becoming a parent is one of the most significant transitions we go through in life, yet the biological, emotional, and social impacts of this change are often overlooked. Matrescence is the term used to describe the complex process of becoming a mother, acknowledging the identity shift, hormonal changes, and emotional adjustments that accompany this stage. Intense emotions such as anger, grief, and anxiety are often stigmatised in the context of new parenthood, leading many to feel isolated, ashamed, or as though they are failing.
It’s important to recognise that fathers and partners also undergo their own unique emotional journeys during this time, as they adjust to new roles, relationship changes, and the demands of caring for a newborn.
Therapeutic support during this time can provide a compassionate space to process these changes, explore emerging challenges, as well as identifying the strengths you might be overlooking.
Pregnancy Loss
Experiencing a pregnancy loss can be devastating, and the grief that follows is often deeply painful and misunderstood. Many people feel isolated, overwhelmed, or hopeless in the aftermath. If you go on to have further pregnancies, many struggle with heightened anxiety and fear.
Therapy can provide a safe and space to process these emotions, make sense of the loss, and begin to heal. With the right support, it is possible to navigate grief and reduce feelings of isolation.
Antenatal or Postnatal Anxiety and OCD
Anxiety is a normal human emotion that helps protect us from danger. However, it can become a problem when the level of anxiety feels out of proportion to the situation and starts to significantly affect daily life.
It is understandable that anxiety may increase during pregnancy and after birth. Suddenly, you are responsible for another life, and you can feel overwhelmed and out of control. Many people who struggle with anxiety also place themselves under immense pressure, setting unrealistic standards and taking on excessive responsibility.
An associated condition is Obsessive Compulsive Disorder (OCD). OCD is
characterised by:
- Obsessions– intrusive, unwanted thoughts or images
- Compulsions – repetitive behaviours or mental acts carried out to reduce distress or prevent a feared outcome
While intrusive thoughts in the perinatal period are actually very common and almost always harmless, for those with OCD these thoughts become overwhelming and dominate daily life. The themes usually centre on fears of harm to oneself or others, accompanied by a strong sense of responsibility to prevent such harm. This can lead to significant distress and impairment.
Both perinatal anxiety and perinatal OCD are highly treatable. The main treatment recommended by research is cognitive behavioural therapy (CBT).
Antenatal and Postnatal Depression
The symptoms of antenatal and postnatal depression are similar to other forms of depression. The two main signs are a persistent low mood and a loss of interest or pleasure in activities that would normally feel enjoyable.
Other common symptoms can include:
- Self critical thoughts
- Low energy
- Difficulty concentrating
- Thoughts of not wanting to be alive or wanting to hurt yourself
- Changes to sleep or appetite
Around 10–15% of mothers experience antenatal or postnatal depression. Despite this, it is often overlooked, as feeling low is sometimes assumed to be a “normal” part of pregnancy or adjusting to parenthood. For some, it can also be hard to accept that becoming a parent does not feel as joyful or fulfilling as expected.
Some (but not all) parents may also struggle with bonding or forming a relationship with their baby, either during pregnancy or after birth. This can add to feelings of guilt, isolation, or distress.
There are a number of effective therapies for perinatal depression. These include cognitive behavioural therapy (CBT), interpersonal therapy (IPT), as well as other approaches that can be tailored to what is driving your low mood.
Issues from the past
Becoming a parent can cause unresolved experiences from the past to resurface. You might find that familiar coping strategies no longer work in the face of new circumstances like pregnancy, birth and becoming a parent. Parenting often brings a new perspective to how we were parented ourselves, raising important questions about what we want to carry forward and what we hope to change. In therapy, we can explore the impact of your early experiences, understand how they may be influencing your parenting, and support you in finding more grounded, compassionate ways to respond.
