Perinatal, Postpartum, and Maternal Mental Health

Pregnancy and postpartum are not only part of a transformative time period because you're bringing another life into this world, but because your very existence is changing in a thousand ways, big and small. This period of life is called "Matrescence." It isn't written about in textbooks. No one talks about it when your family planning or you're pregnant, or even once your baby is earthside. In the processing of becoming a mother, your brain, body, and spirit (if this is part of your sense of self) are going through psychological, emotional, physical, and relational changes. These changes can't be undone. These changes and how they manifest in our lived experience can only be witnessed, responded to, adapted to, and lived. How we go about embodying our experience of matrescence sometimes needs professional guidance and help, especially if we have significant risk factors for developing perinatal and postpartum mental health difficulties. Just like adolescence, matrescence naturally unfolds in ways that can be uncomfortable, empowering, shaky, scary, isolating, confusing, off-centering, loss-filled, and identity-challenging. The matrescent mind is extremely vulnerable during the perinatal and postpartum phases of life. When you are pregnant or have a new baby in our arms, you are very sensitive to intense emotions, hormonal shifts, intrusive thoughts, comments from others, and your own internal changes.  

During postpartum, parents can have scary and unwanted thoughts, feelings that don't align with what they were told or think they should feel, and they struggle to adapt to new routines or lack of routine due to the presence of the new baby at home.  These thoughts can very quickly trap you and make your life feel small - especially if you aren't sure which thoughts to let go of or how to let go of them. Mothers often find themselves searching for themselves again, but can't seem to land on something solid and grounding that guides them through. Acceptance, letting go, tolerating discomfort, harnessing or tapping into your mothering instinct, knowing up from down, and talking yourself through massive hormonal, emotional, and identity changes is overwhelming, to say the least, especially when your primary focus is (supposed to be) to keep your new baby safe and cared for (regardless of how you feel towards your baby or mothering). Most mothers/birthing persons are learning parenthood, their new child, their own new identity, and possibly their partner's new identity - all at once. We were never meant to do that alone. 

Whether it's a depressive fog, overwhelm from intrusive or compulsive thoughts and behaviors, intense emotions and fears, the feeling of coming undone, feeling inadequate or insecure, or constant worry and feeling keyed up - it can be too hard to navigate these constants during this phase of life. 

Sometimes, your mind can tell you that you're no good as a mother, that you're harming your baby, or suicide seems like the better alternative. Or maybe the mind is conjuring of future predictions - worst case scenarios - that take you out of the present so frequently that you're missing this very moment. If you have perfectionistic tendencies, it may be hard to tolerate feeling uncertain, inadequate, incompetent, and out of control. Sometimes creating a new life balance is a task you don't feel up for, or don't know how to begin at even if you want to. Maybe you've been told that pregnancy and being a new mother is supposed to look and feel a certain way, yet you feel like your experience is completely different. You may need help and guidance and that's okay. You won't have to let go of your intense mothering instinct, but you will learn how to harness and respond to it, get to know your new brain, effectively cope, reduce the sense of difficulty you feel, and learn how to confidently navigate your new life experience and identity so you can be with yourself and your baby in a more stable and thriving way.

I have successfully help new or new again moms during pregnancy, pregnancy loss (wanted or unwanted), birth trauma, and postpartum adjustment, as well as in parenting through the years. They typically report feeling empowered, whole, clear, and centered while learning how to better navigate reproductive and postpartum difficulties together.

If this is or has been your experienceh pregnancy. It begins before that, in that mind's eye of the person wishing to get pregnant. Some people already feel like mothers, but they are childless or without a living baby. While assisted reproductive technology (ART) has created opportunity and fulfilled dreams for individuals and families across the globe, it inevitably created new anxieties, hardships, and acute stress for those who struggle to get pregnant.

Individuals enduring choice around IUI, IVF, egg-freezing, sperm donors, surrogacy, and more...are often times beginning their family planning journey with loss. Loss of ease, loss of a hope and expectation for natural pregnancy, loss of certainty around this next phase of their life, loss of perceived control, loss of a certain relationship with their body, loss of certainty in their relationship, and loss of time and money and resources and identity so that they may take the arduous journey of assisted help in making their family dreams come true. 

Not only is their loss involved in the beginning stages of ART, but so is extra burden. There are choices throughout the ART process that other people don't have to deal with in the same way, such as choosing which egg to implant after finding out usually unknown genetic information. Some people liken this choice point to "being asked to play God" or fearing that they could "pick the wrong one." This can bring up unresolved struggles with religion and spirituality and perfectionism, and can create heavy anxiety. The ART journey also involves extra pain and suffering, from injections, to surgeries, to constant doctor's appointments and testing, and often times navigating a system that treats you like a medical patient instead of a human being having an incredibly vulnerable experience. Some individuals choose to go through this process over, and over, and over. I've heard individuals described a 3-4 year time period in their life when things got very small, dark, and weakened because they made a choice to revolve their lives around their fertility journey for the hope that one day it'd be worth it. 

If this is or has been your experience, I can help. I have effectively supported and guided individuals across the ART process. The mind can be especially susceptible to self-criticism, body shaming, irritability/hostility with others, loss of sense of self, an inability to tolerate extra stress in other domains of life, emotional reactivity, religious/spiritual struggles, stress on partnership and with family members or friends, trauma reactions, loss, grief, and burden. I have effectively helped mothers/birthing person's maintain, enhance, or get back their mental health during their unique fertility journey. 

Whether our pregnancy occurred through natural intercourse or assisted reproductive technology (ART), miscarriage effects one in five women/birthing persons. Even though 20% are affected, making miscarriage a common consequence of pregnancy, the experience and topic are often avoided, leaving the experiencer to feel like there is no space for her to talk about, process, grieve, explore meaning, and decide next steps.  Further, miscarriages can be experienced as traumatic loss - and the symptoms of posttraumatic stress and other traumatic reactions in the brain and body are in need of help.

I have successfully worked with individuals to process traumatic grief and loss through their miscarriage journey.

Neonatal loss and still birth is traumatic grief that, while is more likely to be acknowledged in one's family or community, leaves the individual or family with an experience that has forever shaped their mind and their path in ways that become invisible to community after the acute time period after loss has passed. Individuals are often left with much to process, feel, prepare for, and experience. Even immediately after loss, decisions need to be made about where to recover (i.e., in the labor and delivery wing around newborn babies? In the postpartum wing where mom's with new babies are recovering?), whether or not to see their baby, what rituals if any are important surrounding grief and loss and death, how to tell others, how to deal with milk supply if it comes in or the no-longer-pregnant body that still feels pregnant. While some of the loss is observable to others, much of it is invisible, hard to put into words, harder to open up about, and unbearable to experience. How to move through, how to move forward, how to carry the loss and sense of brokenness without it diminishing the person forever?

I have effectively worked with individuals to process these great losses and make space for an experience they never wanted to have to endure. I'm not in the business of "getting over" losses, but I am very passionate about how we adapt ourselves and our lives in meaningful ways to carry our losses with us and develop an intimate relationship with our losses that works for us. 

On the other side of pregnancy is parenting, which is a lifelong journey experienced differently across the lifespan of your child(ren). How we were parented, our relationship with those parents, knowledge about healthy parenting strategies and attachment, our own sensitivities, traumas, triggers, and personalities, our baby's temperament and personality....all these things coalesce to create and test our parenting style. I work with parents on how they think about parenting, how to effectively interpret their child's behavior, emotion regulation and coping, child development and parent development, boundaries, co-regulation, and values. I have also effectively worked with parents enduring a child's chronic illness or substance use, empty nesting, and how their marriage/domestic partnership/co-parenting relationship changes across time.