PublishedApr 20th, 2026•12 min read
Perinatal Therapy: How to Decide If It’s Right for You
Author
Leigh Hall
LMFT
It’s normal to experience difficult moments during pregnancy and when transitioning to parenthood. However, people who have ongoing or severe mental health or emotional issues may benefit from seeing a perinatal therapist or seeking maternal mental health therapy.
Is Perinatal Therapy Right for You?
Perinatal therapy provides individuals and families with support and therapy during pregnancy, after childbirth, and in early parenthood. It can help manage prenatal anxiety, postpartum anxiety, postpartum depression, and relationship stress associated with the transition to parenthood. Evidence-based therapies commonly used in perinatal care – such as cognitive-behavioral therapy and interpersonal therapy – are widely recommended for perinatal mood and anxiety disorders.
Perinatal therapy may be a good fit if…
- You feel overwhelmed, anxious, and pressured to “do it all” during pregnancy or after birth
- You’re experiencing mood changes or intrusive thoughts that are intense or feel difficult to manage on your own
- You’re feeling overwhelmed about changes in your identity or shifts in your relationship
- You feel unsupported, isolated, or misunderstood
- You faced pregnancy or birth complications, or fertility issues that still affect you emotionally
- You want a safe space to navigate the transition to parenthood, not crisis relief
- You’re having trouble bonding with your baby and find it difficult to care for yourself and enjoy life
Perinatal therapy may not be the best first step if…
- There’s an immediate risk of harm to yourself or others
- You’re experiencing severe mental health symptoms, such as hallucinations and delusions, mania, paranoia, or confusion
- There are unaddressed substance abuse issues
- There are immediate medical or safety concerns that would make it unsafe to participate in therapy sessions
Therapy requires enough safety and stability to engage in sessions and benefit from treatment. If you’re not yet there, it doesn’t mean you won’t be. It just means that your first step might look different.
If you’re experiencing severe mental health symptoms or urgent medical concerns, seek an assessment with a physician — your primary care doctor, OB/GYN, psychiatrist, or, in urgent situations, an emergency room. Initial treatment may include medical care, psychiatric support, medication, or a higher level of care before beginning outpatient therapy.
If substance use is a concern, a substance use assessment and appropriate treatment program are important first steps. Your primary care doctor or OB/GYN can refer you to a specialized substance abuse treatment program for pregnancy or postpartum care.
If you are in an unsafe living situation, seek medical care if needed and consider contacting a domestic violence hotline or local support service for help accessing a safer environment.
When to seek immediate support first
If you’re in any of the following situations, it’s important to seek immediate help:
- Thoughts of harming yourself or your baby
- Feeling unable to care for yourself or your child
- Severe emotional distress, panic, or disconnection from reality
- Domestic violence or unsafe living conditions
If you or someone else is in immediate danger, call 911. For 24/7 confidential, free crisis support before, during, and after pregnancy, call the National Maternal Mental Health Hotline at 1-833-852-6262.
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How Perinatal Therapy Helps
Pregnancy, birth, and postpartum come with emotional and physical changes. In addition to new roles and relationship changes, fluctuating hormone levels and sleep deprivation can impact prenatal and postpartum mental health. Therapy is a safe space to navigate these changes. It can also help you learn tools for emotional regulation, boundary setting, and self-compassion that can make you a better parent, partner, and friend.
Mental health issues are common during pregnancy and after birth. Statistics indicate that 1 in 7 people experience perinatal depression during pregnancy or in the first year after birth. Both birthing and non-birthing parents can be affected.
Experiencing perinatal depression, or any other perinatal mental health issue, doesn’t mean that you’re a bad parent. Instead, it’s often a sign that therapy for postpartum depression or maternal mental health therapy could be beneficial. It’s also important to note that perinatal therapy isn’t only for first-time parents. Every pregnancy and birth is unique, and there are times in your life when you might need more support than others.
What Good Perinatal Therapy Looks Like
In this section, we’ll go over more about what perinatal therapy is, how it can support you, and how to know if you’re working with a good perinatal therapist. Note that perinatal therapy can be individual, partner-based, or include family therapy sessions when appropriate.
At a glance, good perinatal care includes:
- Proper assessment and goal setting
- Compassionate, non-judgmental care
- Skill building and support
- A therapist with specialized postpartum/perinatal training
Proper Assessment and Goal Setting
A good perinatal therapist will start with an assessment to gather information that helps them provide you with personalized support. They will ask you questions to learn about your pregnancy or postpartum experience. They’ll also ask about any personal history or mental health background that might be impacting how you’re feeling.
You’ll also be screened for any mood, anxiety, and safety concerns that might need to be addressed first. This involves answering questions about how you are feeling and how you are functioning on a daily basis. Keep in mind that this isn’t a test. Because perinatal mental health concerns, such as perinatal depression, are common, screening helps with early detection and treatment. It also provides a way for your therapist to track how you’re feeling over time to check that treatment is helpful.
After assessment, you’ll work with your therapist to develop goals based on your needs and stage of parenthood. They’ll use these goals to guide your care. But keep in mind that goals in perinatal therapy aren’t fixed. A good perinatal therapist will help you adjust your goals as circumstances or symptoms change or new challenges come up.
Compassionate, Non-Judgmental Care
New parenthood can be joyous, but it can also bring up feelings of anxiety, guilt, loneliness, sadness, and resentment. A good perinatal therapist understands that mixed feelings are normal. They create a safe space for grief, ambivalence, and emotional complexity during this time. A good perinatal therapist will also consider cultural background, identity, and lived experiences that shape how pregnancy, birth, and parenting are experienced.
Skill-Building and Support
Good perinatal therapy often includes structure while remaining flexible to meet your needs. In sessions, you’ll discover practical ways to manage anxiety and intrusive thoughts. This includes self-care, mindfulness, and grounding techniques. You will also learn skills for problem-solving and emotional regulation. These can help you set boundaries, prioritize rest, and ask for help.
Specialized Training
Because fertility, pregnancy, and the postpartum period are unique experiences, a skilled perinatal therapist will have specialized training, such as Postpartum Support International (PSI) Perinatal Mental Health Certification (PMH-C). This training gives them an understanding of evidence-based perinatal approaches, such as cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), that will guide sessions. They will have experience working with perinatal and maternal mental health clients. This means they understand issues like pregnancy, postpartum, loss, and fertility challenges.
For some people, therapy alone is effective. Others may benefit from a combination of therapy and medication, especially when symptoms are moderate to severe. A good perinatal therapist can collaborate with medical or psychiatric providers to support coordinated care.
Quality Signals to Look for
A skilled perinatal therapist will explain what to expect in each session. They will also check in often on your feelings and progress toward your goals. They should also make sure that you feel safe and supported, paying attention to safety and emotional load so that you’re not taking on too much at once.
Red Flags
Though therapy can be challenging at times, it’s important to not ignore red flags of low-quality care or a therapist that isn’t a good match for you. Red flags to watch for specific to perinatal care, include:
- Not feeling comfortable with your therapist;
- feeling as though you’re not being heard;
- a lack of direction in sessions;
- advice that feels generic;
- downplaying postpartum or pregnancy distress; and
- ignoring intrusive thoughts without assessing them.
Remember that you deserve to work with a therapist who makes you feel supported and heard.
How to Choose a Perinatal Therapist
Many therapists offer initial consultations to help potential clients find a therapist who is a good fit. During this time, you can ask them questions about their experience and approach towards therapy. You can also check that you feel comfortable and heard by your potential therapist.
Questions to Ask
Questions to ask your potential perinatal therapist include:
- What experience do you have working with perinatal mental health?
- How do you support individuals with postpartum depression or anxiety?
- How do you handle intrusive thoughts or emotional overwhelm?
- What does progress usually look like in perinatal therapy?
- How do you approach safety and support planning?
What Matters Beyond Credentials
Credentials matter because they prove your therapist is well trained. They also ensure your therapist follows ethical codes and professional standards. But there are some qualities to look for beyond credentials.
There are many different prenatal and postpartum experiences, so you’ll want to look for a therapist who has experience with your specific concerns. You’ll also want to ensure that you feel emotionally comfortable and trust the therapist. They should align with your cultural, identity, and parenting values. Finally, you’ll want to address practical concerns, such as insurance, scheduling, and virtual access.
Why Consider Octave for Perinatal Therapy
Octave’s access to specialized perinatal therapists, thoughtful matching, and flexible care make it a good place to start looking for a perinatal therapist.
Specialized Perinatal Therapists
Octave has fully licensed clinicians, with many therapists who are trained in perinatal and maternal mental health and who have clinical experience supporting pregnancy, postpartum, loss, and transitions. More than 100 therapists are part of Octave’s Perinatal Mental Health Center of Excellence.
These therapists have direct experience working with perinatal populations. They also have in-depth training, including over 20 hours of recent training to support prenatal and postpartum individuals in clinical settings and at least 6 hours of continuing education every 2 years.
Thoughtful Matching
Finding the right therapist can be a time-consuming and sometimes overwhelming process. But Octave can make this process easier by connecting you with a Care Navigator. Our Care Navigation team looks at your life stage, symptoms, preferences, emotional needs, and care goals. Then, we match you with a therapist who suits you well. 89% of our clients report a strong therapeutic alliance, which helps to improve therapy success.
Measured Outcomes
Measured outcomes are important because they show that therapy is working. At Octave, care changes based on feedback and progress. Clients have reported better emotional clarity early in treatment and are 40% more likely to continue therapy compared to other practices.
Accessible, Flexible Care
We know that it can be difficult to make time for therapy, especially as a new parent. Appointments at Octave are usually available in 1 to 8 days. You can choose from virtual or hybrid options, with various appointment times to suit your schedule. Many people also prefer virtual options as they can be more affordable, and you don’t need to travel to your therapist’s office, saving on time and transportation costs.
At Octave, the average copay is around $32 per session.
Ongoing Clinical Support
Client safety and consistency are valued at Octave. Your therapist uses a structured intake process. This includes safety screening to help plan your treatment and set goals. Ongoing clinical consultation and training mean therapists remain up-to-date with evidence-based treatment to offer high-quality care.
When Octave Isn’t the Best Fit
While Octave provides high-quality, measurement-informed care, it isn’t the best option for everyone. If there are safety concerns, like a medical emergency, need for inpatient or intensive psychiatric care, or active domestic violence needing special services, Octave isn't the best first step. Octave also focuses on in-network care, so it isn’t the best choice if you’re seeking an out-of-network provider.
Next Steps: Starting Perinatal Therapy
When you’re ready to take the first step, here’s how to get started.
Find a Therapist Yourself
Some people prefer having the control of finding a therapist they feel comfortable with. You can filter Octave’s vetted network of therapists by location or insurance. You can also filter by perinatal specialization to find possible options. Next, review experience and approach, and book directly with the therapist you choose.
Get Matched With a Care Provider
If you prefer, you can choose to work with one of Octave’s Care Navigators, who will match you with a therapist. If you choose this option, you’ll speak with a real person to discuss your pregnancy, postpartum mental health concerns, and your personal preferences. With this information, your Care Navigator will provide you with a personal recommendation. Appointments are typically scheduled within 1-8 days.
What to Expect in the First Session
It’s not unusual to feel nervous about attending therapy for the first time. Knowing what to expect can make this process a bit easier. You’ll start by discussing your pregnancy and postpartum experience. Your therapist will complete an emotional and mental health screening and check for any immediate safety concerns. They’ll also give you an overview of their approach to therapy and begin shared goal setting. This sets you up for the second session, where you’ll begin discussing priorities and start learning early coping methods.
Frequently Asked Questions About Perinatal Therapy
About the Author
Leigh Hall
LMFT
In my work, I use mindfulness and cognitive-behavioral approaches, combined with cultural sensitivity and curiosity — as well as a dose of irreverence — to help clients reconnect with themselves and their true values, honor their emotions without being controlled by them, and access their strengths to build resiliency and a sense of purpose.
