Issues Treated in Therapy:

Pregnancy and Birthing

Having a child can be one of the most joyful experiences available to human beings. It can change lives for the better, give us new meaning and purpose, and strengthen our romantic partnerships. On the other hand, it can also be stressful (it is almost certain to be at least a little bit stressful at times), strain relationships, trigger all kinds of difficult or confusing emotions, and, if there are complications, such as health issues or financial difficulties, can result in grief, major life changes (beyond the obvious changes required by any pregnancy and birth), and a variety of unpredictable challenges. Unplanned pregnancies can create intense strain. New parents’ unrealistic expectations or lack of preparedness can lead to myriad troubles. Being a parent is perhaps “the toughest job you’ll ever love,” and the most wonderful job you’ll ever drive yourself up a wall over. It’s great, and it’s hard!

Psychological Issues that may Arise from Pregnancy
Pre and Post-Pregnancy Depression
How Psychotherapy Can Help with Pregnancy and Birthing Issues
Difficulty Deciding Whether to Keep Child - Case Example
Relationship Difficulties after Birthing - Case Example

Psychological Issues that may Arise from Pregnancy

Pregnancy is especially challenging for the mother, and she needs lots of help and understanding from her partner, who is also under a strain. Relationship problems are likely to get worse, not better, with the arrival of a child, unless they are consciously addressed by both partners. Research shows that when both partners want a child and have basic agreements about parenting and relationship arrangements, a baby can bring a renewed sense of excitement and joint meaning to a marriage or intimate partnership. However, if there is ambivalence about the child on the part of either partner, a birth is more likely to hinder, not help, the level of harmony in a couple.

Expectant parents should keep in mind that there is a great deal of support available for them. Health clinics often offer services at low costs for families that require them. Midwives and doulas – traditional assistants to pregnant women – have had a resurgence in popularity, and can greatly enhance a mother’s sense of support and well-being. Choices about how and where to have a baby are more abundant in many places, as some families have decided that conventional hospital births are not best for them, and choose birthing centers or planned homebirths.

Pregnancy can be overwhelming, and therapy can assist mothers and their families in managing all responsibilities, choices, and emotions that can sometimes seem too much to bear.

Pre- and Post-Pregnancy Depression

Sometimes, women become depressed during or after pregnancy. Severe depression can result in a diagnosis of post-partum depression, and professional intervention is strongly recommended if depression lasts for more than a day or two, or if a mother of a new baby experiences thoughts of violence towards her child or has a break from reality, such as hallucinations or delusions. This condition is relatively rare, and some feelings of sadness, anxiety, anger or other emotions are normal and not cause for alarm (although therapy or counseling may still be quite helpful). However, if the emotions don’t go away, or if they prevent a mother from caring for her baby, it is best to seek professional intervention.

How Psychotherapy Can Help with Pregnancy and Birthing Issues

With support, raising children, even those with special needs, can be a wonderful experience; without support, it can be harrowing and upsetting on a daily basis. A familial or social support network is essential to the happiness and well-being of both parents and children. Therapy cannot replace such support, but it can be a stopgap measure if such support is lacking, it can help parents develop better support networks, and it can supplement even the best support network by providing additional information and resources and by offering a neutral, supportive space for parents to process thoughts and emotions and renew their spirit.

Difficulty Deciding Whether to Keep Child - Case Example

Tonia, 27, enters therapy due to depression after finding out she is pregnant. She is considering an abortion but is very confused and not sure what to do. She tried therapy earlier and the therapist pushed her to end the pregnancy, as she is not married and is unemployed. Tonia does not want to give her child up for adoption, but is not comfortable aborting the pregnancy either. The father of the child is not interested in helping her raise the child, and she says she does not love the man. Through therapy, Tonia is able to clarify her choices and resources. The therapist does not give her advice, but instead helps her to be firm in her own values and choices. Tonia eventually decides to keep the baby and raise it with help from her parents – not an “ideal” choice, according to Tonia, but one she “can live with.”

Relationship Difficulties after Birthing - Case Example

Dave and Karla, 30’s, enter therapy after the birth of their first child. Both were quite upset by the experience of the birth in the hospital, where they felt the care was impersonal and inattentive. Karla’s doctor insisted on a C-section after 12 hours of labor, and Karla agreed to this despite being very reluctant and wanting to continue to a normal delivery. She is angry at Dave for not supporting her; Dave reports being very confused and feeling that the doctor knew best. Therapy helps the couple recognize that in the field of gynecology, neither is an expert, and that their experience of being helpless, passive participants in the birth was not the fault of either of them, but the result of an overburdened, impersonal medical system. In therapy, the couple talks about their vision of an ideal birth experience, and agrees that in the future, when they have their planned-for second child, they will explore other options.

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