Signs You Should Start Therapy During Pregnancy

Why Prenatal Mental Health Support Can Change Everything

You're newly pregnant. Or trying to conceive. You're both exhausted and exhilarated.

You might be putting off starting therapy due to the mental load of pregnancy—the appointments, the planning, the physical symptoms. Sure, you notice some warning signs creeping in: racing thoughts, difficulty sleeping, low mood, unexpected tearfulness.

These aren't just "pregnancy hormones." They're signs you could benefit from professional support during this transformative time.

As a perinatal mental health therapist in Chicago, I encourage clients to come before crisis hits. Instead of waiting until you can't get out of bed or having panic attacks in the Prentice Women's Hospital parking lot, make an appointment when you first notice your mood shifting.

Why Therapy During Pregnancy Matters

The Case for Prenatal Mental Health Care

Prevention Is Powerful Research shows that untreated prenatal anxiety and depression are the strongest predictors of postpartum mood disorders. Translation: Getting help during pregnancy can prevent postpartum depression.

Your Mental Health Affects Baby This isn't meant to add guilt—it's meant to motivate support-seeking. Chronic stress and untreated mental health conditions during pregnancy can impact:

• Baby's stress response system
• Birth weight and timing
• Infant temperament
• Bonding after birth

You Deserve Support Now You don't have to wait until after birth to matter. Your wellbeing during pregnancy is important for its own sake, not just for baby's benefit.

Clear Signs It's Time for Support

When "Normal" Pregnancy Stress Becomes Something More

1. Persistent Anxiety That Disrupts Daily Life

Normal pregnancy worry:

• Occasional concerns about baby's health
• Some nervousness about birth
• Wondering if you're prepared

Time for therapy:

• Constant, intrusive worries
• Unable to enjoy pregnancy due to fear
• Googling symptoms obsessively
• Panic attacks or physical anxiety symptoms
• Can't sleep due to racing thoughts

"I couldn't stop imagining everything going wrong. Every twinge sent me spiraling." - Client, 32 weeks pregnant

2. Mood Changes Beyond "Hormones"

Expected pregnancy mood shifts:

• Some weepiness
• Occasional irritability
• Fatigue affecting mood

Therapy-worthy concerns:

• Persistent sadness lasting 2+ weeks
• Feeling empty or numb
• No joy about pregnancy
• Hopelessness about future
• Rage that feels uncontrollable

Remember: While hormones affect mood, they don't cause clinical depression or anxiety.

3. Previous Mental Health History

Seek support if you have history of:

• Depression or anxiety
• Bipolar disorder
• Eating disorders
• OCD or panic disorder
• Postpartum mood disorders
• Trauma/PTSD

Why it matters: Pregnancy can trigger recurrence. Having support in place prevents crisis.

"I'd been stable for years, but pregnancy brought my anxiety roaring back." - Client with anxiety history

4. Complicated Feelings About Pregnancy

Therapy can help if:

• Pregnancy was unplanned
• You're ambivalent about becoming a parent
• Career/life timing feels wrong
• Partner isn't supportive
• You're grieving the life you're leaving

These feelings don't make you a bad person or future bad mother. They make you human.

5. Pregnancy After Loss or Infertility

The unique challenges:

• Anxiety about another loss
• Inability to connect with pregnancy
• Survivor's guilt if others still struggling
• Fear overshadowing joy
• Hypervigilance about symptoms

Specialized support helps navigate the complex emotions of pregnancy after struggle.

6. Traumatic Experiences Resurfacing

Pregnancy can trigger past trauma:

• Sexual assault or abuse
• Medical trauma
• Childhood trauma
• Previous birth trauma
• Body autonomy issues

Body changes and medical procedures during pregnancy can reactivate trauma. EMDR and trauma-informed therapy help.

7. Relationship Stress Escalating

Warning signs:

• Increased conflict with partner
• Feeling unsupported or alone
• Partner's mental health struggles
• Family boundary issues intensifying
• Isolation from support system

Pregnancy amplifies existing relationship dynamics. Therapy provides tools before baby adds more stress.

8. Identity and Body Image Struggles

Beyond normal adjustment:

• Severe body image distress
• Eating disorder behaviors
• Identity crisis about motherhood
• Grief over changing body
• Disconnection from self

"I didn't recognize myself anymore—physically or emotionally." - Client, second trimester

9. Overwhelming Life Stressors

When pregnancy coincides with:

• Job loss or change
• Moving homes
• Family illness or death
• Financial stress
• Other major transitions

Multiple stressors increase risk for perinatal mood disorders significantly.

10. Your Gut Says Something's Wrong

Trust yourself if:

• You feel "off" but can't explain
• Something feels different from normal
• You're worried about your mental state
• Others express concern
• You're asking "Is this normal?"

If you're wondering whether you need support, you probably do.

Common Barriers to Seeking Help

What Holds Pregnant Women Back

"I Should Be Happy" Pregnancy is supposed to be joyful, right? This myth prevents women from acknowledging struggle. You can be grateful for pregnancy AND need support.

"It's Just Hormones" While hormones influence mood, they don't negate the need for help. Therapy works regardless of cause.

"I Don't Have Time" Between OB appointments, prenatal classes, and preparation, adding therapy feels impossible. But investing time now saves crisis time later.

"What Will People Think?" Stigma around prenatal mental health persists. Remember: Getting help is responsible parenting, not weakness.

"I Should Wait Until After Birth" Why suffer for months? Plus, untreated prenatal symptoms often worsen postpartum.

Benefits of Starting Therapy During Pregnancy

What You Gain

Immediate Relief

• Coping strategies for current symptoms
• Safe space to process feelings
• Validation and support
• Anxiety reduction techniques

Birth Preparation

• Process birth fears
• Develop pain coping strategies
• Plan for postpartum support
• Communicate needs to partners

Postpartum Prevention

• Identify warning signs early
• Build coping skills now
• Establish therapeutic relationship
• Create postpartum plan

Relationship Strengthening

• Improve partner communication
• Set family boundaries
• Navigate role transitions
• Build support network

What to Expect in Prenatal Therapy

How We Support Pregnant Women

Safe, Judgment-Free Space All feelings welcome—including the scary, shameful, or confusing ones.

Practical Strategies

• Sleep hygiene for pregnancy insomnia
• Anxiety management techniques
• Mood regulation skills
• Stress reduction practices

Birth and Beyond Planning

• Process fears and expectations
• Postpartum support planning
• Feeding decision support
• Return-to-work preparation

Collaborative Care We coordinate with your OB/midwife when helpful, ensuring comprehensive care.

Finding the Right Therapist

What to Look For

Essential Qualifications:

• Licensed mental health professional
• Perinatal mental health training
• Experience with pregnancy/postpartum
• Understanding of local resources

Green Flags:

• Validates your experience
• Doesn't minimize concerns as "just hormones"
• Flexible scheduling for pregnancy needs
• Offers postpartum continuity

Questions to Ask:

• Do you specialize in perinatal mental health?
• What's your experience with [your specific concern]?
• Can we continue after birth?
• Do you coordinate with OB providers?

Chicago-Specific Resources

Local Prenatal Mental Health Support

Therapy Practices:

• KMH Counseling (Bucktown) - Perinatal specialists
• Postpartum Wellness Center of Chicago
• Northwestern Medicine Perinatal Mental Health

Support Groups:

• Prentice Women's Hospital groups
• Chicago Postpartum Depression Alliance
• Bloom Maternal Wellness

Immediate Needs:

• Postpartum Support International: 1-800-944-4773
• Crisis text line: Text HOME to 741741

Taking the First Step

How to Start

1. Acknowledge the Need Recognizing you need support is brave, not weak.

2. Research Providers Look for perinatal specialists in your area or via telehealth.

3. Schedule Consultation Most therapists offer brief calls to ensure fit.

4. Prepare for First Session

• List current symptoms
• Note pregnancy details
• Bring partner if desired
• Ask questions

5. Commit to Process Give therapy several sessions to help.

A Message to Pregnant Women

You Deserve Support

Pregnancy is monumentally challenging—physically, emotionally, spiritually. Adding therapy to your care team isn't excessive; it's essential.

You're not weak for struggling. You're not selfish for needing support. You're not broken for finding pregnancy hard.

You're a woman navigating one of life's biggest transitions, and you deserve all the support available.

When to Seek Immediate Help

Crisis Situations

Call 988 or 911 if experiencing:

• Thoughts of harming yourself or baby
• Hallucinations or delusions
• Severe panic attacks
• Complete inability to function

These are medical emergencies requiring immediate care.

Start Your Support Journey

If any of these signs resonate, don't wait. Prenatal therapy can transform your pregnancy experience and set the foundation for healthier postpartum adjustment.

Schedule Prenatal Therapy Consultation

Remember: Seeking therapy during pregnancy isn't just self-care—it's prenatal care. Your mental health matters as much as your physical health.

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About the Author: Katherine Hayes, LCPC, is a perinatal mental health specialist in Chicago, supporting women from conception through postpartum. She provides evidence-based, compassionate care from her Bucktown practice.