01.23.23 4 min read

Why New Moms Should See a Therapist Early in Pregnancy

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As a society, we are very reactive when it comes to mental health. Many times, I will have clients say they don’t want to meet because they feel “fine” – and therefore have nothing to talk about. In reality, it’s valuable to meet with a therapist even if you do feel fine. Read on to learn why new moms should see a therapist early in pregnancy.

When should you seek therapy?

When it comes to therapy, there is a preconceived notion to only seek therapy once something is wrong. Or, when one’s mental health has gotten to such a debilitating point one has no choice but to seek therapy.

Among the numerous maternal mental health clients I see, all but one sought out treatment prior to developing a full diagnosis. That is a failure of the systems in place, not a comment about the individuals. While I always try to help clients focus on the fact that they made it into therapy at all, there is something to be said about the importance and value of preventative care. Particularly in therapy and perinatal mood and anxiety disorders (PMAD).

Prevention doesn’t mean people should be expected to predict or know that they may develop a mental health concern. Still, I believe there is space for the culture of mental health to shift to a more proactive field.

Pregnancy and Postpartum Depression

Every mental health disorder has some degree of risk factors. Some more than others, including women at risk for developing postpartum depression and anxiety (PMADs). If preventative treatment of PMADs through therapy was more normalized, it could vastly reduce the intensity and duration. The recovery rate for moms would increase, as well as the quality of  her relationships with her baby, other children, partner, family, work, and friends. 

Postpartum mental health disorders are the number one complication that mothers experience. Not to mention, the disproportionate ways in which it affects communities of color. If that’s the case, why does the mental health field find themselves reacting to PMADs, instead of working to prevent symptoms from that very first ultrasound?

Our country seems to give mixed messages about pregnancy and motherhood. On the one hand, motherhood is expected to come “second nature” to moms. If it doesn’t, and you need support or help, there must be something wrong with you and you are left on your own.

While strides have been made, mental health has not exactly been the most supported or funded cause. Many individuals don’t find themselves rushing to a therapist for general mental health concerns, like anxiety or depression. The likelihood of perinatal mothers doing the same is probably less!

The Gaps in Mental Health

According to the New York State Department of Health, only 50% of OGBYNs screen their patients for depression. Where does this leave the other 50% of mothers who are not screened? Where does it leave the 50% of screened mothers who score positive or display signs of a PMAD? Screening is crucial, but it’s only the first step. Often, doctors and pediatricians are unsure of what next steps should be taken. This leaves a significant accessibility gap for important treatment.

If perinatal mothers had more established therapy care from the beginning, it would not only help take the burden off of medical providers but it would help eliminate significant gaps in care. This is another reason why new moms should see a therapist early on in pregnancy.

Motherhood is a massive emotional and physical shift. Dr. Diana Lynn Barnes from The Center for Postpartum Health calls it a “psychological gestation.” Particularly for new moms, there should be a greater emphasis put on mental health services in the early stages of pregnancy. There are many important preventative tests and screenings done during those nine gestational months. Yet, all too often, perinatal moms may find themselves experiencing symptoms that just don’t feel right throughout their pregnancy but are given no chance to review such concerns.

Additionally, a decline in a mom’s postpartum mental health is misattributed to baby blues or hormones. What happens at the two week mark of baby blues when a mom finds her mental health is still in decline? Pregnancy and postnatal periods are such a vulnerable time for a new birthing mom. Given how taboo mental health remains, it takes a lot for a new mom to ask for help.

Motherhood and Mental Health

As a new mom, there are a vast set of expectations from society at large, social media, friends/family, partners and oneself as to what kind of mother you should be. What happens if you find those expectations are not being met because of your mental health? It can be an extremely shaming, scary, embarrassing and confusing experience to become a new mom and feel like you need support with your mental health. This is why we should offer as many services as possible to set a mom up for success from the beginning.

What happens if you find yourself four weeks postpartum and those blues, anxiety, tearfulness, intrusive thoughts, or mania have begun? What happens if it began six months into your pregnancy? Not only can it be scary and isolating, it can also leave perinatal moms questioning their worthiness and capability in their role as a mom.

Therein lies the perfect storm. A sense of failure and a lack of information in prevention, leaving the looming question of who or how do I ask for help? Everyone can relate to their relief when someone breaks that awkward silence in the room with a question or comment, and I find that to be a similar circumstance when a perinatal woman may find herself with a therapist and she is asked about her mental health.

I can’t guarantee that early prevention and therapy in relation to PMADs will 100% prevent symptoms. But I can confidently say the significant difference in receiving therapeutic interventions early on can only support perinatal moms. Motherhood can feel lonely, isolating, and chaotic. This is why new moms should see a therapist early on in pregnancy. You deserve to set aside forty-five minutes a week to carve out space just for yourself. You deserve it.

Written by Lily McWilliam, MSW, LCSW, Zaya Provider

Zaya Care is a network of maternity care specialists covered by insurance. Lily, MSW, LCSW is passionate about working with women, mothers and pregnant women needing mental health and addiction services. Her approach to therapy is client centered and every client has their own unique needs – there is no one-size-fits-all. Click here to schedule a consultation.