Therapy for Reproductive, Pregnancy, and Postpartum Mental Health
I provide therapy for adults navigating reproductive and perinatal mental health concerns, including: depression, anxiety, and OCD during pregnancy and postpartum, birth trauma, the transition to parenthood, grief after pregnancy and neonatal loss, infertility, hormonal changes, menstrual concerns, and invasive medical procedures. Reproductive mental health refers to how reproductive events, life transitions, and stressors across the lifespan can have on mental health and well-being.
I completed a specialized Residency in Reproductive Psychology at the UNC Chapel Hill School of Medicine — one of very few programs in the country offering dedicated, expert-level clinical training in therapy for adults experiencing a variety of mental health concerns across the full reproductive lifespan. I also hold the Perinatal Mental Health Certification (PMH-C) through Postpartum Support International, a nationally recognized credential for clinicians with demonstrated expertise in perinatal mental health.
✺ What encompasses reproductive mental health? ✺
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The perinatal period encompasses pregnancy and up to 1 year postpartum, although I believe that the postpartum period can impact people much longer.
About 1 in 5 birthing parents experience anxiety, depression, intrusive thoughts, or mood changes at significant levels during pregnancy or postpartum. Perinatal mood and anxiety disorders (PMADs) are the most common complication of childbirth, and they can impact people who have never had mental health concerns before. Cognitive behavioral therapies are highly effective for treating PMADs.
Symptoms of PMADs can include:
constant worry that is difficult to control
scary, intrusive and unwanted thoughts or images
fear of letting others care for the baby
feeling like something terrible is going to happen to the baby
irritability
sadness and frequent crying
often feeling guilty
feeling disconnected, overwhelmed, or numb
not able to enjoy moments of parenting
difficulty bonding with their baby
I also support partners who are experiencing mental health changes as they adjust to parenthood, and people who had mental health concerns before pregnancy and want to be proactive to prevent worsening of symptoms.
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I provide evidence-based PTSD treatment for adults who have experienced trauma in medical, reproductive, and other contexts, including survivors of sexual violence whose trauma is being reactivated by healthcare experiences.
Experiences during pregnancy, birth, postpartum, or medical care can sometimes feel overwhelming or frightening—especially when they involve feeling out of control, dismissed, helpless, rushed, or risk of harm to the birthing person, fetus, or baby. Navigating medical complications, emergency procedures, loss, difficult decisions about care, and time spent in medical settings (such as NICU, PICU, labor and delivery, fertility, and oncology clinics) can also be emotionally intense. These experiences can bring up memories or emotions tied to prior trauma. Infant feeding and caregiving can also bring up distressing reminders of prior trauma.
I also support clients whose current reproductive or medical experiences are reactivating prior trauma — including histories of discrimination, intimate partner violence, sexual violence, and medical trauma.
Some people develop posttraumatic stress symptoms after experiencing medical trauma, including intrusive memories or nightmares about the trauma, avoiding reminders of the trauma, being constantly on guard, startling easily, trouble sleeping, difficulty making decisions, and changes in how they see themselves, others, and the world. For some, these symptoms fade with time, though for others, the trauma continues to significantly impact how they feel and how they move through their life.
I provide Prolonged Exposure and Cognitive Processing Therapy, which are the gold standard treatments for Posttraumatic Stress Disorder (PTSD). Therapy to process trauma can often be helpful whether it is a few months after a traumatic event, or many years later. I also work with clients to create coping plans for upcoming invasive or stressful medical procedures (such as pelvic exams, fertility treatment, vaginal or cesarean birth, or cancer diagnosis and treatment procedures) so that they can communicate their needs for support, preferences, and boundaries with their healthcare providers.
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Pregnancy loss, neonatal loss, stillbirth, infant loss, or terminating a pregnancy for medical reasons can be devastating. Grief is a normal, non-linear process and cannot be rushed.
People often carry sadness, anger, confusion, guilt, shame, and a sense of powerlessness after loss. It is also common to feel like no one truly understands the reality and the impact of what happened, or that others are afraid to talk about the loss. Some people also hear harmful messages such as “at least you know you can get pregnant.”
I often utilize Acceptance and Commitment Therapy (ACT) for grief work. ACT involves exploring what each client values, practicing noticing and validating their emotions, giving language to the loss and how it is impacting them, and trying out ways of coping. Together, I work with clients to begin to live alongside grief without erasing the pregnancy or person who was loved and wanted.
I also work with clients navigating trying to conceive, pregnancy, and welcoming a baby after loss.
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Sometimes, childbirth itself can bring unexpected grief or disappointment, even when everyone is physically healthy. Parents can feel sadness or anger about how the experience unfolded, a sense of disconnection, or loss of the birth they hoped for. These feelings are valid and worth attention, even if someone doesn’t identify their experience as traumatic.
I work with clients to make sense of what happened and integrate the experience into their story. Often people are told that they should be grateful that everyone is alive and healthy, but that can prevent the opportunity for someone to seek support in processing their labor and delivery experience.
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Making decisions regarding family building can often be challenging and stressful. It is common to feel ambivalent about pregnancy or the decision to have a child, have difficulty weighing important factors, and question one’s decisions or preferences.
These decisions also include considering LGBTQ+ family building options, childfree living (by choice or not by choice), if/when to try to conceive, fertility preservation, pursuing assisted reproduction, considering selective reduction, pregnancy termination, and choosing single parenthood; I welcome and support all types of family building related decisions.
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Bringing a baby into your life can feel joyful and also destabilizing. Often, parents can feel like they are on a rollercoaster, including feeling anxious, exhausted, resentful, overstimulated, or numb. It is normal for people to grieve the version of themselves and their family that they were before the baby was born. This can happen with a first child or any subsequent child.
In therapy, I work with both birthing and non-birthing parents on various aspects of this experience including:
Navigating identity shifts and making space for all aspects of you as a person
Reducing self-judgment, self-questioning, and comparison to other caregivers
Practicing emotion and nervous system regulation when feeling overwhelmed or overstimulated by children’s needs
Coping with distress related to feeding challenges and decisions
Working toward intergenerational healing, boundary-setting, and caring for yourself when childhood wounds resurface
I work with clients to move toward caregiving that feels sustainable, self-honoring, and aligned with their values.
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Hormonal shifts can affect mood, anxiety, energy, thinking, and physical comfort throughout each menstrual cycle and throughout the reproductive lifespan. These shifts can be natural or medically induced.
I work with clients on coping with relevant concerns such as:
Premenstrual symptoms, including Premenstrual Dysphoric Disorder
Polycystic Ovary Syndrome, endometriosis, autoimmune or endocrine conditions that can impact mental health, reproductive health, and trying to conceive
Lactation, chestfeeding, and weaning, including Dysphoric Milk Ejection Reflex (D-MER)
Pelvic pain
Medically induced or natural perimenopause symptoms, and the menopause transition
I use cognitive behavioral strategies in my work with clients to cope with emotional and physical symptoms, reduce shame, and approach these challenges with more support. I view hormonal shifts and cycles as parts of the human experience that can bring both difficulty and wisdom, not as personal flaws or pathology.
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It is common to feel anxiety, dread, or anger about invasive procedures, high-stakes medical decisions, or navigating health systems that do not feel supportive or emotionally safe.
In therapy, clients and I can work together to:
Prepare for stressful or invasive procedures like pelvic exams, egg retrieval, vaginal birth, cesarean birth, endometriosis excision surgery, cervical or breast biopsies, or cancer surgeries, pelvic radiation and brachytherapy
Cope with complex decisions about preventive surgeries (such as mastectomy or oophorectomy), fertility preservation, or cancer treatment
Cope with invasive fetal or infant procedures and making stressful medical decisions during pregnancy, NICU or PICU care
Cope with uncertainty and symptom management related to chronic health conditions before pregnancy, during pregnancy, or pregnancy complications
Regain a sense of agency in medical care settings after feeling dismissed, pressured, or mistreated by medical providers
Many clients come to therapy not only to cope in the moment, but to be able to stay engaged in their own care and their child’s care long-term without shutting down or avoiding.
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Many medical providers face moments in their careers when they feel burned out, exhausted, or that a medical case is weighing on them. Therapy is an avenue to process those stressors and find a path forward. Often this looks like building coping strategies to use in and out of work, building in restorative activities in one’s personal life, and re-evaluating bandwidth.
I often provide therapy for PTSD to medical professionals who are recovering from witnessing a traumatic medical experience with a patient at work, or a series of severely stressful workplace events. Often people come to therapy noticing constant thoughts of “could I have done more?”, experiencing cases are haunting them and replaying in their minds, and feelings of guilt, shame, or anger. These medical cases may also bring up painful reminders of previous traumatic medical experiences or losses that the provider has experienced in their own life.
Some providers are carrying grief or anticipatory grief related to losing patients in their care. It is an honor to hold space for providers who are struggling to hold the weight of trying to care for others in a moment of crisis or complications, or long term chronic illness and uncertainty about a patient’s recovery.
I enjoy working with birth workers and medical professionals who provide OB/GYN care, inpatient care, PICU and NICU care, pediatrics, oncology, anesthesiology, ICU, emergency medicine, and surgery contexts. All types of medical professionals are welcome.
If you are navigating perinatal mood and anxiety symptoms, birth trauma, the transition to parenthood, grief after loss, fertility and family-building stressors, medical trauma, or hormonal or menstrual concerns, I may be a good fit. I offer telehealth therapy to adults in North Carolina and many PSYPACT states. You can contact me here.
Personalized therapy for adults in North Carolina, California, and PSYPACT states