Pregnancy Challenges

Here is a true thing: For many people, pregnancy is a magical, exciting time, full of promise, planning, amazement, and overwhelming love.

Here is another true thing: The above isn’t everyone’s experience.  Pregnancy and birth can be deeply complicated by emotional and medical challenges, previous trauma, identity questions, and more.  I work with pregnant and postpartum people who are trying to make meaning of some of these complications.

As with everything I do, my work with pregnant people is guided by a strength-based, feminist, queer-affirming, anti-racist, body-positive perspective.  I won’t treat you like a fragile snowflake, make assumptions about your gender identity or sexual orientation, ask you “what” you’re having (it’s a baby, I assume), or comment on your size.  I will validate your lived experiences, follow your lead in regards to how your pregnancy is impacted by your intersecting identities, and remind you of the ways you’ve demonstrated resiliency in the past.  And FFS, I’ll never put my hand on your belly.

Here are some of the pregnancy-related questions and stressors I work with:

Identity questions

A lot of pregnant people get overwhelmed when they think about how their life and identity are about to change.  We spend a lot of time and energy building our sense of self, and becoming a parent tectonically shifts that.

The truth is, your life will change after you’ve had a baby.  (Maybe it’s changed quite a lot already through pregnancy alone.)  Things will shift – your relationship, your identity, your career, your values, the way you spend your money, the way you think about time.  This is a hard thing, but the fallacy here is that it’s intrinsically a bad thing.

Identities are supposed to be fluid.  If you find that you value different things in pregnancy than you did before, and if you are uncomfortably aware that after the transition to parenthood, you’re likely to spend your time very differently, congratulations, you’re human.

And yet, there can be grief in this transition.  I support pregnant people in sitting with the ambiguity, anchoring their identities in their core values, and navigating the ways in which their lives have changed and will change.

Perinatal anxiety and depression

Most people have heard of postpartum depression, but here are two things a lot of people don’t know:

1. Postpartum anxiety is at least as common as postpartum depression.
2. Both postpartum depression and postpartum anxiety can start during pregnancy.

If you’re pregnant and you’re feeling anxious or depressed, it might be circumstantial – after all, a lot is about to change in your life, and you can’t predict or control much of it – but it also might be related to hormonal shifts and other bodily changes.

The good news is that there’s a lot you can do for postpartum (or, in this situation, perinatal) anxiety and depression.  You can talk to your doctor about lifestyle changes, such as how to get more sleep.  Your pregnancy permitting, you can move your body, or see a chiropractor, yoga teacher, or other bodyworker to alleviate your aches and pains.

And, most relevantly to this page, you can talk about the scary, overwhelming, or uncomfortable thoughts and feelings you’re experiencing.  Research shows that therapy is very effective for perinatal and postpartum anxiety and depression.

High-risk pregnancy and birth trauma

When I was 28 weeks pregnant, I went to a prenatal yoga class.  The other people in the class introduced themselves and, one by one, talked about how uncomfortable they were, and how much they hated pregnancy.  “Don’t kill me,” I said, “but I kind of love being pregnant.”

Two days later, an ultrasound specialist told me that I had placenta previa, a high-risk pregnancy condition that not only meant I would need a scheduled c-section, but that also put me at risk of beginning to hemorrhage dramatically at any moment, necessitating an emergency c-section and an extremely premature birth.  For the last two months of my pregnancy, I felt like a ticking time bomb.  I no longer loved being pregnant.

Traumatic pregnancy and traumatic birth are so fraught.  I can’t tell you how many pregnancy and birth stories I’ve heard that include the phrase, “I thought I was going to die.”  This sentiment is essentially the whole definition of trauma – an experience that was, in actuality or perception, life-threatening.

If you are in the midst of, or have had, a traumatic experience with pregnancy and birth, I can help you process it.  You won’t find any fluffy affirmations here.  I’ll never tell you to just reduce your stress and everything will be fine.  I don’t have a crystal ball.  But what I will do is remind you of who you are and the ways you’ve survived past challenges, and give you a safe place to let out all of your hard feelings.  If your traumatic pregnancy or birth experience is in the past, rather than something happening now, I’ll help you make meaning of and integrate your experience, support you in healing from the trauma, and separate it from the relationship you’re building with your baby.

Telehealth services are available to support pregnant people on bedrest and new parents who can’t get away for more than 50 minutes.

Gender dysphoria and pregnancy

If you’ve read this far, you’ve probably noticed that I use gender neutral language throughout this page.  That’s because women are not the only people who become pregnant.

Trans and nonbinary people who seek or experience pregnancy can share all of the challenges of pregnant cis women, but also have other murky waters to navigate.  Some of these challenges are logistical (clothing for pregnant people is aggressively feminine), but many are identity-related.

When you’ve worked hard to feel comfortable in your trans-ness, gestating a biological child can be a minefield of micro and macroaggressions.  Stopping hormones, trying to find an affirming obstetrician, and accessing prenatal services while repeatedly being called “mama” can be deeply invalidating.  Furthermore, if you’re male-presenting and pregnant, you might feel invisible.  (Some people talk about the assumption of a “beer belly”.)

Therapy with me is a safe space to bring both your pregnancy and all of your transness, queerness, and beyond.  I speak “pregnancy”, and I also speak “queer”.  Your pregnancy is welcomed and celebrated here.  And if it’s hard, you’ll also find unfettered support here.

Reach out

I am a Certified Perinatal Health Professional, and would love to help you navigate this difficult period.  For support in maximizing your mental health during or after pregnancy, reach out to schedule a free phone consultation now!