Pregnancy &
The Transition to Parenthood
The perinatal period — from fertility and pregnancy through postpartum and early parenthood — can push you to places you've never been before. It can be overwhelming, disorienting, and at times deeply unfamiliar, even when it's something you wanted or planned for. Many people find themselves wondering whether what they're feeling means something is wrong with them, or whether they're failing in some way. These feelings are more common than people realize, and they deserve attention and support.
Below we describe common issues that we see and how we can help. Click on the links below or scroll down to see the full list.
Pregnancy & Prenatal Mental Health
Pregnancy is often portrayed as a time of pure joy and anticipation — glowing, radiant, uncomplicated. But for many people, it's also a time of profound change, uncertainty, and stress. Your body is changing in ways that can feel unfamiliar, uncomfortable, and outside your control. Your identity is shifting. And alongside the excitement, there is often ambivalence, worry, and a sense of not knowing what comes next.
The concerns that come up during pregnancy are wide-ranging. How will this change my relationship? My friendships? My career? Will I be able to handle the demands of parenthood? For those adding to their family, new questions arise: Will I be able to love another child as much as I love my first? Will I be able to handle it? Will this disrupt what we've already built? These are not signs of being unprepared or ungrateful — they are a normal part of navigating one of life's biggest transitions.
Pregnancy is also a time full of expectations. You may have your own expectations for how you'll feel emotionally during your pregnancy, how gracefully you'll handle the physical changes, how you'll prepare for the baby, how organized you'll be, how you'll perform at work while pregnant. Other people — friends, family, coworkers, strangers on the street — are likely to have their expectations of you too, and they may let you know about them in both appropriate and inappropriate ways.
These expectations can feel heavy and sometimes impossible to meet, and you may feel like you're bound to disappoint someone, including yourself. One thing that often surprises people is feeling disappointed, or like they've let others down, upon learning the sex of the baby. There can be real loss in letting go of what you had imagined and having to adjust expectations. This can be uncomfortable to admit and can bring on significant guilt. But these experiences are more common than people know, and they don't reflect how much you will love your child or what kind of parent you will be.
Women's mental health has been notoriously understudied and underreported, and for a long time it was considered taboo to talk about the difficulties of pregnancy and postpartum. We are finally hearing more about the challenges that women face during the postpartum period, but the conversation about psychological wellbeing during pregnancy is still evolving. Given all of these changes, uncertainties, and the weight of expectations, pregnancy can be a very vulnerable time when we are more susceptible to anxiety and depression. This isn't something to fear — it's something to be aware of, so that you don't mistake a common experience for something being fundamentally wrong with you, or for a sign that you shouldn't be a parent. If you have a history of anxiety, depression, or other mental health concerns, connecting with a therapist during pregnancy — or even before — can be reassuring. Not because you have to, but because having support already in place can make a real difference if things become harder.
Therapy during pregnancy offers a space to process all of this — the physical experience, the identity shifts, the worries, the ambivalence, the expectations and disappointments — and to prepare for what's ahead. Depending on what feels most useful, it can also help you think through how you want to approach parenthood, how to talk to your partner, and how to build the support you'll need.
The Transition to Parenthood
Becoming a parent is one of the most significant transitions a person can go through — and one of the most demanding. It brings enormous joy for many people, but also exhaustion, uncertainty, and a shift in nearly every aspect of life: your identity, your relationships, your priorities, your sense of self. These changes can feel disorienting even when they are wanted, and the mixed emotions that come with them are more common than our culture tends to acknowledge. And even for those who find this time largely joyful, there can still be aspects of the transition that are worth exploring with support.
We live in a time of particularly high expectations for parents. Social media presents images of parents doing it all without complaint — meeting every need, providing every opportunity, maintaining beautiful homes and thriving relationships. The abundance of information available online means there is always something else you could be doing, always a way you might be falling short. Our culture has also become increasingly child-centric — in some ways a positive development, but one that can mean parents consistently place their own needs last, sometimes to the point of losing touch with themselves.
For birthing parents, this transition involves what researchers and clinicians now call matrescence — a term coined to capture the profound hormonal, physical, and psychological transformation that accompanies becoming a mother, paralleling in many ways the intensity of adolescence. Birthing parents may feel like they don't recognize themselves, that their values and priorities have shifted, that the frameworks they once used to make decisions no longer apply. Recent research also shows that non-birthing partners go through their own significant hormonal and psychological changes during this time — less extreme than those of birthing parents, but real and often underacknowledged.
This is also a time when couples tend to experience more conflict. Research from the Gottman Institute found that nearly two-thirds of couples experience a significant decline in relationship satisfaction and an increase in conflict within the first three years of having a baby. This is largely due to the enormous demands of early parenthood that can be depleting for both parents, and it's not necessarily a sign that the relationship is broken or can't recover. Knowing this can be reassuring. And while it may feel like yet another ask of an already exhausted couple, getting support during this time can make a real difference.
Our perinatal and postpartum therapists understand the unique challenges of this transition — the identity shifts, the relationship strain, the weight of expectations, and the exhaustion of navigating early parenthood in a world that offers a great deal of advice and not nearly enough support. Therapy can help you process what you're going through, balance your own needs alongside others', and navigate the competing demands of this time. It can also help you clarify what you value most — as a parent, as a partner, and as a person — which can itself bring a sense of direction when everything feels uncertain.
Single Mothers & Parents By Choice
Choosing to become a parent on your own is a significant decision. For some people, this has always felt like the right path. For others, it came after hoping to find a partner and deciding not to wait any longer. Either way, the path to parenthood as a single parent by choice is rarely straightforward.
Many single parents by choice must navigate fertility treatment, IVF, and third-party reproduction — with all the financial, emotional, and logistical demands that entails — without a partner to share the burden. Medical and administrative systems weren't always designed with their family structure in mind. Forms that ask for a father's name, providers who make assumptions, and institutions that require them to prove their fitness as parents in ways that coupled parents never have to — these experiences are common and can feel exhausting and demoralizing.
The social dimension of single parenthood by choice can bring its own challenges. People may not understand your family structure, ask intrusive questions, or respond with confusion or judgment — even when they mean well. Explaining your situation to friends, family, coworkers, and others can feel like an ongoing labor. The anticipation of judgment can be as tiring as the judgment itself. There may also be moments of grief or complexity along the way, whatever path brought you here.
We work with single parents by choice with respect for the decision and an understanding of the unique challenges it can bring. Therapy can help you navigate the complexity and the full range of emotions that may accompany this path, and build the support you need.
Women of Color
The data on Black maternal health is stark and well-documented. Black women in the United States experience maternal mortality rates more than three times higher than those of white women — a disparity that persists across income and education levels. Black women also experience higher rates of perinatal mood and anxiety disorders (PMADs), and face greater barriers to accessing care. These are not abstractions — they are real risks that Black women navigating pregnancy and the postpartum period have every reason to be aware of and feel concerned about.
The fear and anxiety that can accompany pregnancy as a Black woman are not irrational. They are a reasonable response to a system that does not always provide equitable care. So are feelings of frustration and injustice. These feelings deserve to be acknowledged and taken seriously.
Women of color more broadly may also face additional layers of stress during the perinatal period — including navigating healthcare systems that may not fully see or understand their experience, cultural expectations around strength and self-sufficiency that can make it harder to ask for help, and concerns about whether the support they seek will truly understand where they're coming from.
Therapy can offer a space where your experience is understood in its full context — including the systemic realities that shape it.
LGBTQ+ Families
Building a family as an LGBTQ+ person or couple often involves navigating obstacles that others don't face. Many LGBTQ+ families must pursue IVF or third-party reproduction from the outset, without a medical diagnosis of infertility to help justify insurance coverage. This means facing additional financial burden, fighting harder, and jumping through more hoops than heterosexual couples in similar situations. The process can feel deeply unfair — and the research confirms that it is.
The medical and administrative systems that surround family-building were largely designed with heterosexual couples in mind. Forms that ask for "mother" and "father," providers who make assumptions or use incorrect language, and institutions that require LGBTQ+ families to prove their fitness as parents in ways others never have to — these experiences are common. Beyond the medical system, LGBTQ+ families may also encounter lack of support or acceptance from their own families or communities, and the ongoing labor of navigating a world that doesn't always make room for their family structure.
Research shows that LGBTQ+ individuals experience higher rates of perinatal mood and anxiety disorders (PMADs) than the general population, largely driven by the cumulative effects of these stressors.
We are an LGBTQ+ affirming practice. We recognize that understanding the experiences of LGBTQ+ families is an ongoing process, and we approach this work with humility and a genuine commitment to learning. We also recognize that no two LGBTQ+ families are the same — the challenges you face and the support you need will be specific to you. Our goal is to offer care that is genuinely informed by your circumstances and tailored to your experience.
Our Perinatal Specialists
The perinatal period brings its own distinct psychological landscape, and not all therapists are trained to navigate it. Our perinatal specialists know how to recognize and treat the full range of perinatal mood and anxiety disorders (PMADs) as they specifically present during pregnancy and the postpartum period, provide psychoeducation tailored to this time, and know when a referral to other services would be helpful. Often, understanding that what you're experiencing is a recognized and common response to this period — rather than a sign that something is fundamentally wrong with you — can itself bring significant relief. We work with the full range of perinatal experiences — from clinical conditions like PMADs to the broader emotional challenges that this period can bring, with or without a formal diagnosis.
Our director has completed advanced training in perinatal mental health psychotherapy through Postpartum Support International and the Seleni Institute, and is a Gottman Bringing Baby Home educator, with specialized training in supporting couples through the transition to parenthood. Our team brings broad experience across the full perinatal continuum, from fertility and pregnancy through postpartum and early parenthood.
We also understand the practical realities of new parenthood. We offer in-person sessions in Princeton, NJ, virtual sessions, and hybrid arrangements — whatever works best for you in the moment. New parents are welcome to bring their infants to sessions when childcare isn't available. We've found this works well before babies become mobile, and our priority is making support accessible to new parents in whatever way we can.
Get in Touch
Whether you're ready to get started or just have questions, feel free to reach out — we're happy to help you figure out your next steps. We're available in person in Princeton, NJ and virtually across NJ, NY, and more than 40 states. You can contact us by text, email, or through the form below to schedule a free 15-minute phone consultation.
If you are having thoughts of harming yourself or others and feel like you might act on them, or find yourself thinking of a plan, this is an emergency. Please call or text 988 (the Suicide and Crisis Lifeline), reach out to a mental health provider, or go to your nearest emergency room.