Perinatal Depression
Persistent low mood, loss of interest, and hopelessness during pregnancy or after birth. One of the most common perinatal concerns, and highly treatable with the right support.
Learn more
Trauma Care Psychology
Therapy for Perinatal Mental Health in Ontario
Pregnancy and the postpartum period can bring profound joy and profound difficulty at the same time, and if this season has felt harder than you expected, or harder than you feel allowed to admit, you are not failing at this. Our clinicians in Toronto and across Ontario offer compassionate, evidence-based support for perinatal depression, anxiety, birth trauma, and more.
Now Accepting New Clients · Virtual & In-Person · Ontario
Understanding the Condition
What is Perinatal Mental Health?
The period during pregnancy and in the year after birth is one of the most significant emotional transitions a person can go through. It is considered a period of vulnerability for mental health due to the impact that hormonal, identity, social and psychological changes have. It does not always "feel" the way society says it should. Perinatal mental health conditions include depression, anxiety, birth trauma and PTSD, intrusive thoughts, and the emotional impact of pregnancy loss, infertility, and complications. They affect roughly 1 in 5 new birthing parents and a significant number of non-birthing partners too.
They are among the most common complications of childbearing and among the most undertreated, because of stigma, the pressure to appear joyful, and the fear that asking for help means failing. Untreated perinatal mental health difficulties affect both the parent and the baby. Treatment is safe, effective, and does not require you to reach a crisis point first.
Common symptoms
Persistent low mood or hopelessness
Feeling sad, empty, or despairing in a way that does not lift. Difficulty bonding with the baby or feeling emotionally disconnected from the pregnancy or newborn.
Excessive anxiety and worry
Persistent, difficult-to-control worry about the baby's health, safety, or wellbeing. Fear of being alone with the baby or of doing something wrong.
Intrusive thoughts
Unwanted, distressing thoughts about harm coming to the baby. These are ego-dystonic and reflect anxiety or OCD, not intent. They are more common than most people realize.
Birth trauma symptoms
Flashbacks, nightmares, or avoidance related to a traumatic birth experience. Fear of future pregnancies or medical settings.
Emotional numbness or detachment
Feeling disconnected from the baby, the pregnancy, or oneself. Going through the motions without feeling present or emotionally engaged.
Rage or irritability
Intense anger or irritability that feels disproportionate, often alongside shame about these feelings in the context of new parenthood.
Causes & Risk Factors
Who Develops Perinatal Mental Health Concerns and Why
Perinatal mental health conditions develop through a combination of biological, psychological, and social factors. Hormonal changes during and after pregnancy, sleep deprivation, the identity transition of new parenthood, relationship changes, and loss of previous roles and freedoms all contribute. Prior mental health history significantly increases risk.
Birth trauma develops when the birth experience involves perceived or actual threat to life, loss of control, feeling unseen or unheard by medical staff, emergency procedures, neonatal complications, or previous traumatic experiences that are reactivated by the birth. The subjective experience of the birth matters more than what happened objectively.
Risk factors
- Previous history of depression, anxiety, or trauma
- History of pregnancy loss, infertility, or complicated fertility treatment
- Traumatic birth experience or emergency intervention
- Limited social support from partner, family, or community
- Significant relationship stress or domestic conflict
- Premature birth or neonatal illness
- Ambivalence about pregnancy or parenthood
Our Approach
How we treat Perinatal Mental Health Concerns
We provide compassionate, evidence-based therapy specifically for perinatal mental health concerns. Our clinicians understand the unique context of pregnancy and new parenthood and approach this work without judgment. Treatment is adapted to accommodate the realities of caring for an infant and the specific demands of the perinatal period. Our founder, Dr. Arela Agako, has published peer-reviewed research specifically in this area, including a randomized controlled trial on CBT for perinatal anxiety and a pilot study on DBT skills for emotion dysregulation during the perinatal period.
Cognitive Behavioural Therapy (CBT)
Highly effective for perinatal anxiety and depression. Addresses unhelpful thinking patterns, worry, and the avoidance behaviours that maintain difficulty during the perinatal period.
Learn more →Acceptance and Commitment Therapy (ACT)
Reduces anxiety, intrusive thoughts, and avoidance. Supports reconnection with values and meaning in the parenting role.
Learn more →Dialectical Behaviour Therapy (DBT)
Builds emotion regulation and distress tolerance skills relevant to the emotional demands of new parenthood.
Learn more →Cognitive Processing Therapy (CPT)
For birth trauma and perinatal PTSD, addresses trauma-related beliefs and reduces intrusive symptoms.
Learn more →Emotion Focused Therapy (EFT)
Supports bonding, attachment, and the emotional processing of grief and identity change in the perinatal period.
Learn more →Trauma-Informed Couples Therapy
For couples navigating the relational impact of perinatal mental health challenges together.
Learn more →Related Concerns
Common Perinatal Mental Health Concerns
Nearly half of Canadian mothers and birthing parents report challenges with their emotional or mental health during pregnancy or after birth. Here are the concerns we see most often, and where to find out more about each.
Perinatal Anxiety
Excessive worry about the baby's health and safety, difficulty relaxing, or a persistent sense of dread. Often overlaps with depression but can also occur on its own.
Learn morePerinatal OCD & Intrusive Thoughts
Unwanted, distressing thoughts about harm coming to the baby, often followed by checking or avoidance behaviours. These thoughts are a recognized symptom, not a sign of danger to your child.
Learn moreBirth Trauma & Perinatal PTSD
Flashbacks, nightmares, or avoidance following a birth experience that felt frightening, out of control, or medically traumatic, regardless of the outcome.
Learn morePregnancy Loss, Infertility & Grief
The grief that follows miscarriage, stillbirth, infertility, or a difficult fertility journey is real and deserves support, even when it goes unacknowledged by others.
Learn morePerinatal Bipolar Disorder
Pregnancy and postpartum are high-risk periods for mood episodes in people with bipolar disorder. Close monitoring and a coordinated care team make a significant difference.
Learn morePostpartum Psychosis
A rare but serious condition involving confusion, hallucinations, or delusions, usually within the first two weeks postpartum. This is a psychiatric emergency: please seek immediate medical care through your hospital or emergency department.
The Recovery Journey
What to expect from treatment
You might come to a session running on no sleep, still in yesterday's clothes, or with the baby in tow, and none of that gets in the way of the work. Treatment meets you in the middle of this season exactly as it is, at whatever pace you have the capacity for right now.
You do not have to feel guilty about getting help
Getting support right now is not selfish or something you're taking away from your baby. It's something you're doing for both of you. Untreated struggles during this period affect the whole family, including the bond you're trying so hard to build.
You can say the unsayable thoughts out loud
So many parents carry the same frightening, unwanted thoughts in silence because they're scared of what saying them out loud might mean. Here, you can say them, and you will be met with understanding, not alarm.
Your birth experience does not have to "make sense" to be traumatic
It does not matter if your baby is healthy or if everyone keeps telling you to just be grateful. If your birth experience left you shaken, that is real, and it deserves care.
Sessions work around your baby, not the other way around
Feedings, naps that never happen on schedule, a baby who will not be put down: we plan around all of it. Virtual sessions are available for the days when leaving the house just is not realistic.
Related Conditions
How Perinatal Mental Health differs from related conditions
vs.
Baby blues
The baby blues involve mild mood changes in the first one to two weeks after birth, affecting up to 80 percent of new parents. They resolve on their own. Perinatal depression and anxiety are more severe, longer-lasting, and require treatment.
vs.
Postpartum psychosis
Postpartum psychosis is a rare but serious condition involving hallucinations, delusions, and confusion, typically emerging within the first two weeks postpartum. It requires urgent medical attention. It is distinct from perinatal depression and anxiety.
vs.
General anxiety or depression
Perinatal mental health conditions share features with general anxiety and depression but occur in the specific context of pregnancy and new parenthood, with unique contributing factors and treatment considerations.
Frequently Asked Questions
Common questions about Perinatal Mental Health
Is what I'm feeling normal?
It's common to feel things during pregnancy and after birth that catch you off guard, including feelings you don't think you're allowed to have. The baby blues affect up to 80 percent of new parents in the first couple of weeks and pass on their own. If what you're feeling is more intense, lasts longer, or is making it hard to function or feel connected to your baby, that is worth talking to someone about, and reaching out is never an overreaction.
What if I am having thoughts about harming my baby?
First, please know that intrusive thoughts about harm coming to your baby are a common symptom of perinatal anxiety and OCD, not a reflection of your intentions, your character, or the kind of parent you are. Many parents carry this fear silently because they are terrified of what it might mean, when in reality it means the opposite of what they fear. Please speak with a clinician as soon as you can. These thoughts respond well to treatment, and having them is not a reason anyone would take your baby away.
Will I need to go on medication?
Not necessarily. Psychotherapy alone is often enough, and it is completely safe during pregnancy and while breastfeeding. If medication ever becomes part of the conversation, that decision is made carefully and collaboratively with your physician or psychiatrist, never assumed or pushed on you.
Can fathers and non-birthing parents experience perinatal mental health difficulties?
Yes, and this often gets overlooked. Partners of birthing parents are also at real risk for perinatal depression and anxiety, particularly when supporting a partner through their own mental health challenges, a traumatic birth, or neonatal complications. Whatever role you played in bringing your baby into the world, your struggle is just as real, and support is available to you too.
What if I am struggling but do not feel like a bad enough case to seek help?
Please do not wait to feel bad enough to deserve support; that threshold does not need to exist. If your mental health is affecting your daily functioning, your relationship with your baby or partner, or simply your quality of life, that is already sufficient reason to reach out. You do not need to reach a crisis point before accessing care, and getting help earlier tends to make things easier, not harder.
Take the First Step
Compassionate perinatal mental health therapy in Ontario. Support for pregnancy, postpartum, and birth trauma.
Our clinicians will help you find the right treatment fit and build a plan that works for you.
Book a Free Intro CallVirtual & In-Person · Ontario
Getting Started
Starting therapy is simple and supportive.
- 1
Get in touch by booking a call online with our intake coordinator or by completing the contact form. You can also email admin@traumacarepsychology.ca or call (647) 456-7500.
- 2
Complete a 20-minute intake call so we can determine the best therapist fit and treatment direction. Alternatively, browse our clinician directory and book a free 20-minute consultation directly with a clinician you feel is a good fit.
Browse our clinician directory → - 3
Schedule your first session and begin a personalized treatment plan based on your goals and concerns.
→
Contact Us
Fill out the form and our intake coordinator will be in contact shortly.
Virtual care across Ontario · In-person in Toronto.