Perinatal mental health

Perinatal mental health covers the emotional and psychological difficulties that can arise during pregnancy and in the first two years after birth, including depression, anxiety, intrusive thoughts and reactions to a difficult birth. These difficulties are common, and they respond well to the right support at the right time.

We provide clinical psychology support for adults across Brighton and East Sussex, working online with people from Hove, Kemptown, Preston Park, Hanover, Withdean and Portslade, as well as the wider BN1 and BN2 postcodes. Sessions take place remotely, so where you live locally makes no difference to how support is arranged.

What is perinatal mental health?

The perinatal period stretches from conception through pregnancy to around two years after birth. Hormonal change, sleep disruption, the physical impact of pregnancy and birth, and the sheer scale of adjusting to a new baby all interact with someone’s existing mental health history. Some people develop difficulties for the first time in this period; others find that an existing condition such as anxiety or obsessive compulsive disorder becomes harder to manage. Difficulties can also follow a difficult, medicalised or traumatic birth, a loss, or a baby needing neonatal care, regardless of how a pregnancy or delivery might look from the outside. These difficulties are common, well documented in NICE guidance on antenatal and postnatal mental health, and they are not a reflection of failing as a parent.

Signs of perinatal mental health difficulties

Signs vary from person to person and can include persistent low mood, tearfulness, numbness or feeling disconnected from the pregnancy or the baby, alongside practical struggles with sleep, appetite and concentration. Anxiety often shows up as constant worry about the baby’s health or safety, checking behaviours, or a racing mind that will not settle even when the baby is safe and settled. Some people experience unwanted, frightening thoughts, for example about harm coming to the baby, which can be distressing but are a known feature of perinatal anxiety and perinatal obsessive compulsive disorder rather than a sign that harm is intended or likely. Flashbacks, nightmares, avoidance of anything that recalls the birth, or a strong wish to avoid another pregnancy can point to a traumatic response to birth. Rarer but more serious symptoms, such as losing touch with reality, hearing voices or having thoughts of harming yourself or the baby, need urgent same-day assessment through a GP, midwife, health visitor or the NHS urgent mental health line, not routine talking therapy.

During pregnancy, similar patterns can appear as antenatal depression or antenatal anxiety, sometimes alongside a specific fear of birth or intense worry about pregnancy loss, particularly after a previous difficult pregnancy or baby loss. These are treated in the same way as postnatal difficulties and do not need to wait until after birth to be addressed.

How therapy can help

Talking therapy gives structured space to make sense of what has happened and to build practical ways of managing mood, anxiety and intrusive thoughts. For depression and anxiety in the perinatal period, NICE guidance points to approaches such as cognitive behavioural therapy and guided self-help as effective options, often alongside support from a GP or midwife. For difficulties following a traumatic birth, trauma-focused approaches such as trauma-focused CBT or EMDR are recommended by NICE for post-traumatic stress reactions, including those triggered by birth. Therapy will not change the facts of what happened, but it can reduce the grip that intrusive memories, worry or low mood have on daily life, and help rebuild confidence in caring for a baby and in your own judgement as a parent.

Our approach

Sessions take place online with an adult, one to one, working at a pace that fits around feeds, naps and the unpredictability of life with a new baby. Work usually starts with understanding your history, current symptoms and what has changed since pregnancy or birth, before agreeing a focus, whether that is low mood, anxious thoughts, intrusive images, or the aftermath of a traumatic birth. Sessions draw on evidence-based methods matched to what you are dealing with, explained clearly so you understand why a particular technique is being used. Support is delivered by qualified clinical psychologists, and methods are chosen to match what the evidence shows works, rather than a single approach applied to everyone. We will update this site as the practice develops.

What does perinatal therapy involve?

Early sessions focus on assessment: understanding symptoms, their impact and any risk factors, and agreeing what support is realistic given a baby’s needs. From there, sessions typically involve structured conversation, between-session tasks that fit around caring for a baby, and monitoring of mood and anxiety over time so that progress is visible rather than assumed. Family members, partners or other support people are not required to attend, though where relevant we can discuss how to involve a partner in supporting recovery. Sessions are confidential, and any contact with other professionals involved in your care, such as a GP, midwife or health visitor, happens only with your knowledge and consent.

The number of sessions and how often they take place is agreed between you and your therapist and reviewed as things progress, rather than fixed in advance, since some people need a short, focused piece of work while others need longer support to feel steady again.

When to seek help

It is worth seeking help if low mood, anxiety, intrusive thoughts or reactions to a difficult birth are lasting more than two weeks, getting in the way of daily functioning, or simply feeling heavier than you can manage alone. Support is equally appropriate during pregnancy and at any point in the two years after birth, and it does not require a formal diagnosis first. If you have any thoughts of harming yourself or your baby, or you are experiencing symptoms such as hearing voices or believing things that others do not, contact your GP, midwife, health visitor or NHS 111 straight away, or go to A&E, since these need same-day assessment rather than a routine referral.

Frequently asked questions

Common questions about perinatal therapy are answered below.