How to Find the Right Postpartum Therapist
Pregnancy & postpartum
Finding a therapist during pregnancy or postpartum can feel surprisingly complicated. Many therapists work with anxiety or depression, but the emotional and psychological experiences surrounding pregnancy, birth, postpartum recovery, and becoming a parent can bring unique considerations.
The right therapist depends on what you're experiencing and what kind of support you're looking for—but there are several things you can consider when choosing a mental health provider during the perinatal period.
By Caroline Shanholtz, PhD, PMH-C | Licensed Clinical Psychologist Scottsdale, AZ
What is a Perinatal Mental Health Therapist?
A perinatal mental health therapist is a mental health professional who works with concerns that can arise during pregnancy, postpartum, and the transition to parenthood. Depending on their professional background, this may be a psychologist, counselor, clinical social worker, marriage and family therapist, or another licensed mental health provider.
What matters isn't simply whether a therapist lists “postpartum” as a specialty. It can be helpful to look at their specific training and experience with perinatal mental health, as well as whether their approach fits what you're experiencing.
Perinatal mental health care can address concerns such as depression, anxiety, intrusive thoughts, birth trauma, pregnancy or infant loss, NICU experiences, infertility and fertility treatment, identity changes, relationship stress, and the emotional adjustment to becoming a parent.
“What training and experience do you have working with pregnancy and postpartum mental health?”
A therapist who works with pregnancy and postpartum mental health may have additional training in perinatal mood and anxiety disorders, birth trauma, pregnancy and infant loss, or other concerns unique to this stage of life. Ask about their specific training and experience, as well as how they approach the concerns you're experiencing.
A Good Question
to Ask:
Look for Specialized Training in Perinatal Mental Health
Pregnancy and postpartum are periods of enormous physical, emotional, and relational change. While many therapists are trained to treat concerns like anxiety and depression, providers with specialized training in perinatal mental health may also have additional knowledge about how these concerns can show up during pregnancy and after birth.
This can include understanding perinatal mood and anxiety disorders, intrusive thoughts, birth trauma, pregnancy and infant loss, NICU experiences, infertility and fertility treatment, and the adjustment to becoming a parent.
When you're considering a therapist, look beyond the list of specialties on their website. You can ask what additional education, training, or clinical experience they have in perinatal mental health and how frequently they work with people during pregnancy and postpartum.
What does PMH-C mean?
PMH-C stands for Perinatal Mental Health Certified, a certification offered through Postpartum Support International (PSI). The credential reflects additional education and training related to perinatal mental health as well as successful completion of the certification exam and requirements.
A PMH-C credential isn't the only way a therapist can develop experience in perinatal mental health, and a credential alone doesn't determine whether a provider will be the right fit. However, it is one way to identify professionals who have pursued specialized training in this area.
Perinatal Mental Health Certified (PMH-C)
I'm a licensed clinical psychologist and Perinatal Mental Health Certified (PMH-C) provider. My specialized training in perinatal and reproductive mental health has included education through Postpartum Support International, alongside my broader doctoral training in evidence-based psychological treatment.
In my clinical practice, I work with individuals navigating fertility and family building, pregnancy, postpartum anxiety and depression, birth trauma, NICU experiences, pregnancy loss, working parenthood, and the many emotional adjustments that can accompany becoming a parent.
Postpartum Mental Health Isn't Just Postpartum Depression
Postpartum depression is one of the most widely recognized perinatal mental health concerns, but it isn't the only reason someone may benefit from support during pregnancy or after having a baby.
Some people experience persistent worry, panic, irritability, intrusive or unwanted thoughts, difficulty sleeping even when they have the opportunity, or a sense that they can't relax or “turn off” their brain. Others may feel disconnected from themselves, overwhelmed by the transition to parenthood, or distressed by a difficult pregnancy, birth, or NICU experience.
Perinatal mental health concerns can also emerge in the context of infertility, pregnancy loss, feeding challenges, relationship changes, returning to work, or adjusting to an identity that suddenly feels very different from the one you had before becoming a parent.
You don't need to know exactly what to call what you're experiencing before reaching out for support. A therapist with perinatal mental health training can help you understand what you're experiencing and determine what kind of support may be helpful.
You Don't Have to Feel “Depressed” to
Seek Postpartum Support
Postpartum mental health concerns can look like sadness, but they can also look like anxiety, irritability, intrusive thoughts, feeling constantly on edge, difficulty adjusting, or simply not feeling like yourself. If something feels different or is making daily life harder, it's reasonable to talk with a qualified provider.
Good to Know
Ask About Their Approach to Treatment
Perinatal mental health therapy shouldn't be one-size-fits-all. The approach a therapist recommends should depend on what you're experiencing, your goals, your history, and the kind of support that would be most helpful right now.
Evidence-based treatment may include approaches such as Cognitive Behavioral Therapy (CBT), exposure-based treatment for anxiety or intrusive thoughts, or trauma-focused treatment when a difficult birth, pregnancy complication, loss, or NICU experience continues to cause distress.
Therapy may also focus on practical concerns that accompany this stage of life—adjusting to a new identity, navigating relationships, returning to work, managing expectations about parenthood, or finding ways to care for yourself while caring for a baby.
When you're meeting with a potential therapist, they should be able to explain what they recommend, why they recommend it, and how the approach connects to what you're experiencing.
“What treatment approach would you recommend for what I'm experiencing, and why?”
A therapist should be able to explain their approach in language that makes sense to you. You don't need to know the names of different therapy models—the important part is understanding how treatment is expected to help and feeling comfortable asking questions about your care.
A Good Question
to Ask:
Consider Your Pregnancy and Birth Experience
What you're experiencing postpartum doesn't always begin postpartum. Pregnancy complications, infertility or fertility treatment, pregnancy loss, a difficult or unexpected birth, or time in the NICU can all shape how someone feels after bringing a baby home.
For some people, these experiences can leave behind anxiety, grief, guilt, anger, intrusive memories, or a sense that they're still trying to process what happened. Others may struggle when their experience of pregnancy, birth, or early parenthood looks very different from what they expected.
If these experiences are part of your story, consider asking whether a therapist has experience working with birth trauma, reproductive mental health, pregnancy loss, or NICU families. You shouldn't have to spend your first several sessions explaining why these experiences can be emotionally complicated.
Treatment should make room for the full story of how you arrived at this point—not just the symptoms you're experiencing today.
Your Experience Doesn't Have to Look “Traumatic”
to Anyone Else
Two people can go through similar pregnancies or births and experience them very differently. What matters is how the experience affected you—not whether someone else thinks it was “bad enough” to warrant support.
Worth Remembering
Questions to Ask When Choosing a Perinatal Therapist
You don't need to interview a therapist with a long checklist before scheduling an appointment. But if you're trying to decide whether someone may be a good fit, a few questions can help you understand their training and approach.
1. What training and experience do you have in perinatal mental health?
Look for a provider who can describe specific education, training, or clinical experience related to pregnancy and postpartum mental health. Some providers pursue additional credentials such as the Perinatal Mental Health Certification (PMH-C), while others may have developed specialized experience through clinical training and practice.
2. How often do you work with people during pregnancy and postpartum?
A therapist doesn't necessarily need to work exclusively in perinatal mental health, but regular experience with this population can be helpful. Pregnancy and postpartum can involve unique emotional, physical, relational, and medical considerations that may influence treatment.
3. What experience do you have treating the specific concern I'm experiencing?
“Postpartum” can describe many different experiences. Someone seeking help for postpartum depression may need something different from someone experiencing intrusive thoughts, panic, birth trauma, grief, or difficulty adjusting to parenthood. Ask whether the therapist regularly works with concerns similar to yours.
4. What treatment approaches do you use, and how would you decide what's appropriate for me?
A therapist should be able to explain how they think about treatment and why they would recommend a particular approach for you. Evidence-based care doesn't mean everyone receives the same treatment—it means treatment decisions are informed by research, clinical expertise, and your individual needs and preferences.
5. Do you have experience treating birth trauma, pregnancy loss, infertility, or NICU experiences if those are part of my story?
If one of these experiences is important to what you're going through, it can be helpful to work with someone who understands its emotional complexity. You should be able to talk about your experience without having to convince your therapist that it mattered.
6. How will we know whether therapy is helping?
Therapy should have a purpose beyond simply attending sessions. You and your therapist can identify what you hope will change and periodically check whether you're moving in that direction. Progress may look different for everyone, but you should have a shared understanding of what you're working toward.
You don't need to find a therapist who checks every possible box. The goal is to find someone whose training and approach fit the concerns that matter most to you—and with whom you feel comfortable being open about what you're experiencing.
When Should I Reach Out for Postpartum Mental Health Support?
You don't have to wait until you're in crisis to reach out for support. Pregnancy and postpartum can be difficult even when nothing is “wrong,” and therapy can be helpful when the way you're feeling is beginning to interfere with your well-being, relationships, sleep, work, or ability to enjoy daily life.
You might consider reaching out if you're experiencing persistent sadness or hopelessness, anxiety that feels difficult to control, frequent panic, intrusive or unwanted thoughts, intense irritability or anger, difficulty sleeping even when you have the opportunity, or feeling disconnected from yourself or your baby.
Support may also be helpful if you're struggling to process a difficult pregnancy or birth, adjusting after a NICU stay, grieving a pregnancy loss, returning to work, or simply finding that the transition to parenthood feels much harder than you expected.
You don't need to have a diagnosis—or even know exactly what's wrong—to talk with someone. Sometimes the first step is simply having a place to make sense of what you're experiencing and determine what kind of support would be most useful.
There Isn't a “Bad Enough” Threshold for Asking for Support
If something is causing distress or making it harder to function or feel like yourself, it's reasonable to reach out. A qualified provider can help you determine whether therapy, additional support, or another level of care may be appropriate.
You don't
have to wait
If you are concerned that you may hurt yourself or someone else, are experiencing a mental health emergency, or feel unable to keep yourself or your baby safe, seek immediate emergency support rather than waiting for a routine therapy appointment. In the U.S., call or text 911 or 988 for the Suicide & Crisis Lifeline or go to the nearest emergency department.
Finding Pregnancy & Postpartum Therapy in Scottsdale, Arizona
If you're looking for a pregnancy or postpartum therapist in Scottsdale, Arizona, consider both the provider's general mental health training and their specific experience with perinatal mental health. The right fit will depend on what you're experiencing, the kind of support you're looking for, and the treatment approach that makes sense for your needs.
I'm Caroline Shanholtz, PhD, PMH-C, a licensed clinical psychologist in Scottsdale, Arizona. I work with individuals navigating pregnancy, postpartum anxiety and depression, birth trauma, NICU experiences, pregnancy loss, fertility and family building, working parenthood, and the emotional adjustment to becoming a parent.
My approach is evidence-based, practical, and individualized. Depending on your needs, treatment may draw from Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), exposure-based approaches, trauma-focused treatment, and other evidence-based strategies.
Therapy is tailored to the person in front of me. We'll work together to understand what you're experiencing, identify what you want to change, and determine an approach that is supported by the research and fits your individual needs.
In-person therapy is available in Scottsdale, Arizona. Telehealth availability varies based on location and applicable licensure requirements.
"What if I'm Not Sure What Kind of Help I Need?"
You don't need to figure out the right diagnosis, therapy approach, or type of provider on your own before reaching out. If you're unsure what kind of support you need, a consultation with a qualified mental health professional can be a place to start.
Sometimes outpatient therapy is appropriate. In other situations, someone may benefit from medication evaluation, additional medical support, a support group, or a higher level of mental health care. A good provider should be willing to help you think through those options—even if the best next step isn't treatment with them.