What is Perinatal Counselling?

“Perinatal” is a term that I only heard long after I was postpartum with my first child. It's a medical term that is similar to "postpartum," but the timeline is a little different. While "postpartum" describes only the period of time immediately following the birth of a child, "perinatal" describes the time from pregnancy through the two years following the birth.

What does this mean for counselling?

Honestly, the terms are often used interchangeably so often not a lot. What is more important is reaching out to a potential counsellor to ask if they can support your specific situation. Some counsellors are trained to support postpartum depression but may not be a good fit for postpartum anxiety, OCD, psychosis, or even relationship dynamics that arise during the postpartum period. Or perhaps in your situation, you are postpartum with one child and currently pregnant. This changes the dynamic and you my find that a counsellor who truly specializes in the perinatal period is better able to help you navigate the nuances of pregnancy and postpartum simultaneously.

Do I really need a “perinatal” specific counsellor?

Not necessarily! If you’ve already been working with a counsellor and find that they are supporting you in the way that you need, that’s wonderful! That said, the perinatal period is unique and a counsellor with no training in that area could miss something important, like the presence of a postpartum depression or anxiety disorder. Perinatal mental health disorders are a little different and they benefit from specific interventions. A counsellor who specializes in another area may not be aware of this. If you think you may be experiencing a postpartum or perinatal mood or anxiety disorder, someone who is trained to assess and treat these concerns specifically is important to consider. A perinatal specialist will likely know better when another referral may be needed, for example to a doctor, psychiatrist, lactation consultant doula, etc.

What makes mental health concerns unique in the perinatal period?

There are changes that start happening in pregnancy and long after the postpartum period is technically over that make this transitional time unique. First, you have all the wonderful (and less wonderful) hormonal changes that happen during this time. Then you have a massive life adjustment. Suddenly, seemingly all of your time and energy is dedicated to keeping a small person alive and much less time is dedicated to caring for yourself. Your relationships change. If you are parenting with a partner, that relationship changes. Your relationship with your friends may change. Suddenly, you don’t have as much social time as you once did and some people even lose friendships through this time. Other new parent friends might come into your life and become your new support system. Your relationship with your own parents may change. Suddenly they have become grandparents! You may find yourself reliving aspects of your own childhood and realizing what you’re grateful for and want to replicate with your own children. On the flip side, you might recall things that make you feel like your upbringing wasn’t always so wonderful. Some people recall trauma or neglect in this time that can be distressing. Others may find they disagree with their parent’s parenting style which can create new challenges in boundary setting.

During the perinatal period there are also unique challenges with sleep, nutrition, and general self-care. Getting 8-10 hours of sleep may no longer be an option and your typical sleep hygiene tips just wont cut it. Parents with infants and young kids also face new kinds of evolving stressors like parenting style decisions, feeding decisions, childcare decisions, and all kinds of exhausting choices to make each and every day.

Perhaps the most obvious difference between perinatal counselling and general counselling is that there is now a baby in the mix!

In short, this is a unique time in people’s lives that can be beautiful, chaotic, messy, hilarious, horrifying and everything else you can imagine. A perinatal counsellor is not going to be shocked if you arrive and haven’t had a shower in days. They understand some of the challenges you are up against and are ready to support you through this stage. A perinatal counsellor can help you gain control over scary thoughts and worries, advocate for yourself, set boundaries, and work with the supportive people in your life to ensure that you are taken care of as well as your baby.

If you are interested in speaking with a perinatal professional you can find a provider in your area using the directory provided by the Canadian Perinatal Mental Health Trainings site here. Or you can reach out to the author of this blog post who provides perinatal mental health support to parents throughout British Columbia at alex@clarityokanagan.com.

Alex Franzius, RSW is a master’s level counsellor specializing in trauma healing and perinatal mental health care to individuals and families. Alex creates an accessible, supportive, empathetic environment where people can process and heal from their experiences, figure out what they value most, and step into the fullest versions of themselves where they feel confident and capable of handling whatever life throws at them. Birthing parents AND their partners can experience postpartum mental health challenges. Alex makes space for birthing parents and their families to heal. If you’re interested in connecting with Alex to learn more, email her at alex@clarityokangan.com or click here to book a free consult.