Perinatal mental health encompasses mental health care in pregnancy through the first year after birth or loss (although some consider it up to two years and beyond). It is a season of big physical, hormonal, and relational changes, and it can bring up a lot of complex and at times conflicting emotions like joy, grief, worry, overwhelm, sadness, and rage.
What "perinatal" means
The word perinatal refers to the time around birth. In mental health, it usually means pregnancy and the first year or more after birth. It also includes perinatal loss and experiences that don't end with a living baby, like miscarriage, ectopic pregnancy, termination for medical reasons (TFMR), stillbirth, and neonatal loss (loss in the first 28 days).
If you are trying to conceive, experiencing infertility, starting fertility treatments, or dealing with chronic reproductive health issues, read more about reproductive mental health about the support you may be looking for.
It starts in pregnancy, and it includes loss
Pregnancy brings its own changes in mood, sleep, energy, your body, and your sense of self. It can also bring worry, fear, grief from an earlier loss, or the stress of a pregnancy that isn't going the way you hoped. While postpartum often gets most of the attention, mental health care during pregnancy can be just as important.
For people who have experienced a loss, the perinatal season can look very different. There is still a postpartum period that is often underacknowledged and may be filled with the same mental health challenges, in addition to layered grief. In therapy, there is space to acknowledge and get support with all of it.
It is more than postpartum depression
When people think of perinatal mental health, they often think of postpartum depression. While this is one perinatal mental health disorder (PMHD), it can show up in many other ways too:
Anxiety that won't turn off, or worry that feels bigger than the moment
Intrusive thoughts that feel scary or out of character
Irritability, rage, or feeling on edge
Panic, or trouble sleeping even when there is time to rest
Trauma reactions after a difficult birth or a loss
None of this means you are doing something wrong. In fact, about 1 in 5 mothers experience symptoms of depression or anxiety during pregnancy or the first year postpartum. These are common responses to a lot of physical, emotional, and hormonal change, and support can help.
Partners are part of it too
Partners can feel the weight of this season as well. Research shows up to 1 in 10 fathers experience postpartum depression, and partners are more likely to struggle when their partner is also dealing with PMHDs. Sleep loss, worry, feeling disconnected, and the pressure to hold everything together are all common experiences. Their wellbeing matters, and support can benefit them, both individually or as a couple.
What support can look like
Support starts with a conversation, at your pace. In sessions, we make room for what you are feeling, what your body is telling you, and the areas of your life that you want to tend to first. My approach is integrative of different somatic and evidence-based techniques and highly collaborative with both my clients and their care team.
I work with individuals and couples and have specialized training in reproductive and perinatal mental health and EMDR. I currently see clients in person in Sebastopol and Petaluma, and virtually throughout California.
You don't need a crisis to get support
You do not need a diagnosis, a crisis, or the right words to reach out. If something about your pregnancy, loss, or the months after birth is taking up more room than you would like, or you want a place to share the intensity for a while, support can help. If you would like to talk, you are welcome to schedule a free 20-minute consultation at kelseyweisslmft.com.
If you need support right now
If you are in crisis, call or text 988 or visit your local emergency room. The National Maternal Mental Health Hotline is also available 24/7 at 1-833-TLC-MAMA (1-833-852-6262). This post is for educational purposes and is not a substitute for care.
Kelsey Weiss, LMFT #146182, PMH-C
Statistics from Postpartum Support International, 2026.
