Early Conversations, Lasting Impact: Helping new parents have the best possible start

Becoming a parent is widely acknowledged as a major life change, with common warnings such as: “You’ll never sleep again!” or “Say goodbye to your freedom!” Parenthood can test our limits, including the love that we have for our partner. Most of us imagine that having a baby will bring us closer together. But the truth is, a new baby can shake the foundation of even the most connected relationships. John and Julie Gottman’s research showed 67 per cent of couples describing a decline in relationship satisfaction after their baby arrived^.1 

Relational impacts are often underestimated. Becoming a new parent is one of the hardest tasks a couple will face and for good reason. New identities and hormonal changes. Relentless sleep deprivation. So many unknowns. Next to no time for yourself. Isolation. Dealing with the new stress of life with a baby. These issues add up and become a perfect storm for resentment, disconnection, miscommunication, and even doubting the relationship or questioning the decision to become a parent. 

 

Complexities of Perinatal Mental Health and Matrescence

 

Perinatal is a term used to describe pregnancy and one year following birth. Perinatal mental health is complex because it involves so many layers of change at once. To say that pregnancy is physically and emotionally taxing would be an understatement. When someone gives birth, they experience the greatest hormonal change of their life, with estrogen and progesterone dropping significantly and oxytocin and prolactin spiking to facilitate bonding and milk production. 

Psychologically, new parents are adjusting to shifts in identity, routine, time, and autonomy, to name a few. For many who identify as mothers, the concept of Matrescence captures this experience. The term was coined by anthropologist Dana Raphael and describes a developmental phase marking the transition from womanhood to motherhood that begins in pregnancy and may last a lifetime.² Author Lucy Jones, in her book Matrescence, describes the impact well: “We still barely acknowledge the psychological and physiological significance of becoming a mother: how it affects the brain, the endocrine system, cognition, immunity, the psyche, the microbiome, the sense of self.”³

Here are few statistics worth acknowledging:

• Women are more likely to develop depression and anxiety during the first year after childbirth than at any other time in their life.⁴ 

• Approximately 1 in 5 women and 1 in 10 partners will experience a perinatal mood and anxiety disorder.⁵ 

• This risk is 5x higher in high-risk pregnancies^.6 

• Perinatal women are 2x greater risk for OCD onset than the general population^.7 

Consensus among perinatal clinicians is that these estimates are likely low. Due to the nature of the symptoms and limitations with screening, distressed parents tend to underreport. This is compounded by the associated shame, stigma, and even parental fears about having their capacities to care for their baby questioned. As a result, many new mothers experiencing symptoms describe feeling very alone and worry that something may be “wrong” with them. 

These estimates further fail to capture the experiences of parents from marginalized communities, who are frequently underrepresented or excluded in perinatal mental health research and who face additional barriers due to a lack of culturally responsive and accessible community support.

Partners also can experience parallel shifts and emotional reorganization, sometimes with less societal or cultural acknowledgment. And we know that dads and partners can struggle with symptoms of depression, anxiety, OCD, PTSD, and more. 

We also wish to acknowledge here that there are many pathways to building a family, including surrogacy, adoption, donor sperm or egg, etc. This highlights that everyone’s journey is unique, and as therapists, we want to remain curious about what someone has gone through to become a parent.

 

Prenatal Education for Couples

 

Many expectant parents seek prenatal education, which can be invaluable for understanding pregnancy, labour, and delivery. Programs such as those offered by local organizations Brood and Ready, Babe have broadened these offerings to include deeper conversations about informed consent, medical interventions, and diverse birth experiences, as well as infant care. These are wonderful additions to support new parents. 

That said, what often receives less attention is the relationship friction that can emerge after welcoming a new baby. This goes back to the question: what might it be like for couples to have space to reflect on these changes before they are living them? Rather than feeling caught off guard amid exhaustion and emotional volatility, pre-baby counselling can invite important conversations ahead of time. Then, when couples are in this stressful, sleep-deprived period, making a hundred decisions a day while learning on the job, they are revisiting conversations previously explored, not questioning the future of their relationship when conflict catches them off guard. 

 

Postpartum Dissonance and Accumulated Resentment 

Postpartum dissonance is an all-encompassing term that many birthing people and any new parent can experience. Simply put, it is the experience of postpartum not matching with what was pictured. This dissonance is often accompanied by feelings of disappointment, confusion, anger, or regret — in other words: “This isn’t what I signed up for” — a sentiment that can become especially intense if there is also a sense of being alone in the struggle. 

 

You can think of this most simply using the following formula:

EXPECTATION + STRESS + UNCERTAINTY + ISOLATION =

POSTPARTUM DISSONANCE 

 

Often these overlapping issues and emotional experiences can lead to feelings of resentment which accumulate during a very vulnerable time. Many postpartum challenges are perceived as relational, because in the absence of a strong support system, the simplest narratives become riddled with blame — “This is hard, and I feel like it’s my fault” or “That was hard… and you weren’t there for me when I needed you.” When this blame towards self or others accumulates, it becomes more difficult for couples to recover. 

Some interesting correlations worth mentioning: maternal depression is the greatest predictor of paternal depression; and women who are more supported by their partner do better (less severe mental health symptoms, faster resolution of PMADs, increased relationship satisfaction).

For many, the arrival of a baby can reveal individual differences in coping styles, responses to stress, and needs. Sleep deprivation and less time for self can make it much harder to “fight fair” or use humour, diplomacy, and compromise (e.g., in the middle of the night with a crying baby). When conflict feels unexpected, couples may question themselves or their relationship, rather than recognizing the broader context. 

 

Counselling as a Space for Preparation and Reflection

 

Counselling before the arrival of a baby can be a space for reflection — an opportunity for couples to slow down and become more aware of how they approach stress, change, and uncertainty, as well as what they are picturing their life could look like with a baby. 

One of the most important messages we want to send our clients is to normalize support, especially for those who do not have reliable or consistent family available. Many new parents value independence or self-sufficiency and struggle with the idea of accepting help. A therapist’s office may offer a place to explore these beliefs and make room for alternative narratives, such as those that frame support as protective rather than a reflection of their competency as new parents. 

Here are some questions that we may encourage expectant parents to explore:

• What is your typical response to stress or overwhelm?

• How do you usually let one another know when you are struggling?

• To what degree do you tend to avoid issues? 

• Do you tend to allow frustrations to stack up until they become too much? 

• What do you feel more uncertain or apprehensive about?

• What does self-care mean to you, and how might this look postpartum?

• Who has been supportive to you in the past, and what made that feel helpful?

From here, all sorts of meaningful conversations can unfold, including those around hopes, dreams, fears, values, beliefs, and expectations. 

Final Thoughts 

Counselling can serve as a preventative offering during the transition to parenthood invites us to work a little further upstream. When couples seek support during this stage, they enter parenthood with greater understanding of themselves, each other, and the systems around them, with more skills and readiness to handle what comes their way. If you are interested in our BabyPrep Counselling Services, please read more here.

 

References 

1 Gottman’s Bringing Baby Home Educator Program (2014).Gottman Institute. https://www.gottman.com/professionals/training/bringing-baby-home/

2 Raphael, D. (1975). Being Female: Reproduction, Power and Change. The Hague: Mouton.

3 Jones, L. Matrescence: On the Metamorphosis of Pregnancy, Childbirth and Motherhood (2024). Allen Lane. 

4 Perinatal Depression (2018). National Perinatal Association. https://www.nimh.nih.gov/health/publications/perinatal-depression

5 “Psychology Works” Fact Sheet: Perinatal Anxiety (2021). Canadian Psychological Association. https://cpa.ca/psychology-works-fact-sheet-perinatal-anxiety/

6 Fairbrother N, Collardeau F, Albert AYK, et al. High prevalence and incidence of obsessive-compulsive disorder among women across pregnancy and the postpartum. Journal of Clinical Psychiatry. 2021;82(2):20m13398. DOI: 10.4088/JCP.20m13398

7 Uguz F, Kaya V, Gezginc K, Kayhan F, Cicek E. Clinical correlates of worsening in obsessive-compulsive symptoms during pregnancy. Gen Hosp Psychiatry. 2011 Mar-Apr;33(2):197-9. doi: 10.1016/j.genhosppsych.2011.01.013. Epub 2011 Mar 4. PMID: 21596214.\

NEW SERVICE!

Prenatal Mental Health Planning

This is a 75-minute, one-time education session with our Perinatal Mental Health specialist (additional sessions available as needed).

It is designed to help you feel more prepared, informed, and supported as you move through your pregnancy and into postpartum.

This session is ideal for those experiencing anticipatory anxiety, if you are wanting to reduce your risk of postpartum challenges, or simply are hoping to feel more confident going into parenthood. Partners are welcome and encouraged to attend this session.