What we help with / Pregnancy support

Pregnancy changes more than your body.

Support for anxiety and depression in pregnancy, the identity shift into parenthood, mixed feelings, fear of birth, a past difficult birth, pregnancy after infertility or loss, and high-risk pregnancy. Virtual across Ontario, or in person in Toronto.

Book a free 15 minute call See the therapists for this

What prenatal therapy covers, and when to start

Prenatal therapy is counselling during pregnancy. It can help with anxiety, depression, past trauma, and the identity shift that comes with becoming a parent. Roughly one in five people experience a mood or anxiety disorder during pregnancy or the year after. That makes it the most common complication of pregnancy, more common than gestational diabetes or pre-eclampsia. It’s treatable, and getting support during pregnancy can make the postpartum period easier.

At Toronto Therapy Practice, all of our therapists work with people during pregnancy. Sessions are available virtually across Ontario, with in-person sessions in Toronto with select therapists. Fees are $175 to $200 for 50 minutes depending on the therapist, with a free 15 minute consultation first. It’s never too early or too late to start. We see people from a positive test right through to the week of birth.

You might recognize this

Things we often hear in a first session

"I can't let myself be happy about this."

"I hold my breath until every scan."

"Everyone keeps congratulating me and I feel sick."

"I've already planned how I'd tell people if it goes wrong."

"I don't feel bonded and I think that means something."

"I'm terrified of giving birth and nobody will talk about it."

"I waited years for this and now I'm not enjoying it."

"I don't know who I'm about to become."

Pregnancy after loss or after infertility runs on a different clock. The milestones other people celebrate are the ones you brace for, and joy starts to feel like something you'd be punished for. Protecting yourself by not getting attached is an intelligent response to having been hurt, and it is also exhausting to sustain for forty weeks.

Fear of birth has a name, tokophobia, and it is more common than the silence around it suggests. It is not fixed by being handed more information. It usually responds to trauma-focused work, particularly where there is a previous difficult birth, a medical history, or a history of your body not being listened to.

What the work looks like

Specific, and shorter than people expect.

What we do

Treat prenatal anxiety and depression directly, with approaches built for the perinatal period
Work on scan anxiety and milestone dread, which have a shape you can prepare for
Use trauma-focused work, including EMDR, where a previous birth or medical experience is driving the fear
Prepare you for birth psychologically rather than just logistically, including what happens if the plan changes
Talk about medication in pregnancy factually, and coordinate with your OB, midwife or family doctor
Start the postpartum conversation before the baby arrives, which is the single most useful thing you can do

What we don't do

Tell you to stay positive, or that stress is bad for the baby
Treat a lack of bonding during pregnancy as a warning sign about you as a parent
Assume you're excited, or that this pregnancy was straightforward to arrive at
Make you justify fear of birth with a specific reason
Hand you a birth plan and call that preparation

Who works with this

Three of the seven work here most. Pick whoever you'd rather talk to.

Alana Jackson

MSW RSW · 20 years, including Mount Sinai

Prenatal anxiety and depression. Warm, funny and straight with you.

Waitlist, about 3 weeks

Kate Bailey

MSW RSW · EMDR and trauma

Fear of birth, past difficult births, pregnancy after loss.

Openings this week

Emilie Ballarino

MSW RSW, MBA · 10 years

Skills-focused support for prenatal anxiety and big transitions.

Openings this week

Mila Arsenijevic

MSW RSW · Founder, 18 years, including 10 at Mount Sinai

High-functioning anxiety and the identity shift into parenthood.

Openings this week

Caroline Nikiel

MSW RSW · 11 years, hospital practice

Managing big emotions in pregnancy, and support for partners.

Openings this week

Annie Peralty

RP · Fertility, loss and surrogacy

Pregnancy after infertility, loss or donor conception.

Openings this week

Ruth Diemer

MSW RSW · 30 years

Mood changes in pregnancy, family relationships and preparing for the baby.

Openings this week

See all seven therapists

A pregnant person and their partner standing together outdoors at sunset

Being pregnant and being frightened are not mutually exclusive.

Before you book

Questions we get about this one in particular.

Is it too late to start if I'm due soon?

No. Even three or four sessions before birth is useful, particularly for birth fear and for setting up postpartum support before you need it. We also keep working with you after the baby arrives if you want that.

I had a loss before this pregnancy. Do I need a loss specialist or a pregnancy specialist?

The same person, ideally. Pregnancy after loss is its own thing rather than two separate issues stacked, and it is one of the areas this practice was built around.

Can therapy help with fear of giving birth?

Yes, and it is one of the more treatable things we see. Fear of birth usually responds to trauma-focused approaches rather than more information. Kate Bailey works with this specifically using EMDR.

Should I be worried about taking medication while pregnant?

That is a conversation for your doctor or psychiatrist, not for us, and we won't pretend otherwise. What we can do is help you work out what you actually want to ask, and hold the decision with you. Untreated depression and anxiety in pregnancy carry their own risks, which often gets left out of the conversation.

Do you work with partners during pregnancy?

Yes, individually or as a couple. Partners often start a pregnancy after loss carrying a fear they've decided not to mention, which tends to come out sideways.

All questions people ask us

Reading on this