What to Expect in Postpartum Anxiety Therapy: A Guide for New Moms
You’ve taken a brave step. You reached out because you don’t feel like yourself anymore. Yes, you love your baby, and next to that feeling is sadness and worry. It may feel like the steadiness you used to feel prior to pregnancy and postpartum has shifted under this weight of constant worry, exhaustion, and all the newness of motherhood.
Maybe you’re constantly checking the monitor, wondering if your baby’s breathing is okay. Feelings of tension every time you leave the house with the baby. Maybe feeding has become a source of anxiety because as much as you’ve heard “feeding will come naturally,” it’s actually really hard work and you’re constantly worrying, “Did they get enough from me, or am I producing enough?” Or perhaps you find your thoughts racing at night: What if they don’t sleep through the night? What if something goes wrong?
These worries are valid and more common than you might think. In fact, about one in five women experience anxiety during pregnancy or in the postpartum period (Postpartum Support International (PSI), MGH Women's Mental Health).
What Happens in Your First Session?
1. Validation and Normalization
You’ll walk into therapy and be met with deep understanding. This isn’t just a clinical exchange. It’s a shared space where your fears are seen, heard, and met with deep expertise and support. It’s okay that you’re struggling. It’s more common than you think and not a sign of weakness. In the initial session, your therapist may ask you to complete forms like the Edinburgh Scale and/or PASS Scale, which screen for anxiety.
2. Exploring Your Story
Next, your therapist will take a gentle but curious inquiry into your personal history:
We’ll explore what you're experiencing now, whether it’s persistent rumination, repetitive worries, or something that might be more specific like postpartum OCD.
We'll ask whether these anxious thoughts feel intrusive, repetitive, or tied to particular fears around harm or safety. Identifying the patterns and triggers to the worry helps pave a clear path forward.
3. Creating a Tailored Treatment Plan
Once your therapist understands both your history and your symptoms, they will likely create a personalized treatment plan. If it looks like postpartum anxiety, the most common approach is Cognitive Behavioral Therapy (CBT). Through CBT, we gently challenge and reframe the negative thoughts that feel so overwhelming now. It may feel impossible at first, but step by step, we’ll rebuild a sense of balance in your thinking.
4. Rhythm of Therapy
Depending on how things are going, you’ll meet weekly or every other week, giving you a rhythm of support as you navigate the ups and downs of early motherhood.
5. Foundation: NEST—Nutrition, Exercise, Sleep, Time for You, Support
Treatment goes beyond therapy sessions. We’ll explore your basic building blocks for preventing anxiety from worsening called “NEST”:
Nutrition: Are you getting the nourishment your body needs?
Exercise: Gentle movement, even short walks, can do wonders.
Sleep: Even fragmented rest matters.
Time for Yourself/Support: You need pockets of calm such as a 30-minute nap, or even a moment to walk away.
These pillars support therapy’s effectiveness and your resilience.
What This Journey Looks Like Overall
Highly individualized: Through collaboration, a plan will be made specifically for your needs and goals.
Rooted in compassion: This is not about pathologizing you, it’s about understanding.
Growth-oriented: Though it might feel overwhelming now, therapy and self-care build toward calm, confidence, and reconnection with yourself and your baby so you can reclaim joy in motherhood.
A Final Word
If you’re considering therapy or still on the fence, I hope this blog gave you insight. I recommend finding a therapist who specializes in perinatal mental health. Additionally, Postpartum Support International is a wonderful resource for postpartum anxiety support groups. Lastly, if you live in Maryland or Washington DC, I'd be honored to support you.
Learn more about my therapy services here: https://worthytolivetherapy.com/birth-trauma.
Stay connected for more resources on birth trauma, postpartum mental health, and motherhood:
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Until next time,
Brittany Moffitt, LCSW-C
