Psychological therapy in pregnancy

Pre-Conception, Pregnancy & Birth

Pregnancy is often framed as a time of pure joy. For many people, it is also a time of profound psychological upheaval that nobody prepared them for.

Antenatal anxiety and antenatal depression affect around one in five pregnant people, yet they are routinely missed, dismissed, or wrongly assumed to belong only to the postnatal period. You can be eating well, attending every appointment, decorating the nursery, and still living with relentless worry, broken sleep, or a flat heaviness you cannot name.

That is not failure. It is a sign that something needs attention.

Little Steps Psychology Practice offers specialist online psychological therapy for pregnancy-related mental health difficulties, available across the UK with Dr Natalie Cook, a HCPC-registered Clinical Psychologist based in Oxford.

What antenatal mental health difficulties can look like

Antenatal mental health remains poorly understood, even within parts of the healthcare system. Signs that you might benefit from support include:

• Persistent worry about your baby, the birth, or your ability to cope

• Intrusive thoughts you cannot switch off

• Difficulty sleeping even when exhausted

• Low mood or numbness that does not lift

• Hypervigilance about your body, the pregnancy, or appointments

• Avoidance of pregnancy-related conversations, planning, or appointments

• A sense of dread you cannot explain to anyone

• Feeling disconnected from the pregnancy or from yourself

You do not have to meet a diagnostic threshold to benefit from therapy. Early support is protective.

Areas I can help with

I offer psychological support for individuals, couples, and families navigating:

• Antenatal anxiety (pregnancy anxiety)

• Antenatal depression (pregnancy depression)

• Tokophobia (severe fear of birth or childbirth)

• Birth trauma and birth-related PTSD, including from previous births

• Preparing psychologically for birth and the postnatal period

• Fertility challenges and assisted conception, including IVF

• Pregnancy following loss or fertility treatment

• Antenatal diagnosis of a medical condition (for parent or baby)

• Perinatal loss, including miscarriage, stillbirth, and termination for medical reasons

• Pregnancy after birth trauma

• Unresolved feelings from your own experiences of being parented

How therapy helps

Therapy in pregnancy is not about fixing you. It is about understanding what is happening, why your nervous system is responding the way it is, and what would actually help.

My approach draws on evidence-based models including Acceptance and Commitment Therapy (ACT), Compassion Focused Therapy (CFT), EMDR for trauma processing, and systemic and narrative approaches. We will work out together which approach fits your situation. You will leave with practical tools, a clearer sense of what is going on, and support grounded in clinical expertise rather than wellness platitudes.

What to expect

We always begin with a comprehensive assessment session to understand who you are, what you are experiencing, and what you would like to be different. From there, we collaboratively develop a treatment plan. Sessions are delivered weekly or fortnightly online, structured around your goals.

If any of this sounds familiar, you do not need to wait until things feel worse.