You Don’t Have to Walk This Journey Alone: The Importance of Perinatal MentalHealth, Loss, and Community

There are certain seasons of life that can hold more emotions than we ever imagined possible.

Pregnancy and becoming a parent can be filled with excitement, hope, anticipation, and love. But they can also bring fear, uncertainty, exhaustion, anxiety, grief, and sometimes emotions that are difficult to put into words.

Recently, I had the opportunity to attend a conference focused on perinatal mental health, pregnancy, postpartum care, and loss and grief. I left the conference carrying a deeper understanding of just how important it is that we talk about these experiences openly and how important it is that no one feels they have to navigate them alone.

One of the biggest reminders for me was this:

Mental health matters throughout the entire pregnancy journey.

Pregnancy Is More Than a Physical Journey

Pregnancy is often discussed in terms of physical health: prenatal appointments, nutrition, medications, ultrasounds, blood pressure, and preparing for birth.

But pregnancy is also an emotional and psychological journey.

There may be changes in identity, relationships, expectations, body image, family dynamics, finances, work, and one’s sense of self. Previous experiences can also resurface during pregnancy, including trauma, anxiety, depression, infertility, difficult pregnancies, or previous losses.

For some, pregnancy after loss can be particularly complicated.

A pregnancy that others see as joyful may be accompanied by fear.

What if something happens again?

Can I allow myself to become attached?

What if I get excited and then lose everything?

Is it okay to be happy when I am still grieving?

These experiences can coexist. Someone can feel grateful and terrified. Hopeful and sad. Excited and overwhelmed.

There is room for all of those emotions.

When Pregnancy and Grief Exist Together

Pregnancy loss, miscarriage, stillbirth, infant loss, and other forms of reproductive loss can create a grief that is incredibly difficult to explain.

Grief after loss does not simply disappear because time passes. It may change, become quieter, or appear unexpectedly. And for someone experiencing a subsequent pregnancy, the pregnancy itself can bring those emotions back to the surface.

Postpartum Support International (PSI) recognizes pregnancy, post-loss, and postpartum experiences as part of the perinatal period and provides specific resources for individuals experiencing loss and grief. PSI notes that loss can be associated with increased risk for depression, anxiety, and symptoms of PTSD, emphasizing the importance of compassionate support and connection.

This is why grief needs to have a place in conversations about perinatal mental health.

We do not need to rush people through grief.

We do not need to find the “right” words to make it better.

Sometimes, what someone needs most is simply for another person to say:

“I see you. I remember. Your experience matters. You don’t have to go through

this alone.”

Learning to Recognize the Warning Signs

Another important takeaway from the conference was the value of recognizing changes in mental health early.

Perinatal depression and anxiety are not simply a person being "hormonal," overly emotional, or struggling to adjust to parenthood. They are real and treatable mental health concerns that can occur during pregnancy, after birth, and following a loss.

Some signs that additional support may be helpful include:

•  Persistent sadness, hopelessness, or feeling emotionally numb

•  Excessive worry or fear that feels difficult to control

•  Frequent panic or feeling constantly on edge

•  Intrusive or frightening thoughts

•  Significant changes in sleep or appetite beyond what would be expected

•  Difficulty connecting with or enjoying things that once brought pleasure

•  Feeling overwhelmed or unable to manage everyday responsibilities

•  Intense guilt, shame, or feelings of inadequacy

•  Withdrawal from family, friends, or other sources of support

•  Difficulty bonding or feeling connected

•  Increased irritability or anger

•  Re-experiencing a traumatic pregnancy, birth, or loss

•  Feeling disconnected from oneself or one's surroundings

These symptoms deserve attention not judgment.

Postpartum Support International recommends routine screening for perinatal mood and anxiety disorders during pregnancy and postpartum, emphasizing that screening should be connected to appropriate follow-up, treatment, and support.

And perhaps most importantly, you do not have to wait until things become unbearable before reaching out.

You do not need to have the “right” diagnosis.

You do not need to prove that you are struggling enough.

You are allowed to ask for help simply because something doesn’t feel right.

The Power of Community

One of the most meaningful themes I took away from this experience was the importance of community.

Mental health care does not happen in isolation.

A therapist can be part of someone’s support system. So can a partner, friend, parent, sibling, doula, midwife, OB/GYN, pediatrician, support group, peer mentor, or another parent who understands what it feels like to walk through something similar.

Sometimes healing begins with one conversation.

Sometimes it begins with someone sitting beside you and saying, “You don’t have to carry this by yourself.”

Community can also be especially important following pregnancy or infant loss. Grieving parents may feel isolated when the world around them seems to continue moving forward. Their grief may not always be visible, but that does not make it any less real.

We can create healthier communities by learning to ask better questions.

Instead of:

“Are you excited?”

We might also ask:

“How are you really doing?”

Instead of:

“You must be so happy.”

We might say:

“There can be a lot of emotions during this time. I’m here if you want to talk.”

And instead of assuming someone has moved on, we can remember that grief does not follow a calendar.

Support Can Begin Before You Need It

One of the things I hope we continue to normalize is creating a mental health support plan before a crisis occurs.

Just as we prepare for childbirth, we can prepare for emotional wellness.

Consider asking yourself:

•  Who can I call when I am overwhelmed?

•  Who makes me feel safe and supported?

•  What are my signs that I am struggling?

•  Who can help me with practical responsibilities?

•  What mental health resources are available in my community?

•  Have I talked with my healthcare provider about my emotional well-being?

•  Would connecting with a therapist or support group be helpful?

•  If I have experienced a previous loss, what additional support might I need during this pregnancy?

Having these conversations doesn’t mean something will go wrong.

It means you are recognizing that your mental health deserves the same preparation and care as your physical health.

You Are Not Alone

Postpartum Support International offers a wide range of resources for individuals and families navigating pregnancy, postpartum experiences, and loss. Their resources include support groups, provider directories, peer support, support navigators, educational materials, and specialized resources for pregnancy and infant loss.

PSI also offers a HelpLine at 1-800-944-4773 (4PPD) by call or text, as well as connections to support and resources. The National Maternal Mental Health Hotline is available at 1-833-852-6262 for pregnant and postpartum individuals in the United States.

You can explore resources through Postpartum Support International.

And if you are experiencing thoughts of harming yourself or someone else, experiencing a mental health emergency, or feel that you are not safe, call or text 988 or seek emergency medical care.

A Final Thought

The perinatal journey is not one single experience.

It is different for every person.

For some, it may be filled with excitement and ease. For others, it may include infertility, complicated pregnancies, birth trauma, postpartum depression or anxiety, difficult transitions, pregnancy after loss, or profound grief.

And for many people, it may include several of these experiences at the same time.

We need to make space for the whole story.

The joy.

The fear.

The grief.

The hope.

The uncertainty.

The love.

And everything in between.

Attending this conference reminded me that one of the greatest gifts we can offer someone during this vulnerable season is connection. Sometimes healing doesn’t begin with having all the answers. Sometimes it begins with knowing that someone is willing to sit beside you while you find your way.

You don’t have to walk this journey alone.

At Rose Counseling Services, we believe that reaching out for support is not a sign of weakness. It is part of caring for yourself and creating a strong foundation for the journey ahead. Whether you are navigating pregnancy, postpartum adjustment, pregnancy after loss, grief, anxiety, depression, or simply trying to make sense of everything you are feeling, support is available.

Your story matters.

Your grief matters.

Your mental health matters.

And you matter.