How to Choose a Postpartum Therapist: 10 Questions to Ask

How to Choose a Postpartum Therapist: 10 Questions to Ask

Finding a therapist when you're already exhausted and overwhelmed feels impossible. You're supposed to research credentials, check reviews, verify insurance, and somehow know if this stranger will be the right fit—all while running on minimal sleep and maximum stress.

I get it. And I'm going to make this easier for you.

After 15+ years specializing in maternal mental health, I know exactly what makes a good postpartum therapist. More importantly, I know what questions will help YOU figure out if someone is the right match.

Here are the 10 essential questions to ask any potential postpartum therapist—and what their answers should tell you.

Before You Start: Where to Find Postpartum Therapists 🌱

**Quick resources:** - **Postpartum Support International directory:** postpartum.net - **Psychology Today:** Filter for "postpartum" - **Your OB/midwife:** Ask for their trusted referrals -

The 10 Questions Every Mom Should Ask ❓

1. "Are you specialized in perinatal mental health?"

Why this matters: General therapists are great—but postpartum issues require specific training. Hormonal changes, identity shifts, sleep deprivation, and the unique stressors of new motherhood need someone who gets it.

**What to look for:** - **PMH-C certification** (Perinatal Mental Health Certified) - **Specific training** through PSI or similar organizations - **Significant experience** with postpartum clients (ask how many)

**🚩 Red flag:** "I work with women's issues" or "I've had kids myself" **without specialized training.**

2. "How many postpartum clients do you currently see?"

Why this matters: If you're their first or only postpartum client, they're learning on your dime. You want someone who sees this population regularly and stays current on best practices.

What to look for: "Postpartum clients make up 30-50% of my practice" or "I work exclusively with perinatal populations." Acceptable answer: "I've worked with 20+ postpartum clients over the past few years and have ongoing training in this area."

3. "What therapeutic approaches do you use for postpartum depression/anxiety?"

Why this matters: Not all therapy approaches work equally well for postpartum issues. Evidence-based treatments get results faster.

What to look for: CBT(Cognitive Behavioral Therapy): Proven effective for PPD/PPA - IPT (Interpersonal Therapy): Specifically designed for postpartum - ERP: Gold standard for postpartum OCD

🚩 Red flag:Vague answers like "I use an integrative approach" without specifics, or reliance solely on "talk therapy."

4. "Do you collaborate with other providers (OB, psychiatrist, lactation consultant)?"

Why this matters: Postpartum mental health often requires a team approach. You want a therapist who sees themselves as part of your care team, not working in isolation.

What to look for: "Yes, I regularly communicate with clients' OBs and can refer to psychiatrists if needed" or "I have strong relationships with perinatal psychiatrists and lactation consultants for integrated care."

🚩 Red flag: Resistance to coordinating care or dismissiveness of medication/medical input.

5. "What's your stance on medication for postpartum depression?"

Why this matters: You need to know if your therapist is anti-medication (which can be harmful) or pushes medication too quickly without trying therapy first.

What to look for: "I support whatever decision you and your doctor make. For moderate to severe PPD, medication combined with therapy often works best. For mild symptoms, we can try therapy first and reassess."

🚩 Red flags: - "You definitely need medication" (that's not their call) - "I don't believe in medicating new moms" (this is dangerous)

6. "How do you handle intrusive thoughts?"

Why this matters: Intrusive thoughts are one of the most terrifying symptoms—and most misunderstood. You need someone who won't freak out or overreact.

What to look for: "Intrusive thoughts are very common in postpartum anxiety and OCD. They're distressing but don't mean you'll act on them.** We use exposure-based therapy to help reduce their power."

🚩 Red flag: Seeming uncomfortable, suggesting hospitalization for intrusive thoughts alone, or not understanding the difference between intrusive thoughts and psychosis.

7. "Do you take my insurance, or what are your out-of-pocket rates?"

Why this matters: Mental health care is expensive. You need clarity upfront.

What to ask: - Are you in-network with [your insurance]? - If out-of-network, do you provide superbills for reimbursement? - What's your session rate? - Do you offer sliding scale? - What's your cancellation policy?

What to look for: Clear, transparent answers. A willingness to work with you on finances if possible.

8. "What's your availability, and how quickly can I be seen?"

Why this matters: If you're struggling now, waiting 6 weeks for an intake isn't okay. You need someone who can see you soon.

What to look for: "I can see you within 1-2 weeks" or "I'm currently full but can refer you to a colleague who has openings this week." Acceptable: A 2-3 week wait if they're highly specialized and worth it. Consider other options: Waitlists longer than 3-4 weeks.

9. "Do you offer virtual sessions?"

Why this matters: With a newborn, leaving the house is hard. Virtual therapy is a game-changer for new moms.

What to look for: "Yes, I offer telehealth and many of my postpartum clients prefer it."✨ Bonus points: "My sessions are baby-friendly—if you need to nurse or soothe during our session, that's completely fine."

10. "Can you describe what the first few sessions will look like?"

Why this matters: You need to know what you're walking into so there are no surprises.

What to look for: "The first session is assessment—I'll ask about your symptoms, birth experience, support system, and history. By session 2-3, we'll have a treatment plan and start working on coping strategies. Most clients start feeling better around week 6-8."

🚩 Red flag: No clear structure or plan. Therapy that just "talks" without actionable strategies.

Bonus Questions for Specific Situations ❓

If you experienced birth trauma: If you're breastfeeding: "Are you familiar with medications safe for breastfeeding?" If you're part of a marginalized community: "Do you have experience working with [Black/LGBTQ+/military/immigrant] families?" If your partner is struggling too: "Do you offer couples therapy or partner sessions?"

The "Fit" Factor: Trust Your Gut

Even if a therapist checks every box, you need to feel comfortable with them.

In your consultation or first session, ask yourself:

✓ Do I feel heard and understood? ✓ Do they explain things clearly? ✓ Do I feel safe being vulnerable with this person? ✓ Do their answers feel thoughtful, not rushed? ✓ Do they normalize my experience without dismissing it?

If something feels off, trust that. You're allowed to try someone else.

What to Do Right Now

1. Make a list of 3-5 potential therapists (use PSI directory + your insurance list) 2. Call or email each one asking for a free consultation (many offer 10-15 minute phone calls) 3. Ask your top 3-5 questions from this list 4. Schedule with whoever feels like the best fit 5. Give it 3-4 sessions before deciding if it's working (first session is always awkward)

If Cost is a Barrier

- Ask about sliding scale fees - Check if your employer offers an EAP (Employee Assistance Program—often 3-8 free sessions) - Use your HSA/FSA for therapy - Look into Open Path Collective ($30-80 sessions) - Contact perinatal mental health non-profits (NurturedTX in Austin, etc.)

Final Thoughts

Choosing a therapist doesn't have to be perfect—it just has to be good enough to get you started. You can always switch later if it's not the right fit.

The hardest part is making that first call. Once you do, the rest gets easier.

You deserve support from someone who understands postpartum mental health, respects your choices, and helps you feel like yourself again.

---

Ready to start your search?

📞 Postpartum Support International: postpartum.net - Provider directory 📞 Bloom Psychology: Specializing in maternal mental health across Texas - Free 15-minute consultations 📞 Psychology Today: psychologytoday.com - Filter by "postpartum" and your insurance

---

*Dr. Jana Rundle is a licensed clinical psychologist and PMH-C (Perinatal Mental Health Certified) specialist at Bloom Psychology in Austin, Texas. She provides evidence-based therapy for postpartum depression, anxiety, OCD, and birth trauma to families throughout Texas.*