Pregnancy, birth, and postpartum are a unique time in a parent’s life, unlike anything else we go through in our whole existence. The changes are physical, hormonal, and emotional; a complete inner and outer transformation!
There are changes to family structure, to relationships within our families, to personal and professional roles, and to personal identity.
To top it off, there’s less sleep, more stress, less time to de-stress, and more financial strain. Especially when you have two at once.
You may have to decorate a nursery or move houses entirely. You may also have added medical hurdles for mom or babies to overcome. There’s so much to do to prepare for welcoming twins and even more to adjust to once they’re actually here!
Change is challenging. It requires coping skills, adjustment, cooperation, and great communication. You must process new emotions and perhaps old traumas. All of these changes are compounded for parents welcoming twins.
The National Institute of Health shows that there is a higher risk of postpartum depression for both mothers and fathers of twins compared with singleton parents.
Even though parents of twins might as well be expected to be superheroes, they should not be expected to do it alone.
Enter the perinatal therapist.
What is a perinatal therapist?
Peri- is a root word meaning “around” and “natal” means born. So, a perinatal therapist is a therapist who supports parents who are in a period of time near their child being born (either pre-pregnancy, pregnancy, or postpartum).
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What does a perinatal therapist do?
A perinatal therapist can help you alleviate stress and work through challenges related to pregnancy, birth, and the postpartum period. Like generalized licensed therapists, they can help you process difficult emotions, offer perspective, manage change, work through challenging decisions, and even prioritize all there is to do. And they can see you individually or as a couple together.
Why should parents of twins work with a perinatal therapist?
While every twin parent has a unique journey, there are a lot of circumstances that may make carrying twins and parenting twins extra challenging. And this, of course, can take a toll on your mental health.
We polled the Twiniversity community on Instagram recently and asked followers to respond to the following question: Did you struggle with any sort of postpartum mood disorder—either diagnosed or undiagnosed?
Here’s what we found:
| Yes, postpartum depression and/or anxiety | 50% |
| PTSD or birth trauma | 8% |
| A combo of struggles | 24% |
| No postpartum mental health struggles here | 18% |
(While the data could be slightly skewed with those who experienced challenges being more likely to respond, this data still shows just how prevalent mental health struggles are specifically for parents of twins).
We also asked how many of them received support and if they felt they found support right on time or past when they should have initially sought help.
Here’s what we found:
| Yes I got help, right on time | 20% |
| Yes I got help, but I wish I would have sooner | 28% |
| No, and I regret not seeking support sooner | 22% |
| No I didn’t get support, but I eventually got through it okay | 30% |
Here’s how a perinatal therapist can specifically help you during your journey with twins:
During the prenatal period (aka antepartum)
If you’ve conceived your twins through artificial reproductive technology or surrogacy, perhaps you’ve experienced losses or a prolonged fertility journey. A perinatal therapist can help you cope with grief and the extra stressors of fertility challenges.
Not to mention the additional complications that are possible during a multiple gestation. If you experience twin pregnancy complications or struggle with anxiety during your twin pregnancy, a perinatal therapist can support you in utilizing helpful coping mechanisms.
During the postpartum period
Once your newborn twins are here, you may face additional stressors or trauma. Whether you have a NICU stay or struggle with the day-to-day difficulties of caring for two babies (and eventually two toddlers) at once, a perinatal therapist can be a great resource for support.
How do you know if it’s time to seek support from a therapist?
We recently asked our community of twin parents to chime in with how they knew it was time to get help from a therapist. Here’s what they had to say:
“My husband didn’t understand the emotional overload I was feeling. I felt overwhelmed.”
“When my doctor asked how I was doing at my postpartum check-up, I just burst out crying.”
“Marriage counselor during pregnancy. For some reason our marriage STRUGGLED.”
“When I felt so overwhelmed at 6 months postpartum, I hid in bed and researched therapists.”
“I felt like I was drowning. I was unable to manage everyday tasks and losing tons of sleep.”
“I AM a therapist, and I knew I wasn’t okay. I didn’t want to visit my babies in the NICU, didn’t eat for three days and I was sobbing uncontrollably.”
“My midwife identified the issue when pregnant with my singleton (my first). And my mood immediately tanked again after conception of twins so I went on meds.”
“I had postpartum rage at 8 months postpartum.”
“I have been seeing one for the past 10 years. Can’t imagine the difference it makes for when times get rough! I had a stillbirth before my twins and it made all the difference.”
“I was in full blown PPD and couldn’t function, primarily due to sleep deprivation.”
“When the sleep deprivation continued and I couldn’t feel joy anymore.”
“When my body physically started giving out along with my mind. It was all-encompassing.”
“When I started ‘snapping’ on everyone including my toddler. I hated who I was.”
“I was highly irritable and socially withdrawn.”
“Seeing my husband parent our twins brought up wounds from my relationship with my own dad.”
“My doctor gave me the PPD test and I scored high.”
Where to find a perinatal therapist
Just like all aspects of healthcare, therapy comes with a cost, so if you have insurance coverage, try to go through your insurance provider to find a therapist within your network. If insurance isn’t an option, some therapists also offer income-based pay on a sliding scale, where the cost of treatment is adjusted based on your income/financial need.
It’s also important to note that to specialize in perinatal therapy does not necessarily require a specific degree or certification. So you can factor experience into your decision, or ask potential therapists if they have addressed your specific concerns before.
Some therapists might be certified in Perinatal Mental Health, which demonstrates competency supporting patients during the perinatal period.
One great resource is Psychology Today, which allows you to filter your searches for a therapist based on various criteria including location, insurance, whether teletherapy is offered, and the type of therapy you are looking for. The “Verified by Psychology Today” seal indicates that a therapist’s license or credential has been verified to ensure they are credible and in good standing.
Other great resources for connecting with perinatal therapists include:
- Perinatal Mental Health Provider Directory (powered by Postpartum Support International)
- Phoenix Health (online therapy for moms and hopeful moms, US-based)
- The Motherhood Center of New York (support for new and expecting moms/birthing people, US-based)
If you have a primary care physician or OBGYN, you can ask them for a recommendation as well. Often, therapists can work in conjunction with your physician on a care plan, especially if medications may be part of your treatment.
Choosing the right perinatal therapist
When choosing a perinatal therapist, you can ask questions such as what techniques the therapist uses and what a typical timeline might look like for treatment.
Always ask for a 15-minute consult phone call to ensure you and your potential therapist work well together and to answer any questions you have ahead of time. (Most therapy clinics offer these automatically, but in case they don’t, be sure to ask!).
Let’s normalize therapy!
Therapists are resources that can be called upon throughout your life for a myriad of reasons. You may never go through as big a change as welcoming twins, which is all the more reason to use this resource during the perinatal period.
Twiniversity tip: You don’t have to wait until you’ve hit “rock bottom” to see a therapist. But if you feel like you’re already nearing or at rock-bottom, definitely seek support ASAP.
Along with getting the nursery set up, stay one step ahead of your mental health care and book a perinatal therapist before you deliver. This way, they can help you with all of the mental and emotional preparations that go into having twins.
Better yet, book one as soon as you hear the exciting news about your twinnies so they can guide you through pregnancy (morning sickness and all)!
Therapy is thankfully becoming more normalized, and hopefully soon it will be just as normal as seeing your primary care doctor.
Mental health and physical health go hand in hand. And after all, you are growing, delivering, and caring for two WHOLE people, so you deserve to care for your one WHOLE self.
Want more resources for supporting your mental health as a twin parent? Check out these articles too:
- Coping With Twin Pregnancy Complications
- Postpartum Depression and Anxiety: What You Need to Know
- 10 Reasons Parents of Twins Experience Anxiety
- Pregnancy Anxiety After Infertility
- My Prenatal Depression With Twins
Maddison Ellison is a mom to vibrant and mischievous twin toddler girls. She works as a nurse in the Denver metro area and enjoys getting outside with her twins, husband, and sheepadoodle, Rosie. Maddison is inspired by health, wellness, the magic of everyday life, and of course, coffee.
