Holding what this passage asks of you
Therapy During Fertility, Pregnancy, and the Postpartum Period
Journeys around fertility, pregnancy, and early parenthood are rarely only medical. Whether you are trying to conceive, undergoing fertility treatment, pregnant, adjusting after birth, or living with uncertainty about what comes next, these experiences often stir deep and complicated emotional life.
Hope and grief, longing and fear, joy and ambivalence can exist side by side. Many people are surprised by how intense or disorienting this period feels. Even when things appear “fine” from the outside, the inner experience can feel fragile, overwhelming, or difficult to name.
Therapy offers a place where this emotional life can be met with care — not managed, minimized, or rushed.
At Amphora Psychotherapy, Stéphanie Gay Moss, PsyD, offers depth-oriented psychotherapy for individuals and couples navigating ambivalence about parenthood, fertility challenges, pregnancy, and the postpartum period. Services are offered in person in San Francisco and Marin, and online throughout California. Stéphanie is affiliated with the American Society for Reproductive Medicine (ASRM).
When Fertility Concerns and Early Parenthood Feel Heavy
People seek therapy during this time for many reasons, including:
Difficulty conceiving or uncertainty about fertility
The emotional toll of fertility treatments, including IVF and assisted paths to parenthood
Pregnancy loss, miscarriage, or complicated grief
Anxiety, depression, or emotional upheaval during pregnancy
Changes in identity, body image, or sense of self
Strain, distance, or misattunement between partners
Postpartum depression, anxiety, numbness, or overwhelm
Feeling disconnected from one’s body, baby, or experience
Cultural, familial, or intergenerational expectations that feel constraining
These experiences often activate older losses, unresolved grief, or conflicts around desire, autonomy, dependency, and belonging. Therapy offers a space where these layers can be explored without pressure to resolve them quickly or feel a certain way.
A Depth-Oriented, Attuned Approach
Stéphanie's work in this area is psychoanalytically informed and attentive to embodiment. She understands fertility and early parenthood as periods that often touch core questions of identity, lineage, intimacy, and continuity.
In therapy, attention is given to:
feelings that feel contradictory, confusing, or hard to speak aloud
the relationship between emotional life and bodily experience
unconscious meanings attached to fertility, pregnancy, or becoming a parent
cultural, familial, and intergenerational narratives
what unfolds between therapist and client as these experiences are explored
There is no expectation to feel gratitude, certainty, or joy. Ambivalence, grief, anger, love, fear, and tenderness are all welcome here.
From beyond time,
beyond oak trees and bright clear water flow,
they were given the work of weaving the strands
of their body, their pain, their vision
into creation, and the gift of having created
Paula Gunn Allen, “Grandmother”
Ambivalence About Parenthood
Alongside longing and hope, many people experience ambivalence about becoming a parent — sometimes quietly, sometimes with great intensity. You may feel uncertain about whether parenthood is truly what you want, or whether it has come to feel inevitable after years of trying, treatment, or expectation. You may find yourself wanting a child deeply while also fearing the loss of freedom, identity, or the life you have known.
Ambivalence is not a sign that something is wrong. It is a natural and meaningful psychological response to a decision that touches identity, the body (for some), history, and relationship all at once. In a culture that can be polarizing on the topic, therapy becomes a space to explore these mixed feelings without pressure to resolve them into certainty or optimism.
Sometimes ambivalence has roots in our earliest relationships, as becoming a parent can unconsciously reactivate experiences of being parented. Desire, doubt, grief, excitement, and resistance can coexist — and making room for all of them can lead to a more grounded, honest relationship to whatever path unfolds.
This kind of reflection can also be important during fertility treatment, where momentum, medical timelines, and external expectations often leave little room to pause and ask: What does this mean for me? For us? Therapy offers a place to slow down and listen carefully, rather than overriding ambivalence in the service of an outcome.
On Your Fertility Journey
Fertility treatment often evokes layers of loss, longing, envy, gratitude, hope, and fear that may feel contradictory or difficult to hold all at once. Being in therapy during this time offers a space where these experiences can be thought about rather than simply endured.
By putting words to what is often unspoken, therapy can support a deeper sense of agency and coherence — helping you remain psychologically present to yourself, your partner, and your future child, even in the midst of uncertainty. In this way, therapy becomes not just support during treatment, but part of the emotional groundwork for parenthood, whatever form that ultimately takes.
Undergoing IVF With One’s Own Eggs (OE)
IVF with one’s own eggs often places intense demands on both body and mind. The body becomes a primary site of focus — monitored, stimulated, punctured, waited on — sometimes for months or years. Many patients describe a sense of living in cycles and numbers, while trying to maintain a feeling of self that is more than what the body can or cannot produce.
Physical side effects, uncertainty about medical outcomes, and the pressure to “keep going” can gradually erode a sense of trust in one’s body.
At the same time, patients are asked to make a series of complex medical decisions in a compressed timeframe — about protocols, testing, risk, finances, and next steps — often while emotionally overwhelmed and fatigued. Disappointment and loss may accumulate with each unsuccessful cycle, miscarriage, or ambiguous result.
These losses are not always socially recognized, yet they can register deeply, stirring feelings of grief, envy, shame, or self-blame.
For some, underlying medical conditions — such as diminished ovarian reserve, endometriosis, or recurrent pregnancy loss — add another layer of complexity, confronting patients with limits they did not anticipate. Therapy can provide a place to slow this process down emotionally, to mourn what has not worked, and to make sense of how repeated disappointments reverberate through identity, relationships, and one’s sense of the future.
Considering and Moving Forward With Donor Eggs (DE)
Sometimes, by the time individuals or couples consider donor eggs, they have already been through a great deal — physically, emotionally, and psychologically. In this instance, the decision to pursue DE is rarely a simple pivot; it is usually preceded by multiple losses, dashed hopes, and a gradual reckoning with the limits of one’s own eggs.
Even when donor eggs offer renewed possibility, they may also require grieving the loss of a genetically related child and the imagined continuity that once felt essential.
Making a family with donor eggs can be a profoundly creative and transformative experience. It invites new ways of thinking about kinship, inheritance, and what it means to be a parent. At the same time, DE can raise complex and often private questions: Will this child feel like my own? Will I bond with them? What does motherhood or parenthood mean without a genetic link?
These questions are not signs of inadequacy or ambivalence about the child, but expressions of a psyche working to integrate difference and loss alongside hope.
There are also relational and ethical considerations that may emerge over time — whether and how to tell a child they are donor-conceived, how to share this story with family, and how to hold one’s own feelings while protecting the child’s developing sense of self. Therapy offers a space to think through these questions without urgency or judgment, allowing parents to arrive at choices that feel emotionally authentic and sustainable.
In this phase, therapy can support the slow work of mourning what was not possible while also making room for something new to take shape. Patients are sometimes surprised to find the process transformative and enlivening beyond what they imagined, helping them move toward parenthood with greater emotional freedom, resilience, and openness to the unique family they are creating.
LGBTQ+ Individuals and Couples in Fertility Treatment
For LGBTQ+ individuals and couples, fertility treatment often unfolds within an additional layer of complexity shaped by social, legal, and relational realities. The process may require intentional engagement with third-party reproduction — such as donor eggs, sperm, or gestational carriers — from the outset, bringing questions about roles, recognition, and belonging into sharp focus.
Many LGBTQ+ patients also carry the emotional weight of navigating systems that were not originally designed with their families in mind, which can evoke feelings of invisibility, vigilance, or the need to repeatedly explain oneself. Therapy can provide a space to explore how these external pressures intersect with internal experiences of desire, identity, and family-of-origin narratives.
It offers support in thinking through questions of parental identity, difference, and disclosure, while also attending to the cumulative impact of minority stress. In this way, therapy can help LGBTQ+ individuals and couples feel more grounded and emotionally accompanied as they create families that are both deeply intentional and uniquely their own.
Pregnancy and the Postpartum Period
Pregnancy and the postpartum period often bring a profound emotional intensification that can feel surprising, disorganizing, or difficult to name. Alongside joy and anticipation, many people experience anxiety, grief, resentment, vulnerability, or a sense of unfamiliarity with themselves.
This period can reactivate early experiences and unconscious expectations about care, dependence, and responsibility. Therapy offers a steady, secure space where these feelings can be thought about rather than managed in isolation or dismissed as something to "get through."
By making space for ambivalence, fear, and change, therapy can help new and expectant parents remain emotionally connected to themselves and their relationships during a time of deep transformation — supporting not only symptom relief, but a more grounded, humane experience of becoming a parent.
The Transition to Caring for a Real Baby
The transition to caring for a real baby often involves a quiet but significant psychological shift — from relating to an imagined child shaped by fantasy, hope, fear, and unconscious expectation, to responding to an actual infant with their own rhythms, needs, and limits.
This meeting between fantasy and reality can stir feelings of love, disappointment, tenderness, grief, and disorientation all at once. In therapy, these reactions are understood not as failures of attachment, but as part of the necessary work of relinquishing imagined versions of parenthood in order to form a relationship with a real, separate other.
Therapy allows this mourning and adjustment to unfold without judgment, helping parents develop a more authentic, flexible connection to their baby and to themselves in the new role of caregiver.
Being Accompanied, Not Managed
Therapy offers an experience of being accompanied rather than managed. The relationship with your therapist becomes a living context in which vulnerability, helplessness, gratitude, anger, shame, or uncertainty can be expressed and worked through with another person.
This can be especially important in a process that often feels medicalized, isolating, and emotionally one-sided — where you may feel dependent on clinicians, protocols, donors, and outcomes beyond your control. Therapy does not aim to eliminate pain or ambivalence, but to make them more bearable and more thinkable. By putting words to what is often unspoken, therapy can support a deeper sense of agency and coherence, even in the midst of uncertainty.
Including Partners
Fertility challenges, pregnancy, and the postpartum period rarely affect only one person. Partners may feel frightened, excluded, helpless, or unsure how to support without making things worse.
When helpful, Stéphanie works with couples to explore these dynamics together — supporting communication, shared meaning, and mutual understanding so the emotional weight does not have to be carried alone or in silence.
Before, During, and After
Therapy can be supportive at many points along this passage:
Before or during fertility treatment, to help steady emotional life and make sense of what is emerging
During pregnancy, when vulnerability and psychological openness often increase
After birth, as identity, relationships, and inner life shift
Following loss or disruption, when grief may not yet have had space to be fully acknowledged
Some people come in the midst of crisis; others come seeking a place to integrate experiences that feel difficult to hold alone.
An Inclusive and Thoughtful Space
This work is offered with care for diversity in:
gender identity and sexual orientation
relationship structures
cultural, religious, and familial backgrounds
varied paths into parenthood
Differences are welcomed as meaningful parts of the emotional landscape, not treated as complications to be managed.
Therapy During Fertility and the Perinatal Period at Amphora Psychotherapy
Whatever stage of this passage you're in — trying to conceive, in the middle of treatment, newly postpartum, or still making sense of what you've been through — you don't have to carry it without support. Therapy offers a place to slow down, to feel what you're feeling, and to be accompanied through it rather than managed.
If you'd like to explore whether this work might be right for you, we invite you to schedule a consultation with Stéphanie.