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The Pregnant Therapist

In our book A Womb of Her Own (Routledge, 2017) I made the following comments about the experience of author Meredith Darcy as a pregnant therapist.

On the other hand, I believe that Darcy overlooks the excellent work that she did with this challenging patient before her maternity leave. She was able to connect emotionally with this woman in a way that was undoubtedly beneficial. Perhaps the therapist’s own experience of shame clouded her capacity to see her good work. As her pregnancy progressed, however, she encountered a “perfect storm” of emotion—her own and her patient’s as they both dealt with their lack of attuned mothering.

My Own Experience as a Pregnant Therapist

I am reminded of a case which Darcy mentioned in my personal communication with her. My patient, whom I will call Fran, was a woman in her mid-fifties while I was a young mother. She had come into treatment following an auto accident in which she was severely injured and suffering a lot of pain. We initially had a very positive connection, stemming in part, I believe, from her resemblance to my own mother. She was petite in stature with the same high cheekbones and sculpted features of my mother. As treatment progressed she was better able to manage her pain as well as her relationships with her children who found her difficult to deal with. This difficulty was due in part to her driven manner of speech and propensity for telling events in excruciating detail, characteristics that I found challenging as well.

As we probed more deeply into Fran’s background she related that although she had four adult children, she had had numerous miscarriages which had been very painful and disappointing to her. She came from a religion that valued fecundity in women. Around this time, I became pregnant with my fourth child. My patient worked in the neonatal unit of the hospital where I gave birth. She was present when my pediatrician announced that my baby was “the fourth son in this family.” After a Caesarean Section I returned to my part-time practice within 10 days. The treatment devolved after that for reasons that remain unclear although Darcy’s paper has been very helpful in this regard. Looking back, I believe that it was also “a perfect storm” of unmet needs and raw emotion that I can only now begin to untangle.

A Comedy of Errors

An incident around that time captured the infinite convolution of the treatment with Fran. I had recently returned from my C Section. Fran wore a neck brace due to her injuries and was unable to drive, so her daughter had dropped her off. For some reason her daughter then parked directly behind another car in our parking lot and walked off with the keys. A few minutes later there was a frantic knock at my office door. There stood a large woman in a hot pink bridesmaid dress. She was a tenant in the building and she told us that we had to move the car because she was late to a wedding. We had no keys and no way to move the car. With the help of the large woman, we contemplated moving the car by pushing it out of the way, but my patient was disabled and so was I. To this day I can’t remember what we did but the incident has stayed in my mind as representative of this treatment.

The Complications

There is no doubt that a pregnant therapist complicates the treatment. We can ignore that fact or we can address questions such as the following: Is the pregnancy of either patient or therapist an enactment? What can be done if a patient works at the hospital where the therapist gives birth? Just who is the mother then? Who is the baby? Who carries the pain of miscarriages and difficult births? Should therapists be forbidden from getting pregnant because it complicates the treatment too much? To that last question I will answer a resounding “No.” Complications are the stuff of life and our commitment in this volume is to speak about them as openly and clearly as possible.


The Pregnant Therapist

Ellen Toronto, Ph.D.

Dr. Ellen Toronto is a licensed clinical psychologist/psychoanalyst in the state of Michigan.

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APA Reference
Toronto, E. (2019). The Pregnant Therapist. Psych Central. Retrieved on November 21, 2019, from


Last updated: 18 Jun 2019
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