Prenatal & Postpartum Therapy in Vancouver, WA

Compassionate, specialized support for the journey into parenthood. Prenatal & postpartum therapy in Vancouver, WA & online across Washington State.

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Baby feet zoomed in

This Wasn’t What You Expected

Maybe you expected more joy, but instead you’re overwhelmed, anxious, or feeling disconnected. Pregnancy loss, infertility, or a traumatic birth may have left you wondering if you’ll ever feel like yourself again. The gap between what motherhood is “supposed” to look like and what you’re actually living can feel isolating and confusing.

At Refuge, we know that becoming a parent is one of the most vulnerable, transformative experiences of your life. You don’t have to pretend everything is fine, and you don’t have to do this alone. We offer specialized prenatal and postpartum therapy to help you navigate this season with real support and real help for healing.

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What We Do in Prenatal & Postpartum Therapy

Depression, anxiety, OCD, panic, and trauma responses during pregnancy and postpartum are real, treatable conditions. We provide evidence-based care to help you feel like yourself again.

Whether you experienced a traumatic birth, pregnancy loss, infertility, or NICU time, we create a safe space to grieve, process, and heal from experiences that have left deep wounds.

Motherhood changes everything. We help you navigate the grief of who you were, the uncertainty of who you’re becoming, and the integration of your old self with your new role.

Becoming parents can strain even the strongest partnerships. We help you and your partner communicate, reconnect, and navigate this transition together with more understanding and less resentment.

Between sleep deprivation, hormonal shifts, and the weight of new responsibilities, it’s easy to lose yourself. We help you set boundaries, reduce overwhelm, and create space to care for yourself while caring for your baby.

Pregnant woman sitting on couch with hands on her stomach

What We Won’t Do In Therapy

  • Tell you to “just be grateful”
  • Minimize your struggles because “this is what you wanted”
  • Make you feel guilty for not feeling instantly bonded to your baby
  • Shame you for needing support

Instead, we’ll honor your experience and do the real work together.

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Prenatal & Postpartum Therapy in Vancouver, WA

More Than Reassurance: Our Evidence-Based Approaches

Perinatal mental health requires specialized care. We use proven therapies designed specifically for pregnancy, postpartum, and the unique challenges of this life stage.

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Our Therapeutic Approaches

We integrate evidence-based and experiential therapies to support you through this transition:

CBT is highly effective for perinatal mood and anxiety disorders. We help you identify and challenge the anxious or depressive thoughts that are keeping you stuck—like fears about being a bad mom or intrusive thoughts that terrify you. You’ll learn practical tools to manage symptoms and regain a sense of control and confidence.

ACT helps you make room for difficult emotions while still moving toward the life and motherhood you want. Instead of fighting against anxiety, sadness, or guilt, you learn to hold these feelings with compassion while taking action aligned with your values. This approach is particularly helpful for moms who feel stuck between what they “should” feel and what they actually feel.

You might have one part of you that loves your baby fiercely and another part that resents the loss of your old life. IFS helps you understand these conflicting feelings with compassion, allowing you to integrate all parts of yourself without guilt or shame. This approach is particularly helpful for moms struggling with ambivalence, identity loss, or harsh self-criticism.

Becoming parents changes your relationship. EFT helps you and your partner understand each other’s emotional needs, break negative cycles, and rebuild connection during a time when you might feel like roommates instead of partners. This approach is especially powerful for couples navigating the stress, exhaustion, and disconnection that often come with new parenthood.

When your mind is racing with worry or you’re replaying what went wrong, mindfulness brings you back to the present moment. We teach you practical mindfulness tools that work even with a crying baby, sleepless nights, and the chaos of early motherhood. These practices can reduce anxiety, improve emotional regulation, and help you find moments of peace amid the overwhelm.

Reality therapy focuses on what you can control right now. Instead of getting lost in what you “should” be doing or feeling, we help you make practical choices that support your wellbeing and relationships. This approach is grounding and empowering for moms who feel overwhelmed by all the conflicting advice and expectations.

Change is hard, especially when you’re exhausted and overwhelmed. Motivational interviewing helps you identify what you truly want for yourself and your family, and supports you in taking steps toward those goals—even when everything feels impossible. This approach honors your autonomy and meets you exactly where you are.

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Why Choose Refuge Counseling & Wellness

At Refuge, you won’t be told to “just enjoy every moment” or that “this too shall pass.” You’ll find real support and belonging in our deeply hospitable therapeutic center. We understand that seeking help during pregnancy or postpartum takes immense courage, especially when society expects you to be glowing and grateful.

Ryanne Smith, our perinatal specialist, brings warmth, expertise, and deep compassion to her work with moms and moms-to-be. She has advanced training in perinatal mental health and truly understands the complex emotions, relationships, and transitions that come with this season.

Meet Our Team
Ryanne Smith

Perinatal Specialist

How Perinatal Therapy Works at Refuge

We get to
know you

Taking time to understand your unique journey—your pregnancy, birth story, losses, fears, and hopes

We Make
a PLAN

Creating a customized therapy approach that honors your experiences and meets your specific needs

We help
you GROW

With guidance and support, you’ll work toward healing, connection, and finding yourself again

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Frequently Asked Questions About Prenatal & Postpartum Therapy

PMADs include depression, anxiety, OCD, panic disorder, PTSD, and psychosis that occur during pregnancy or the first year postpartum. These are medical conditions—not personal failures or signs of weakness. PMADs are treatable, and you can feel better with the right support.

It’s normal to feel overwhelmed, tired, or uncertain as a new or expecting mom. However, if you’re experiencing persistent sadness, intense anxiety, intrusive scary thoughts, difficulty bonding with your baby, thoughts of harming yourself, or feeling unable to function, it’s time to reach out. You don’t have to wait until it gets “bad enough”—if you’re struggling, you deserve support now.

Perinatal mental health issues don’t only happen after birth—they can start during pregnancy. In fact, treating anxiety and depression during pregnancy can prevent more severe postpartum symptoms. We’re here to support you through pregnancy just as much as postpartum.

Absolutely. Birth trauma is real and can have lasting impacts on your mental health and your ability to bond with your baby. EMDR and other trauma-focused therapies can help you process what happened so you can move forward with more peace and less pain.

This is more common than you think, and it doesn’t mean you’re a bad mom. Bonding difficulties can stem from birth trauma, depression, exhaustion, or past experiences. Therapy can help you understand what’s getting in the way and support you in building that connection—without judgment.

Yes. Grief from miscarriage, stillbirth, infertility, or loss is profound and deserves dedicated space to heal. Ryanne specializes in supporting individuals and couples through reproductive loss and the emotional toll of trying to conceive.

Yes! We offer couples therapy for partners navigating the transition to parenthood together. Ryanne can help you communicate better, reconnect, and support each other through this challenging season.

Never. At Refuge, we believe there’s no such thing as a perfect mom—only real moms doing their best. You’ll find a safe, compassionate space where you can share your darkest thoughts and hardest feelings without shame.

Ryanne works with pregnant individuals, new moms, and parents navigating the postpartum period. She also supports individuals dealing with infertility, pregnancy loss, birth trauma, NICU experiences, and caregiver burnout. Additionally, she works with couples adjusting to parenthood.

Refuge is private pay only and does not accept insurance.

For the latest pricing, check Ryanne’s profile page. A full, transparent breakdown of pricing will be provided for all clients.

Refuge Counseling & Wellness accepts credit card payments. Payments are due at the time of each service.

Super Bills — Ryanne can supply you with a super bill, which is a receipt with your diagnosis code that can be submitted to insurance for partial or full reimbursement for therapy services. Not sure if you qualify? Call your insurance provider and ask whether they will reimburse you for an out of network therapist.

Health Savings Accounts (HSA)/Flexible Spending Accounts (FSA) — HSAs and FSAs can help you pay for therapy. Check your individual plan for details.

We recommend weekly 50-minute sessions, especially in the early weeks and months of treatment. As you feel stronger and develop coping strategies, sessions can be spaced to every other week or monthly for ongoing support.

We offer online therapy across Washington State, so you can attend sessions from the comfort of your home—even with a baby in your arms if needed. We understand the logistical challenges of new motherhood and want to make support as accessible as possible.

We offer therapy at our office in Vancouver, Washington as well as serve clients across Washington state via video sessions. Our office is located at 13912 NE 20th Ave. Suite 204 Vancouver, WA 98686.

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