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This is a useful book for any psychoanalytic psychotherapist seeing a patient during her pregnancy — or indeed just before or after pregnancy. It is extremely comprehensive, to the extent of discussing, towards the end of the book, the effects on both patient and therapist of the therapist herself being childless, a parent, or pregnant. I did feel the author was under pressure to cover absolutely every possible psychoanalytic factor and viewpoint — an aspect of her writing particularly apparent in her earlier book, Psychological Processes of Childbearing, but perhaps this is hardly a justifiable complaint!
The author employs a system of dividing pregnant women into three categories, according to their psychological orientation: the Facilitator, whose centre of gravity shifts inwards and who denies ambivalence; the Regulator, whose life-style changes as little as possible, the baby instead having to make adaptations; and the Reciprocator, having a circular as opposed to a linear orientation to the pregnancy, with a capacity to remain aware of ambivalence and internal contradictions. These distinctions provide a very useful framework, lending clarity and continuity to the narrative, and supported by well-chosen excerpts from both individual and group recordings.
The greater accessibility of unconscious material when working with pregnant women, and the way in which this affects the theoretical process are investigated at length, and attention is also given to resistances, such as fantasies of the baby ‘listening in’ to the therapy, and competition around attention or references to the emotional needs of the baby within, and the emotional needs of the woman's baby-self.