The process of terminating therapy due to a therapist’s pregnancy and subsequent maternity leave presents significant emotional and professional challenges, particularly when the duration of leave is long or uncertain. While the termination of a therapeutic relationship is always a complex process, pregnancy introduces unique considerations, including the timing of disclosure, the potential emotional impact on patients, and the therapist’s own psychological experience. Following the line of the faculty viewpoint article, “Lessons Learned: Saying Goodbye to Patients” [1], published in this journal in 2024, the author considers it relevant to discuss therapists’ farewells in relation to their pregnancy leaves and maternity leave. In the case of the pregnant therapist, there are uncertainties as to how long the therapist will be absent from practice, if to return, which complicates the therapeutic processes and can generate a sense of anxiety in patients. The issue of terminating the therapeutic relationship is one of the aspects that pregnant therapists must address, and it can generate concern, anxiety, or doubts [2].

Beyond the influence that pregnancy may have on the therapist’s emotional states or on transference and countertransference processes, the beginning of motherhood implies a temporary withdrawal from professional practice, the duration of which varies depending on the country, as well as work conditions, personal circumstances, and medical factors. In Spain, maternity leave lasts 16 weeks, often supplemented by an additional 4 weeks of breastfeeding leave and the standard 1-month vacation period. Pregnancy leave begins at week 39 of gestation, but certain medical conditions or high-risk jobs (e.g., psychiatric inpatient units, where patients may exhibit psychomotor agitation) may lead to an earlier leave. Additionally, some parents (primarily women, accounting for 84.5% of cases according to Spanish data) opt for unpaid leave to care for children under 3 years old [3]. Consequently, in most cases, maternity leave results in at least 6 months of work interruption, often extending to a year or more, with significant repercussions for therapeutic processes. Thus, for pregnant therapists, saying goodbye to their patients is a priority not without difficulties.

On the one hand, while farewells can sometimes be planned with patients on the basis of the expected delivery date, in other cases, obstetric complications may cause an unexpected and premature interruption of the therapeutic relationship. On the other hand, therapists face dilemmas about the most appropriate time to inform their patients about the pregnancy and to plan the farewell. News of a pregnancy can elicit emotional reactions in patients and personal questions that the therapist may fear yet must address, often without specific therapeutic training. A survey conducted in Spain among 24 female therapists revealed that 75% had not received specialized training on therapist pregnancy and maternity [4]. Those who had received training did so through personal efforts to seek educational opportunities based on their interests and experiences [4].

I have experienced three pregnancies throughout my professional career, each presenting a very different experience. During my first pregnancy, while still a psychiatry resident, I treated it as a private matter, not sharing it with patients until my leave was imminent. My therapeutic training at the time, despite including a gender perspective, had not addressed the management of pregnancy’s effects on therapy. I feared that discussing my pregnancy might negatively impact some patients or require me to disclose personal information that could compromise therapeutic neutrality. This experience was marked by tension and discomfort. However, during my second pregnancy, working in child psychiatry in a Spanish public hospital and participating in a supervision group with women who had explored the influence of their pregnancies on their patients, I opted for open and natural communication with families starting in the second trimester. This approach facilitated better planning and farewells, even amidst the sudden onset of the COVID-19 pandemic. The experience was very positive. Generally, I did not perceive a negative impact on my patients due to the disclosure, and in some cases, it opened avenues for working with families, especially mothers, by revisiting emotional content, expectations, and difficulties encountered during their children’s early stages. The emotional mobilization of patients in response to their therapist’s pregnancy and the interaction in more personal ways have been described in the literature [2, 5]. I allowed patients to learn details such as the baby’s sex or the number of children I had, without making unnecessary self-disclosures but responding to socially common pregnancy-related questions.

My third pregnancy was marked by a sudden obstetric complication early in the second trimester, at a time when I had not yet disclosed the pregnancy to most of my patients. I was working in a public health service, and my patients were immediately assigned to another professional, which typically happens in cases of medical leave, and many patients expressed concern about my health. After discussion within the therapeutic team, we decided that the new professionals in charge would inform patients of the pregnancy and the need for rest. This information was well received, and patients responded with understanding to my sudden absence without the opportunity for a therapeutic farewell.

On the basis of my personal experience, I believe that explicitly disclosing a therapist’s pregnancy to patients can be beneficial for both parties, facilitating the farewell process they must undergo. In some cases, this disclosure may elicit emotional reactions in patients (mostly positive, according to my experience), which can create opportunities for therapeutic work. Therapeutic supervision and support from a knowledgeable and experienced team in pregnancy-related matters are highly recommended to manage complex, unexpected, or stressful situations for the pregnant therapist. It is essential to extend research to examine how the therapist’s own pregnancy affects her experience and therapeutic work. This would improve institutional support and provide pregnant therapists with the best training tools to handle complex situations that may arise with their patients.