To keep a private practice alive during maternity leaves requires good self-care, mindful preparation of existing clients and careful planning for your return to work.

A maternity leave that is too long can result in a drop in the number of clients when you return. A leave that is too short (or a return on a stressful schedule) can cheat you, your baby and the rest of the family of enough time to adjust to the inevitable shifts in roles and relationships.

Let me be clear: Im not a researcher on the topic although since getting curious about it, Ive done a fair amount of reading. But I do have an n of 4, having brought 4 children into the world while in practice.

By number 3, I had a routine that worked. My practice not only survived but thrived as we added to our family. I share what Ive learned from my experiences as a point of departure for your thinking, focusing only on the practical aspects of navigating pregnancy and practice. I will leave it to each school of therapy to define what each feels is important therapeutic content.

Ten Tasks:

  1. Take care of yourself. Dont let yourself deny that your pregnancy is going to have an impact on your energy. Make sure you get enough rest, that you schedule breaks, and that you have food and water available. During my first pregnancy, I eventually bought a dorm size refrigerator for my office for water and juices and scheduled a 2 hour afternoon break for a nap. I wish I had thought of it sooner.
  2. Think carefully about what you are willing to share with clients. Will you limit information to an announcement of the pregnancy and the dates of maternity leave? Or are you willing to share details like the gender of the child or the planned names? Having clear boundaries in mind will help you preserve your privacy and will keep clients focused on their work.
  3. Think carefully about each of your clients history and diagnosis before informing them of your pregnancy. One size really does not fit all. Clients response to a therapists pregnancy is as unique as they are. By thinking ahead, you can be prepared to meet each persons potential needs.
  4. Dont wait too long to share the news. Sensitive clients will notice when you start gaining weight or look tired. Avoid the awkwardness of client ambivalence about whether to ask you questions or the equal awkwardness of being taken by surprise by client concerns.
  5. Determine when and for how long you will take a maternity leave. The advantage of private practice is that you have the freedom to make that decision. The down side is that there is no paid leave unless you are very good about putting money aside. Remember that babies have their own minds about when they will come into the world so create a plan with some flexibility or a Plan B if you go into labor earlier or later than you expect to.
  6. Consider whether and when you will stop taking on new clients. If you dont anticipate taking more than a few weeks off, you may be able to start new clients right up to your due date so long as those clients understand that plans can change if there is a problem. But if you anticipate taking time out for months, think about when it is fair to take on a new client.
  7. Develop a transition plan for on-going clients. If you intend to take a leave of more than a few weeks, decide whether you will be transferring on-going clients to a colleague or if you will be asking them to take a recess. Determine if transfers will be temporary or permanent. Think about whether you are willing and able to accept phone calls from on-going clients during your leave. Having a plan will ease both your own and the clients anxiety.
  8. Develop a financial plan: Fixed expenses dont go away while you are on leave. Create a budget for rent, utilities, etc. and set up a system for getting those bills paid. Since some clients will not return when you do, your income may drop for a few months after you resume practice. Anticipate and plan for it.
  9. Make a plan for how you will reactivate your referral network. Its likely that some clients will terminate therapy. Its possible that your referrals will drop off. If you are mentally and financially prepared, you wont panic. Make sure you have a mailing list or emailing list of your regular referral sources so you can send out an announcement of return to practice as soon as you are ready to do so.
  10. Set up a childcare arrangement that works with your practice: You may want to reconsider your practice schedule. Can you afford to drop back to part time for awhile? Can you go in later so you can have the morning with your baby? Can the babys other parent provide primary care a couple of evenings a week if you need to have those client hours to be financially stable? Investigate childcare options and make your choices long before you will need them.

The transition to parenthood often fosters a reconsideration of when and how we work. Each additional child changes the family configuration. Each new stage of development of our children places new demands on our time, finances and emotional energy.

Private practice offers options that dont exist in agency or academic work. It allows us to be creative in finding alternative ways to meet the competing demands of our professional and personal lives. One of the joys of private practice is the ability to design a family life/work life balance that is unique to our own beliefs and needs.

Pregnant woman photo available from Shutterstock