Sarah Maris-Shaw explains why becoming a parent is an occupational transition, how everyday activities can support recovery and why every occupational therapist should consider the whole family. 

Becoming a parent is one of the most significant transitions a person can experience. It changes identity, routines, relationships and responsibilities, whether someone is welcoming their first child or adding another baby to an established family. For Sarah Maris-Shaw, this makes perinatal mental health hugely relevant for occupational therapists. 

Parents must learn and adapt to new tasks while also managing their own physical and emotional health. Familiar routines around work, study, rest, eating, washing and social contact can change almost overnight. Birth recovery, pain, fatigue, low mood or anxiety may make ordinary activities harder, while the needs of the baby and any older children continue throughout the day. 

Occupational therapy brings these demands into focus. Rather than considering symptoms in isolation, an occupational therapist can help a parent work out how to care for themselves and their child(ren), rebuild structure, pace the day and maintain social connections. This practical focus is especially important when isolation itself may increase mental health risks. 

“It is a huge change for people. Occupational therapists can help them think about their roles, their relationships and the everyday tasks they need to learn or adapt to.” 
 

Making the whole day manageable 

Sarah often works with mothers who spend much of the day alone with a baby while their partner is at work. If someone is experiencing low motivation, anxiety or difficulty making decisions, even a loosely structured day can feel overwhelming. Occupational therapy can break that day into achievable steps and identify where pacing, practical adaptations or additional support may help. 

The work also extends beyond the parent at home and the baby. Older siblings may need attention and reassurance, partners may be adjusting to new expectations, and everyone may experience a complicated mixture of joy, resentment, envy, exhaustion and uncertainty. Sarah describes occupational therapists as well placed to explore how time, tasks and responsibilities are shared, while recognising that compromise will often be necessary. 

This whole family perspective helps prevent one parent from carrying every competing need alone. It also brings relationships into occupational assessment: how does a change in one person’s health or routine affect the baby, their partner, or other children? 
 

Matrescence and the experience of becoming a parent 

Sarah’s work considers matrescence: the physical, psychological, social and identity transition into motherhood. Becoming a parent can prompt people to revisit how they themselves were parented and what they believe a mother or parent should be. Early childhood experiences, family history, social expectations and the idealised images presented through social media may all influence those beliefs. 

For people who have experienced childhood adversity or trauma, routine parenting decisions can carry additional emotional weight. Sleep, feeding, play, shopping and cooking are not simply tasks; they may connect with past experiences, expectations and fears. Sarah’s approach is to help parents recognise that influence while strengthening their agency to make choices that fit their circumstances and values. 

There is rarely one correct way to complete an occupation. Introducing food, for example, can be a process of exploration and shared experience rather than a performance parents must get right. Helping someone understand the range of acceptable approaches can reduce anxiety and create space for the parents and child to learn together. 
 

Co occupation and building connection 

The concept of co-occupation is central to this work. During feeding, play, sleep routines and other daily activities, the parent and child influence one another: neither person’s occupation happens independently. These shared moments can support attachment and help a child feel safe, while also building the parents’ confidence and understanding of their baby. 

That relationship does not always feel immediate. Some parents are distressed because they do not experience the instant bond they expected. They may care deeply for their baby while feeling that love has not yet arrived, and the guilt attached to this can be profound. Sarah emphasises that connection can develop gradually through ordinary occupations: noticing the baby, playing, feeding and responding as the child begins to smile and give more feedback. 

“Parents can feel terrible if they do not fall instantly in love with their baby. We can support that relationship to develop slowly through the things they do together.” 
 

Why perinatal care matters across occupational therapy 

Occupational therapists encounter parents through mental health, physical health, social care, paediatrics and community services. Sarah wants practitioners outside specialist perinatal teams to recognise that a person’s parenting role remains relevant wherever they receive care. Her practical message is simple: think family. 

A parent with a long-term physical condition may previously have developed effective ways to manage it, only to find those strategies no longer work when carrying, feeding or changing a baby. Other parents develop new physical health problems following pregnancy or birth. Occupational therapists can consider positioning, equipment, environmental adaptations, fatigue and pain alongside mental health, as well as the possibility that the child may have additional needs. 

The same principle applies when a parent enters hospital or another service for an apparently unrelated reason. Their absence, health and changing capacity affect their children and family routines; those relationships also shape what recovery and discharge will require. Parenting is not an additional detail but part of the whole person. 
 

A profession with more to contribute 

Specialist perinatal mental health services have expanded during Sarah’s career, creating more opportunities for occupational therapists. Yet clinicians entering the area may still be unsure of their role, particularly when perinatal practice has received limited attention during their training. Sarah argues that the profession’s established focus remains the answer: activities of daily living, roles, relationships and environment are as relevant here as in any other setting. 

She would like perinatal mental health and family-focused practice to have a clearer place in occupational therapy education, supported by further professional guidance and accessible learning. Greater confidence would help more occupational therapists recognise risks, ask about parenting and understand how purposeful activity can support recovery and adjustment. 

“The misconception I want to challenge is that this is someone else’s job. Roles, routines, relationships and tasks are occupational therapy, and there is a real role for us here.” 

That role must be approached with sensitivity. Parents may fear judgement or worry that admitting difficulty could lead to their baby being taken away. Shame can make it extremely hard to say that parenting feels difficult. Building trust and giving people permission to speak honestly are therefore essential parts of effective support. 

Sarah’s message to those attending her session at the Occupational Therapy Show is both practical and hopeful. Occupational therapists can make a tangible difference by helping parents manage the day in front of them, understand their changing identity and participate in family life in ways that feel possible and meaningful. Perinatal mental health may be a specialist field, but thinking about parents, children and the occupations that connect them belongs to the whole profession.