How to Plan a Private Practice Maternity Leave

At the end of 2020, I was thrilled to accomplish my ultimate professional goal of starting a solo private practice. I opened my doors on a Tuesday. On Friday of that week, I took a pregnancy test—and it came back positive. 

The immediate joy I felt for my personal life was quickly followed by anxiety and apprehension for my business. While I had navigated pregnancy and maternity leave as a mental health professional once before, I had done so with the administrative and managerial support of the large group practice that employed me at the time. I was anxious to find a way to take care of myself, my clients, and my growing baby at the same time. 

How I Planned My Private Practice Maternity Leave

Thankfully, with diligence, planning, and communication, I was able to create a comprehensive plan as a therapist going on maternity leave. My plan allowed me to communicate with my clients throughout my pregnancy, take my leave with confidence, and return to my still-thriving practice when I was ready. I’m happy to share that the secret I discovered to this process has been to lean heavily on well-tested ethical practices of consultation, documentation, and informed consent. These are the steps that I took (and one thing I wish I had done differently) to apply these concepts in creating my maternity leave plan. Here’s my plan broken down in true pregnant lady fashion: by trimesters! 

Consultation with Other Therapists

Taking any time off in private practice can be tricky, but it’s generally doable if you have a solid network of trusted therapists to consult with and refer your clients to. Consultation was key in planning my private practice maternity leave.  

First trimester
In the first few months of my pregnancy, I was constantly consulting with myself. Thinking through questions like “When should I tell my clients that I’m pregnant?” (I chose the 6-month point). “How much time will I want to take off?” (I wound up planning for 10 weeks). What things need to be in place for me to feel good about taking the time away? (A solidified plan for each client, clear documentation of this plan, comprehensive referral resources, and a communication plan for when I returned from leave). It was a lot to conceptualize, but I knew first and foremost I needed to wrap my head around what I wanted for my business and my family.

Second trimester
As soon as it felt right for me to share news of my pregnancy with others, I reached out to my local consultation group asking to get connected with any other therapists in private practice that had recently navigated maternity leave. After all, why reinvent the wheel if someone else could share their experience? My big takeaway from these conversations was to plan for the worst and hope for the best. One therapist had experienced a premature delivery and wished they’d had a better plan for communicating to clients what would happen if they would need to start their leave early. With this noted, “Come up with a pregnancy emergency communication plan” was added to my to do list.

Third trimester
As my due date grew closer, I began reaching out to trusted colleagues to compile a list of referral sources that matched the specific needs of my clients—like their locations, accepted insurance plans, and speciality areas. It was very important to me that I provided high quality options to my clients, and that the people I was recommending were willing and able to take on new clients, either temporarily or permanently. 

Communication Through Documentation

I knew one of the most important parts of preparing as a therapist going on leave was creating transition plans for the clients in my care. I also knew from my first pregnancy that, while they would all be offered a referral, many of them would decline to take it and instead opt to wait until I returned from leave. I needed to have documents and plans in place for both eventualities.

First trimester
To streamline this process for myself, I drafted a document that included basic information about my upcoming leave, like my anticipated last day in the office and how long I planned to be away. I asked each of my clients to specify whether they’d like to receive an appropriate referral or pause their services until I returned. I also asked them to select their preferred method of notification for my return date. 

This document also noted that all clients would receive a list of potential alternative providers—regardless of their choice noted on the form—to be used if they experienced a change in functioning or had an emergency that required treatment while I was away. 

Second trimester
After my conversation with the colleague who experienced a premature birth, I realized I needed a plan for how to communicate with my clients if any pregnancy-related emergency interrupted my work before my scheduled leave. Being in solo practice meant I didn’t have a secretary or teammate that could call and cancel appointments for me, so I needed to find a different solution. 

I created a release of information for my clients to sign that consented to me sharing their phone number with my husband, whose full name was noted on the document, so that he could notify them of my absence via text message in the event of an emergency. Clients were allowed to opt out, but were advised that in doing so they may not be notified in a timely manner if a treatment disruption occurred. 

Ultimately, every one of my clients consented to be contacted by my husband if necessary. I created a list of phone numbers, coded with a key that I kept separately, and stored it in a password protected file on a flash drive. I also included previously crafted messages for my husband to send for both birth and non-birth emergencies. 

Thankfully, I made it to my planned leave without issue. However, I have since realized that if I had experienced an emergency prior to taking leave, I would need my husband with me—not busy texting my clients. I chose him because I trust him, but I ultimately recommend selecting another trusted colleague instead of your partner. This is the one thing I would have done differently when planning my private practice maternity leave. 

Third trimester
By my third trimester, all my documents were created, distributed, signed, and stored in client charts via their client portal. I saved my referral list for last, wanting this to be as up-to-date as possible. Once I identified providers and practices that were ready and willing to take on my clients, I created a list with all of their relevant information—accepted insurance plans, locations, specializations, and ages—in one place. I did this so any of my clients who initially had opted out of referrals could easily find an appropriate provider if they changed their mind. I also shared this document with my clients through their client portals, so it was easy for them to access and download if they needed it. 

At this time, I also updated my website’s information to note my maternity leave, paused my online directory listings, and set up a voicemail message and an email to my clients about my maternity leave. 

A Focus On Informed Consent

Informed consent was at the heart of all my plans from the beginning. I wanted my clients to feel included in this process—after all, it directly impacted their mental health care. Most importantly, I wanted them to feel confident in my commitment to their well-being, and that they had some autonomy in their decisions. 

First trimester
By the end of my first trimester, any new clients that were potentially coming onto my caseload were advised of my pregnancy—even before my existing clients knew. This was to give them the opportunity to decide if they wanted to begin working with me knowing I would be going out in a matter of months, or if they would rather receive alternative referrals.

Second trimester
At this point, I did what therapists do best: talked to my clients. By this time my belly was giving me away. Having clients know such a personal thing about your current life is uncomfortable for therapists, but I found that answering simple and appropriate questions about the health and well-being of myself and the baby fostered a deeper, more genuine rapport. This also made it easy for me to present them with the documents I named above, as I knew they understood their options and trusted that I prioritized their care.

Third trimester
As my due date came closer, I began checking in with clients at each session to confirm their choice of plans, allowing anyone to change their minds as needed. Anyone who wanted one (and those for whom, in my professional opinion, a gap in services would be inappropriate) was given an immediate referral to another practitioner or group practice. I made sure everyone knew when my planned last day was, but also that they understood the unpredictable nature of pregnancy and had reviewed and consented to my emergency communication plan. I reminded them of the referral list, where they could find all of this information in their client portals, and assured them all that I would eagerly be back soon. 

All this planning, though it involved a lot of work and thought, allowed me to enjoy my time away with my beautiful second baby and resume my caseload within weeks of being back. I hope other therapists can use the message here to help them lean into tried-and-true ethical best practices, while at the same time—to quote Beyoncé—be “strong enough to bear the children, then get back to business.”