Afterthoughts NI


My name is Anne Marie McKinley. I am a midwife and a therapist. Allow me to share a little about the world of counselling for Birth Trauma in which I work.

Through a model of care, I provide counselling for women and men in a very particular way. This has evolved over the past five years to meet the needs of clients, and is person and story centred. This way of working was audited by the Trust where I work. The results of the audit demonstrated the effectiveness of this model of care.

I have set up a company this year called Afterthoughts Counselling and Training Ltd, we are small with plans to grow.

Mental health services are a hot topic. The local community and NHS has excellent therapists, professional services, and experienced mental health teams. Yet there are still so many needs that can’t be met for everybody.

There are many aspects of becoming a mother that are affected by the journey. Becoming pregnant can be welcomed, longed for or dreaded. The pregnancy can be a wonderful stress free journey, or painful and problematic. The birth journey tends though to be where most women and men will have begun the trauma response that follows them into the postnatal period and beyond.

I have lost count of the number of women who have told me they don’t think they could do it again. I have heard what happened in the birth story and this has surprised me at times; normal birth can be traumatising. Dramatic and emergency births can be recovered from easily.

This unpredictability in sessions makes the work there interesting and challenging. I certainly have developed a healthy respect for what is the brain’s reaction to threat. More importantly the mind-brain combination’s capacity to help, when harnessed, is powerful. Often times wonderful to witness.

Clients find that moment of fear again in therapy, enabling the fear response to complete the process it began during the birth is very satisfying. It feels natural because it is. The process brings a great deal of relief that is normally discernible immediately. The strange thing is that this way of working is not time limited and so events from years ago can be accessed easily by clients in session. Trauma, and the trauma response needs to be treated with respect, and so is a place I tread carefully in.

Anxiety is often the primary response to a traumatic birth. When it is left untreated it can lead to depression. When depression is the primary response it can go very deep, igniting previous life trauma responses, or hurts, or moments that have never been understood by the client.

Sometimes a great deal can be done for both situations. Sometimes it is not appropriate to uncover the whole history. Sometimes too, it is the only way to encourage relief. Sometimes referral to further counselling or for psychiatric input can be the best thing. provides a counselling service and works with both men and women who have adverse reactions along the pregnancy continuum.

We normally treat a Traumatic Birth response within 4 weeks of therapy. During pregnancy, with more complex trauma, some of the treatment can be delayed until after birth.

We offer care for both men and women. Men are recognised much less often as requiring recognition of their journey. We know that women experience the effects of a trauma response in birth. Men fare badly too, and are often overwhelmed and wounded by not being able to help, or being present and traumatised by what they have seen. Men develop anxiety responses and birth trauma. Still focused on a caring role in the immediate time after baby’s birth, reluctant to make an issue of their feelings, it is often up to a year later that they have developed depression. At this point it can be difficult to track it back to source.

At times too it can be difficult in relationships to re-establish the romance and relationship quality that existed before baby was born. We work with couples.

We work also to prepare and equip women who continue to experience symptoms. We work with the clients to complete a psychological birth plan and provide insight into the birth story.

I hope this gives a flavour of this new service and how we work. Our website gives you more information. Please contact us if you would like to be seen, or for more information. Find Afterthoughts Counselling and Training Ltd at Afterthoughtsni.comIf you like us on Facebook and read the journals on the website we will hopefully become visible to those who need this type of care.

Our premises are on the Ravenhill Road and are accessible to the M1, M2, and M3. We are happy to accept clients from across the province.

Anne Marie and Team  

Click here to view the Afterthoughtsni website and here to link to their Facebook page. For more information, please contact Anne Marie and her team - they would be delighted to hear from you and help you.