Creator of the Perinatal Inner Readiness Profile and the RAD framework. The person who named Reproductive Anxiety Disorder.
If you support women around pregnancy, birth and motherhood, one of the hardest parts of the work is simply knowing where to start. A woman arrives frightened, often unable to articulate what she is most afraid of, and you have limited time. The Perinatal Inner Readiness Profile, the PIRP, is a perinatal assessment tool I built to solve exactly that problem: getting to the heart of the matter, fast.
Why I built it
I built the PIRP because these women are so often on a clock. A woman may only realise she is terrified the moment she sees two lines on a test, with months, not years, ahead of her. Another is 38 or 40, weighing up whether to try at all. Their biology is already imposing a timeline, and a practitioner needs to understand what is going on quickly, not after months of circling.
Existing fear-of-childbirth measures tend to be built around pregnancy and around fear of an approaching birth. The PIRP instead assesses the wider picture, what a woman is carrying around pregnancy, birth and motherhood, grounded in the RAD framework, and it works whether or not she is pregnant.
How practitioners use it
The simplest way to use it is at the start of your work together. The client completes the assessment, and you get a clear, structured read on where her fear and readiness actually sit, so you can focus your time where it counts rather than spending sessions trying to locate the real issue.
It is not an intake-only tool, though. Many practitioners run it again partway through a piece of work, and at the end, so that both they and the client can see how far she has moved and where attention still needs to go. Used that way, it becomes a map of the whole journey, not just a snapshot at the door. On my own programmes a client completes it at the beginning and again at the close, and the contrast is often a powerful moment for her.
Who it suits
The PIRP fits a wide range of practitioners, therapists, counsellors, coaches, doulas, midwives and other perinatal professionals, because it does not depend on any one modality. You can use it as a structured starting point regardless of how you then work with what it surfaces.
It comes as codes you assign to clients, with a single code to try it and volume packs for ongoing use, so you can start small and scale as it earns its place in your practice. You can find the details on the PIRP page. If you want to understand the thinking behind screening this way first, see how to screen for fear of childbirth, and the free Introduction to Tokophobia webinar sets the wider context.
Frequently asked questions
What is the PIRP?
The Perinatal Inner Readiness Profile is a structured perinatal assessment tool built on the RAD framework. It gives practitioners a clear read on what a woman is carrying around pregnancy, birth and motherhood, and where her fear and readiness sit, so they can focus their work quickly. It works whether or not she is pregnant.
How do practitioners use the PIRP with clients?
Most commonly at the start of the work, to see where to focus, and then again partway through or at the end, to track progress. It is not intake-only. Used across a piece of work, it maps the whole journey and shows both practitioner and client how far she has moved.
Who can use the PIRP?
A wide range of perinatal professionals, including therapists, counsellors, coaches, doulas and midwives, because it does not depend on any single modality. It works as a structured starting point regardless of how you then choose to work with what it surfaces.
About the author: Alexia Leachman trains and equips perinatal professionals to recognise and support tokophobia and Reproductive Anxiety Disorder, and built the Perinatal Inner Readiness Profile as a practical assessment for this work. More about Alexia →
The PIRP is a structured psychological assessment, not a diagnostic instrument, and does not replace clinical judgement or your scope of practice.
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