This should be one of the most fulfilling and exciting periods of my life. Instead, I'm lost. In two months' time, I'm due to give birth to a baby son, my first child. All the indications are that he is in perfect health. My partner is delighted at the prospect and I know that I am too. At least, I should be. Very close to the time when I conceived, my mother was found to have pancreatic cancer. After a devastating illness, she died only 15 weeks later. We were as close as I can imagine a daughter and mother can be - she raised me with joy, passion, and intelligence - and now she is dead. It makes no sense to me. I feel numb, marooned in a nightmare. Antenatal classes are a torture; being surrounded by joyful mothers-to-be when all I want to do is weep and hide. I worry that I will transmit all this horror to my child, that I am failing to connect with my child and that I could even somehow end up implicating him in my grief. And I worry about postnatal depression. My mother was so delighted when she learnt that she was to be a grandmother. I know she would want me to delight in him too. But I can't.

Emma, Nottingham

Emma, first of all let me say how sorry I am to hear of your horrendously-timed loss. You find yourself in an incredibly difficult place; just when you are wanting to prepare to welcome a new life, you find yourself having to contemplate the loss of the person who not only gave you life, but who would have been such a steadfast support and source of wisdom as you become a mother for the first time.

The internal emotional conflict that you are suffering is extreme. But do not allow yourself to think that it is unnatural or wrong to feel the way that you do. Your natural excitement at the prospect of motherhood is suppressed as you find yourself faced with this profound loss - which at any time of your life would be intensely difficult to deal with, but which is now especially cruel and problematic.

The first thing I will say is that it is important that you try to keep the two factors - your bereavement and your pregnancy - separate. I know it is hard. But you must let yourself know that your baby has no responsibility for the loss of your mother and that loss should not have any impact on your relationship with your baby. You may well need to talk about this with someone. While you are continuing through the last weeks of your pregnancy, you should always allow yourself to grieve - but try to resist any temptation to implicate your child in that grief. It sounds, too, as if you feel disengaged from your baby at the moment. Remember that a lot of women - a lot of women who have none of the problems you face - feel that way. It is OK not to be completely in love with your child before he is born. There is so much social pressure on women to fulfil that ideal of the mum-to-be, totally absorbed and in love with their children-to-be.

Pregnancy and birth are very different experiences and some people fall in love with their baby only after they hold them for the first time. Some mothers take longer. They may find bonding with this new human being a challenge. Often that is because women have a hormonal response after birth, or other factors, that can lead them to suffer from the postnatal depression that you worry about.

This is an illness that can be treated. You are insightful enough to have the concerns that you do, and you should make sure that you talk to your midwife, your GP and your partner now about how you feel so that appropriate support is available to you whenever you need it. Let them know so they can help you. Another source of support is Cruse Bereavement Care (0844 4779400; www.crusebereavementcare.org.uk). You may also find useful the Post Natal Illness Support Forum (www.pni.org.uk), which is run and staffed by mums who have been through postnatal depression.

Don't be afraid to ask for help. And never feel that you are in the wrong - there is no right or wrong here.

One last thought: patients I have encountered in this situation or who have lost a previous baby can find themselves tempted to see their new child as an embodiment of their lost loved one. It can be a seductive thought. Resist it. It is very important that this new child is allowed to have his own identity. Emma, I sincerely hope your baby will eventually bring you joy, and that joy will nourish you as you work through the loss of your mother.

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