I attended a fascinating presentation earlier this week by established Denver therapist Dr. Jennifer Harned Adams about the “Psychological Aspects of Women’s Reproductive Health”. Dr. Adams is a specialist in women’s issues relating to fertility, complicated pregnancy and childbirth, pregnancy and infant loss, and pregnancy and Post-partum Adjustment and she uses a Whole Woman Wellness Approach to consult, assess, and treat women (and their partners) who are going through these issues.
The entire presentation was full of great information and resources about pregnancy and related issues; I had no idea how complicated and complex these concerns can be and how many decisions need to be made that can affect emotional states and coping. In the realm of fertility, there is so much to consider, whether you are fertile and want the child, or infertile and want to have children. Dr. Adams referenced a recent New York Times article The Two-Minus-One Pregnancy, which focuses on the new trend of couples who have used in-vitro fertilization or another type of treatment to conceive, and find that they have multiple embryos growing when they had only planned for one — this may be due to financial or health reasons. Some doctors are helping couples terminate unwanted embryos — can you imagine the debate and controversy that this invites? I encourage you to read the article and the comments it produced.
Dr. Adams also touched on the sensitive and deep issue of pregnancy and infant loss. She works with couples who have lost pregnancies and who are in mourning of this loss, and she described the common reactions that couples have to this trauma: emotional numbing, fear, anger, having a sense of still being pregnant, guilt, and shame. I was taken aback by the high statistics that she presented on this type of loss: approximately 25% of all women will experience a pregnancy loss at some point in their lives. “Many women,” Dr. Adams stated, “may not even know they were pregnant and lose the baby thinking they were having an abnormally heavy period.” She also offered the statistic: “10-25% of all medically confirmed pregnancies will end in loss”. That is shockingly high. A point that stuck with me was how men are just as much victims of pregnancy losses as their partners are, and they are often overlooked or forgotten. A loss such as this needs lots of attention and empathy for both partners, as each will cope in his or her own way. Working with a professional such as Dr. Adams or another specialist can help couples define their feelings and come together in healing instead of shut each other off to their feelings.
The area where Dr. Adams focused and in which I was particularly interested was that of Post-partum Adjustment (which can include depression). Post-partum depression is not talked about much in our society. There is an expectation to be “happy and joyful” when you have a child (and of course, exhausted and adjusting). What happens when a mother is depressed during or after her pregnancy? She may be ostracized. She may hear quotes such as in the title: “why are you sad? you have a healthy baby!”. This can be especially difficult for a depressed mother to hear if she has gone to extreme measures to conceive (such as in-vitro) and still feels down. Many women may experience the birth of their child as traumatic in some way and the anxiety and stress from that event can carry forth into post-partum if not treated.
It is very common for new parents to experience the “baby blues” (up to 80% of new moms experience this). What is the baby blues? You may have trouble sleeping, eating too much or too little, feel tearful, overwhelmed, or have mood swings — typical new-parent adjustments. Post-partum depression, however, is more severe and lasts longer. Post-partum depression affects 1 in 8 new moms — the most common medical complication of childbirth! It can be influenced by prior depression or a family history of depression, and usually peaks at 3-4 months post delivery. It is a serious condition in that it can affect the new mom’s ability to bond with her child or provide it with the best care for its needs. While we are often thinking of the baby and its health in the first few months of its life, we may forget to check up on how the new mom is doing. Doctors should be giving mothers screenings at their six-week check-ups (which they may avoid if they are depressed) to see if the symptoms are present. Most cases of Post-partum depression are not treated because they are not diagnosed or the mom (or dad, who can have PPD as well) do not disclose their feelings.
There is great need for intervention and treatment in the area of women’s reproductive health. I am grateful that I met Dr. Adams and was given all of these wonderful resources so that I may use them to help my clients or give them appropriate referrals. You can find out more about Dr. Adams at her website.