Reproductive Psychological Health and Wellness refers to the psychological well-being related to reproductive processes and issues.  Women, Men, and Partners may suffer psychological distress as it relates to these issues.  Reproductive mental health and psychological well-being can improve with therapy. 

Any woman, man, and non-binary individual, couple, or family may experience Psychological strain, stress, and distress in dealing with the following challenges: Fertility and Conception Concerns; Perinatal (antenatal and/or postpartum) Anxiety, Depression, OCD; Parenting Preterm, Perinatal Trauma; Perinatal Loss; Pregnancy After Loss; Reproductive Related Pain; Menopause; Andropause; Medical Issues & Surgery related to Reproduction.

The Alberta Reproductive Psychological Health Centre (ARPHC) offers therapy, education, and resource and referral information related to these areas.  Acknowledging difficult emotions, thoughts, and symptoms, and seeking help and assistance takes courage and vulnerability, simultaneously - if you are here because you are struggling, you are commended on taking the first step.

The therapeutic relationship need cultivate a deep and enduring curiosity and self-compassion for one's own personal journey, provide appropriate and accurate psychoeducation, and develop the conditions for healing through this alliance.  Reproductive Psychological Health and Well-being is a unique area of mental health and requires a gentle, empathic, accepting environment with deepened education, awareness, understanding, and experience in these specific areas. 

Call for a free consultation. 780.222.4616

 

What is a Perinatal Mood Disorder?

Perinatal Mood Disorder

Any mental health disorder which occurs during the peripartum period (pregnancy up to 12 months postpartum) and are related to a reproductive event.  This may include a depressive disorder, an anxiety disorder, obsessive compulsive and related disorders, trauma disorders or other mental health issues such as the onset of bipolar disorder or psychosis.

 

Some women experience anxiety, depression, anger, obsessive or intrusive thoughts, or perinatal OCD, and fluctuating moods which interfere with functioning during pregnancy or postpartum.  Men and partners of new mothers may also experience symptoms of anxiety, depression, and adjustment.

Who suffers from Perinatal Mood Disorders - Antenatal/Postpartum Anxiety & Depression

Most women notice a period of time following labour and delivery during which they experience strong emotions and reactions and my find themselves tearful, weeping, or crying.  This is generally considered to be a short-lived period called 'baby-blues' and can be expected about 3 days after delivery, not lasting more than a couple of days.  This brief upset does not generally interfere in functioning, relationships, or self-concept.

 

Some women develop symptoms either during pregnancy or following labour and delivery which are more difficult to manage and which suggest a major depressive episode, the onset or worsening of anxiety, difficulty adjusting, intrusive thoughts, and various somatic, or body related, symptoms.  If these changes last over two weeks or are severe, a woman is encouraged to seek medical/mental-health assistance. 

Anyone may develop a perinatal mood disorder, also referred to as antenatal anxiety or postpartum depression, and while there are risk factors which may increase the changes of experiencing this, there are many women who suffer who would report no obvious risk factors. 

Risk Factors:  Risk factors are situations, events, or circumstances which may contributed to an increased likelihood of developing a mental health concern.  These are known risk factors related to the development of perinatal mood disorders.

  • Low socio-economic status

  • Minority group status – e.g. new Canadians, LGBTQI,

  • Violence

  • Lack of autonomy in making reproductive decisions

  • Unintended pregnancy

  • Adolescence

  • Unequal division of emotional/practical labour in the household

  • Occupational fatigue

  • Criticism or lack of support by peer group or elders

  • Discrimination

  • Reproductive difficulties and complications

  • Pre-existing mental health concerns

  • Poor physical health

  • Inadequate or unsafe housing conditions

  • History of trauma

Signs and Symptoms:

  • Reduced interest and enjoyment

       with regard to previously enjoyed activity

  • Insomnia or hypersomnia

  • Fatigue

  • Lethargy

  • Rumination

  • Significantly low or high levels of arousal

  • Restlessness

  • Poor concentration

  • Poor decision making

  • Intrusive thoughts or images involving distressing

       themes, sometimes of harm coming to the baby

  • Melancholia

  • Unwavering gaze

  • Depressive stupor

  • Slack facial musculature

  • Trembling

  • Collapsed posture

  • Tearfulness

  • Shaking

  • Talkativeness

  • Shallow breathing

  • Tense or rigid posture

  • Wide eyes or hyper-vigilant gaze

Symptoms may be made worse by:

  • Extreme fatigue

  • Increase in responsibilities

  • Role transition

  • Relationships stress

  • Domestic violence

  • Partner suffering mental illness

  • Substance use

Poor perinatal mental health may negatively affect:

  • Relationships

  • Social networks

  • Involvement in the workforce

  • Interpersonal relating

  • Attachment

Barriers to service for perinatal mental health include:

  • Poor knowledge of service

  • Poor understanding of what is and what is not a ‘normal’ part of motherhood

  • Where or when to seek assistance

  • Attitudes and stigma

  • Fear of apprehension of children

  • Expectation of self-sufficiency and achievement

  • Desire to preserve an image of competency

  • Dismissive and neglectful response from health professionals

  • Lack of trust in health professionals

  • Time management

  • Childcare difficulties

  • Transportation

  • Cost

  • Poor access to appropriate resources,

       and professionals with adequate screening tools, training, and treatment interventions.
 

Therapy helps.  Making the decision to seek help is an important one; it is an empowering step toward help and healing.  Reaching out takes courage and vulnerability.  Perinatal mood disorders and other reproductive mental health issues are deeply personal and may leave you feeling isolated.  Sharing space, difficult emotions, and worries with a psychologist who has experience in this area may help you feel less alone and provide help and healing to you.  Reaching out will very likely change your peripartum experience. 

 

      You are welcomed to read through some carefully selected thoughts common to women with peripartum mood disorders who have struggled.  These are not testimonials but simply a reaching out so you may not feel quite so scared or alone.

 

 

Other Perinatal Mood Disorders may include trauma related disorders: complex bereavement, adjustment, acute stress, posttraumatic stress disorder, or another trauma related disorder.

Trauma related to perinatal events

Trauma may include adjustment disorder (symptoms of traumatic stress occurring within the first month following an overwhelming experience), posttraumatic stress disorder (onset of symptoms of traumatic stress begins one month or longer after the overwhelming experience), or another trauma disorder.  In the context of a perinatal event, a woman may experience symptoms of trauma following an overwhelming labour and delivery, particularly if there was unmanaged pain, intense fear, or a threat to the life of the mother or baby; or, a woman may experience symptoms of traumatic stress if she experiences perinatal loss or if she becomes pregnant following a previous traumatic loss.  Traumatic loss may lead to a cluster of symptoms termed complex bereavement which is considered a trauma disorder and may follow perinatal loss. 

Women who have suffered difficult labour and delivery or a traumatic birth are at a higher risk for a mood disorder in the peripartum period.  Previous trauma may also be associated with symptoms.

Some women who have suffered reproductive medical trauma - invasive IVF procedures, emergency Caesarian, or postpartum hemorrhage have expressed that, at a time when they were acutely aware of, in tune with, and protective toward their body, intense pain, near death experiences, and a perceived loss of control and decision making was devastating.  For these Moms, anxiety and fears around being able to handle motherhood may be compounded by trauma, and postpartum depression and a trauma disorder may occur at the same time. 

Some women who have a history of sexual assault have reported experiencing distress during pre-natal exam or have reported panic and/or dissociative symptoms during labour and delivery. This incongruence between experience and expectations can ignite some difficult core beliefs and problems with adjustment.

Intimate partner violence, relational trauma, developmental trauma, motor vehicle accidents, complex bereavement, significant life changes... these factors may complicate the peripartum experience.  It is important to take a look at symptoms which may indicate traumatic stress.

 

Perinatal loss

Perinatal loss, unexpected or unexpected, includes early or late pregnancy loss, still-birth, therapeutic abortion, neonatal loss, or loss of a child up following the first year after delivery.  Perinatal loss may be accompanied or followed by feelings of sorrow, loss, and grief, or a trauma disorder, such as complex bereavement, posttraumatic stress disorder, acute stress disorder, or adjustment disorder.

Pregnancy after loss

A pregnancy following perinatal loss may feel difficult and there may be signs and symptoms of anxiety, depression, or traumatic stress.  This can be a confusing time for women as they identify conflicting emotions, including fear, shame, guilt,  apprehensive or conflicted joy, or an inability to experience joy, and loss of a hoped for or expected positive pregnancy experience.

 

Other Reproductive Mental Health Concerns - Women

Reproductive mental health and wellness for women refers to mental health issues, symptoms arise from, and treatment, and wellness related to, situations and events associated with the reproductive aspects of a woman's life, including perinatal mood disorders - depression, anxiety, OCD, trauma; perinatal loss, pregnancy after loss; chronic pelvic pain; conception and fertility; and, gynaecology.

Chronic Pelvic Pain

One of the challenges in dealing with chronic pain is mental wellness.  Women challenged with chronic pelvic pain may experience symptoms of anxiety, depression, anger, and difficulties with self-concept and self-esteem.  Women suffering from mental health symptoms related to chronic pelvic pain, such as loss and adjustment and the emotional aspects of living with chronic pain may find help in speaking with a psychologist who can work with these issues related to pelvic pain.

 

Conception and Fertility

Women and their partners may be challenged with concerns, issues around, and concerns with conception and fertility, including in vitro fertilization; these may elicit symptoms of anxiety, depression, anger, and difficulties with self-concept and self-esteem.

Menopause

Women experiencing menopause may experience various mental health symptoms associated with this phase of life including anxiety, depression, anger, and changes in self-perception, self-concept, and self-esteem. 

Maternal-Foetal Mental Health

Women experiencing challenges within their pregnancy who are considered to have a high-risk pregnancy, or who are involved with a Maternal - foetal Medicine Centre, may find that following a diagnosis and/or during decision making, they need extra support.  These women and families may experience symptoms of anxiety, depression, anger, and adjustment disorder (symptoms of traumatic stress). 

 

Gynaecology

Women experiencing medical or surgical treatments related to gynaecology may experience symptoms of anxiety and depression or traumatic stress.