Reproductive Health Psychology

?This wide-ranging and well-researched book goes well beyond the traditional confines of reproductive psychology. It expertly interweaves evidence on the biological, psychological, social and cultural factors that affect the reproductive development, behaviours, and decision-making of both women and men. As well as the expected chapters on sexual development, pregnancy and birth, and artificial reproduction, it addresses sex and gender development across the lifespan, from childhood to old age; parenthood; and reproductive issues for under-represented groups such as homosexual men and women, intersex individuals, and those who are childless by choice. The book will be a valuable reference for psychologists and sociologists, as well as midwives, gynaecologists and obstetricians, and indeed anyone with research or clinical interests that intersect with reproduction and with gender.?
Christina Lee, Professor of Health Psychology, University of Queensland

?This book provides a comprehensive and accessible introduction to psychological aspects of reproductive health throughout the lifespan. Drawing on psychological theory and a wealth of empirical research, the importance of psychological factors in reproductive health is clearly demonstrated, conceptualized within a broadly bio-psycho-social model. The coverage of a broad range of topics, from foetal growth to menopause, including adolescence, menstruation, contraception, abortion, fertility, pregnancy and post-natal experience along the way, is a great strength. This book will become a key resource for health psychologists, nurses, and medical students who wish to understand psychological aspects of reproductive experience. ?
Jane M. Ussher, Professor of Women?s Health Psychology, University of Western Sydney and Author of The Madness of Women: Myth and Experience

This much-needed resource brings together the most up-to-date and relevant research from a variety of disciplines to give a comprehensive account of the psychological factors surrounding reproductive health today. Olga van den Akker provides a multidisciplinary exploration of all stages of the reproductive life span, from embryonic, infant, child and adolescent sexual and reproductive development through reproductive and sexual health in adulthood and old age. The book addresses the psychological influences on and impacts of, sex, gender and reproduction as well as adjustment to life after sexual or reproductive success, failure or disease and disability. Together, the wide variety of topics are illuminating and challenging, fostering a deeper understanding of the context of reproductive health through the life span.

Preface xiii

Facts xvi

Acknowledgements xvii

Part 1 Psychology of Reproductive Health 1

1 Introduction to the Psychology of Reproductive Health 3

1.1 Maternal Morbidity and Mortality 4

1.2 Age Shifts and Reproductive Consequences 4

1.3 Interactions between Socioeconomic, Behavioural, Biological and Genetic Factors and Reproductive Health 6

1.4 Summary 13

1.5 References 13

2 Psychological Theories of Health and Illness 17

2.1 Twentieth-century Psychological Models Applied to Health and Illness 17

2.2 Health Psychological Models 18

2.3 Changing Health Status 25

2.4 Concepts Used in Health Psychology 25

2.5 Stress, Coping and Appraisal 26

2.6 Cross-cultural Differences 27

2.7 Ethical Issues 28

2.8 Counselling, Advice and Support 29

2.9 Methodologies 30

2.10 Summary 30

2.11 References 31

Part 2 Psychological Processes of Early Growth and Development 33

3 Growth and Development 35

3.1 Foetal Growth and Development 35

3.2 Infant and Child Growth and Development 36

3.3 Causes of Significant Variations in Growth and Development 37

3.4 Manipulations of Growth and Development 37

3.5 Disability 38

3.6 Gender Development 39

3.7 Causes of Significant Variations in Sex and Gender 40

3.8 Epidemiology 41

3.9 Screening / Assessment 41

3.10 Theories / Models 43

3.11 Treatment / Management 45

3.12 Guidelines 46

3.13 Summary 46

3.14 References 47

4 Adolescent Development 50

4.1 Behavioural Factors Influencing Reproductive Health Outcome 50

4.2 Epidemiology 50

4.3 Sexual Development 52

4.4 Effects of Adolescent Sexual and Reproductive Behaviours 52

4.5 Treatments / Interventions 53

4.6 Theories / Models 54

4.7 Disease and Treatment Effects on Adolescent’s Reproductive Health Outcomes 56

4.8 Individual, Household and Family 56

4.9 Guidelines 57

4.10 Interventions 58

4.11 Summary 58

4.12 References 59

Part 3 Psychological Factors of Menarche, Sexual and Reproductive Development 63

5 The Menstrual Cycle 65

5.1 Menarche 65

5.2 Menstruation 66

5.3 The Effects of Eating Disorders on the Menstrual Cycle 67

5.4 The Effects of Exercise on the Menstrual Cycle 68

5.5 The Effects of Nutrition on the Menstrual Cycle 69

5.6 Menstrual Cycle Disorders 71

5.7 Treatment / Management 73

5.8 Summary 75

5.9 Reference 75

6 Premenstrual Dysphoric Disorder 79

6.1 Epidemiology 79

6.2 Definition 79

6.3 Assessment / Measurement 81

6.4 Theories / Models 82

6.5 Characteristics of Women with PMDD / PMS 82

6.6 Effects of PMDD / PMS 83

6.7 Attributions of Symptoms to the Menstrual Cycle 85

6.8 Treatment for PMDD / PMS 85

6.9 Summary 86

6.10 References 86

7 Sex and Contraception 90

7.1 Sexual Behaviour 90

7.2 Sexual Dysfunction / Disease 91

7.3 Epidemiology 92

7.4 Interventions / Treatments 92

7.5 Contraception 93

7.6 Definition 93

7.7 Contraceptive Use 94

7.8 Safe Sex / Contraceptives Behaviours 94

7.9 Effects of Risky Sexual Behaviours 96

7.10 Processes and Factors Affecting the Problem 96

7.11 Theories / Models 97

7.12 Treatment / Management 99

7.13 Guidelines 99

7.14 Summary 100

7.15 References 100

8 Reproduction and Fertility 104

8.1 Definition 105

8.2 Lifestyle Factors Affecting Reproduction 106

8.3 Treatment / Management 113

8.4 Reproductive Health Promotion 114

8.5 Policy / Guidelines 115

8.6 Summary 115

8.7 References 115

Part 4 The Psychological Context of Infertility 119

9 Infertility 121

9.1 Epidemiology 122

9.2 Causes of Infertility 122

9.3 Behavioural and Lifestyle Factors 122

9.4 Infertility in Children and Young Adults Treated for Serious Illness 123

9.5 Behavioural Processes and Factors Affecting Infertility 126

9.6 Age Effects on Reproduction 127

9.7 Theories / Models 128

9.8 Gender and Cultural Differences 133

9.9 Coping with the Psychological Effects of Infertility 134

9.10 Social Support 136

9.11 Summary 137

9.12 References 137

10 Overcoming Involuntary Childlessness and Assisted Conception 144

10.1 Epidemiology 145

10.2 Effects of Lifestyle Factors on Treatment 146

10.3 Treatment / Management 148

10.4 Definitions and Consequences of Treatments 149

10.5 Adoption 165

10.6 Treatment Abroad 166

10.7 Ethical Issues 168

10.8 Giving Up Treatment 168

10.9 Counselling 169

10.10 Guidelines / Policy 169

10.11 Summary 170

10.12 References 170

Part 5 Psychological Processes of Fertility and Pregnancy 181

11 Pregnancy 183

11.1 Behavioural Factors 184

11.2 Lifestyle Factors 185

11.3 Psychological Factors 191

11.4 Social and Cultural Factors 192

11.5 Difficult Pregnancies 194

11.6 Effects of Maternal Mood on the Foetus 196

11.7 Partners of Pregnant Women 196

11.8 Theories / Models 197

11.9 Guidelines 197

11.10 Summary 198

11.11 References 198

12 Screening 207

12.1 Screening for Foetal Health 208

12.2 Screening Tests 208

12.3 Reasons for Uptake of Tests 210

12.4 The Consequences of Taking the Tests 211

12.5 Theories / Models 212

12.6 The Social Impact 215

12.7 Policy / Guidelines 215

12.8 Sex Selection 216

12.9 Foetal Reduction 217

12.10 Foeticide 218

12.11 Summary 218

12.12 References 218

13 Miscarriage 222

13.1 Definition 222

13.2 Epidemiology 223

13.3 Causes / Risk Factors 223

13.4 Theories / Models 225

13.5 Effects of Miscarriage 227

13.6 Monitoring / Assessment 232

13.7 Treatment / Interventions 233

13.8 Summary 234

13.9 References 235

14 Abortion 241

14.1 Abortion Procedures 241

14.2 Epidemiology 242

14.3 Legalization 242

14.4 Attitudes to Abortion 243

14.5 Abortion for Sex Selection 244

14.6 Abortion for Social Reasons 244

14.7 Abortion for Medical Reasons 245

14.8 Characteristics of Women Having Abortions 246

14.9 Psychological Effects 247

14.10 Partners of Women Having an Abortion 248

14.11 Theories / Models 249

14.12 Treatment / Interventions 250

14.13 Guidelines 251

14.14 Summary 252

14.15 References 252

Part 6 The Psychology of the Puerperium and Parenting 259

15 Labour and Delivery 261

15.1 Childbirth 261

15.2 Interventions 263

15.3 The Experience of Childbirth as a Traumatic Event 264

15.4 Preterm Labour / Delivery Complications 266

15.5 Perinatal Death 268

15.6 Summary 268

15.7 References 268

16 Perinatal Anxiety Disorders 272

16.1 Definitions 272

16.2 Epidemiology 274

16.3 Causes of Perinatal Anxiety Disorders 274

16.4 Theories / Models 275

16.5 Treatment / Management 275

16.6 Summary 276

16.7 References 276

17 Perinatal Depressive Disorders 279

17.1 The Baby Blues 279

17.2 Maternal Postnatal Depression 280

17.3 Paternal Postnatal Depression 288

17.4 Puerperal Psychosis 288

17.5 Summary 289

17.6 References 289

18 Parenting and the Postnatal Period 295

18.1 Effects of Parenting 295

18.2 Parenting Practices 296

18.3 Adjustment to Parenthood 297

18.4 Theories / Models 298

18.5 Gender Roles 299

18.6 Decision to Become Parents 300

18.7 Transition to Parenthood 302

18.8 Summary 307

18.9 References 308

Part 7 Psychological Factors of Menopause, Sex and Reproduction in Later Life 315

19 Menopause 317

19.1 The Menopause and Health 317

19.2 Definition 318

19.3 Causes of Menopausal Distress / Discomfort 319

19.4 Epidemiology 321

19.5 Screening / Assessment 321

19.6 Theories / Models 322

19.7 Processes and Factors Affecting the Problem 323

19.8 Treatment / Management 324

19.9 Guidelines 327

19.10 Summary 327

19.11 References 328

20 Ageing and Sexual Behaviours and Sexual Health 333

20.1 Factors Affecting the Sexual Health of Older People 333

20.2 Attitudes to Sex in Older People 334

20.3 Sexual Health Education 335

20.4 Effects of Ignorance / Problems with Sex 335

20.5 Health Risks 337

20.6 Theories / Models 338

20.7 Treatment / Management 339

20.8 Policy / Guidelines 340

20.9 Summary 341

20.10 References 341

21 Ageing and Reproduction 344

21.1 Epidemiology 345

21.2 Characteristics of Older People Seeking Assisted Conception 345

21.3 Reproductive Choice and Reproductive Rights 346

21.4 Reproductive Health of Older People 347

21.5 Reproductive Outcomes 348

21.6 Screening / Assessment 349

21.7 Treatment / Management 349

21.8 Theories / Models 350

21.9 Policy / Guidelines 350

21.10 Summary 350

21.11 References 351

Index 353

Olga B.A. van den Akker is Professor of Health Psychology and head of Department at Middlesex University London. Since completing her BSc and PhD in Psychology, she carried out postdoctoral research at the Institute of Psychiatry and St. George’s and St. Mary’s hospitals London, and held senior academic posts at a number of other UK Universities. She currently carries out research into the health psychology of challenging reproductive behaviours.