Reproductive Health Psychology

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 post-doctoral 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.

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 Signifi cant 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 Signifi cant 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 Infl uencing 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 Defi nition 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 Defi nition 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 Defi nition 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 Defi nitions 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 x Contents 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 Diffi cult 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 Defi nition 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 Defi nitions 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 Defi nition 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