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Infertility and Perinatal Loss: When the Bough Breaks

  • Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
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Abstract

Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy.

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Authors and Affiliations

  1. Department of Psychiatry, University of Washington, Box 35650, Seattle, WA, 98195, USA

    Amritha Bhat

  2. Departments of Psychiatry and Obstetrics and Gynecology, UMass Medical School, Worcester, MA, USA

    Nancy Byatt

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  1. Amritha Bhat
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Correspondence to Amritha Bhat.

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Conflict of Interest

Amritha Bhat is a postdoctoral fellow in the NIMH T32 MH20021 Psychiatry-Primary Care Fellowship Program Training Grant PI Unutzer 07/01/15–06/30/17.

Nancy Byatt has received grant funding/support for this project from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grants KL2TR000160 and KL2TR001455. Dr. Byatt has also received salary and funding support from the Massachusetts Department of Mental Health via the Massachusetts Child Psychiatry Access Project for Moms (MCPAP for Moms) and is the Medical Director of MCPAP for Moms.

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The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

This article is part of the Topical Collection on Complex Medical-Psychiatric Issues

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Bhat, A., Byatt, N. Infertility and Perinatal Loss: When the Bough Breaks. Curr Psychiatry Rep 18, 31 (2016). https://doi.org/10.1007/s11920-016-0663-8

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