Fertility, Infertility, and Sexuality

  • Malkah T. Notman
Part of the Critical Issues in Psychiatry book series (CIPS)


Pregnancy is a complex experience, with many personal, societal, and economic implications. It can be a confirmation of adulthood or a fulfillment of childhood wishes and fantasies. It can represent a mature wish for a child, an expression of creative desires, or an accidental, unanticipated, or denied result of sexual relations. Sometimes all of these elements are present to some extent. Pregnancy can also be a maturational experience and has been considered a normal “developmental crisis” (Benedek, 1959, 1970, Bibring, 1959). This chapter will consider some of the motivations, psychological concomitants, and consequences of pregnancy and the postpartum period and their effects on sexuality.


Oral Contraceptive Sexual Desire Sexual Relationship Postpartum Period Contraceptive Method 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Adams, D., Gold, A., and Burt, A. Rise in female-initiated sexual activity at ovulation and its suppression by oral contraceptives. New England Journal of Medicine, 1978, 299 (21), 1145–1150.PubMedCrossRefGoogle Scholar
  2. Adler, N. Psychosocial issues of therapeutic abortion. In D. Young and A. Ehrhardt (Eds.), Psychosomatic obstetrics and genecology. New York: Appleton—Century—Crofts, 1980. Pp. 159–177.Google Scholar
  3. Babikian, H. Abortion. In B. Saddock, H. Kaplan, and A. Freedman (Eds.), The sexual experience. Baltimore, Md.: Williams and Wilkens, 1976. Pp. 349–357.Google Scholar
  4. Behrman, S., and Kistner, R. Progress in infertility ( 2nd ed. ). Boston: Little, Brown, 1975.Google Scholar
  5. Belsey, E., Greer, H., Lal, S., Lewis, S., and Beard, R. Predictive factors in emotional response to abortion: Kings Termination Study IV. Social Science and Medicine,. 1977, 11, 71–82.CrossRefGoogle Scholar
  6. Benedek, T. Infertility as a Psychosomatic Defense, Fertility and Sterility, 1952, 3; 527–541.PubMedGoogle Scholar
  7. Benedek, T. Sèxual functions in women. In S. Arieti, American handbook of psychiatry. New York: Basic Books, 1959. Vol. 1, p. 37.Google Scholar
  8. Benedek, T. The psychobiology of pregnancy. In J. Anthony and T. Benedek (Eds.), Parenthood: Its psychology and psychopathology. Boston: Little, Brown, 1970.Google Scholar
  9. Beral, V., and Kay, C. R. Mortality in women on oral contraceptives. The Lancet, 1977, 2; 1276–1277.CrossRefGoogle Scholar
  10. Bernard, V. Psychodynamics of unmarried motherhood in early adolescence. Nervous Child, 1944, 4; 26.Google Scholar
  11. Bibring, G. Some considerations of the psychological processes in pregnancy. Psychoanalytic Study of the Child, 1959, L4; 113.Google Scholar
  12. Bradley, R. Husband-coached childbirth. New York: Harper and Row, 1965.Google Scholar
  13. Bunker, J. Elective hysterectomy: Pro and con. New England Journal of Medicine, 1976, 295 (5), 64–72.Google Scholar
  14. Castelnuevo-Tedesco, P., and Krout, B. Psychosomatic aspects of chronic pelvic pain. Psychiatry in Medicine 1970, 1 (2); 109–126.CrossRefGoogle Scholar
  15. D’Esopo, D. Hysterectomy when the uterus is grossly normal. American Journal of Obstetrics and Gynecology, 1962, 83; 113–122.PubMedGoogle Scholar
  16. Deutsch, H. Psychology of women, Vol. II; Motherhood. New York: Grune and Stratton, 1945. Dick-Reid, G. Childbirth without fear (4th Ed.). New York: Harper and Row, 1972. (Originally published, 1944.)Google Scholar
  17. Doering, S., and Entwisle, D., Preparation during pregnancy and ability to cope with labor and delivery. American Journal of Orthopsychiatry, 1975, 45; 825–837.PubMedCrossRefGoogle Scholar
  18. Enkin, M., Smith, S., Dermer, S., and Emmett, J. An adequately controlled study of the effectiveness of PM training. In M. Norris (Ed.), Psychosomatic medicine in obstetrics and gynecology, Proceedings. Basel: Karger, 1972.Google Scholar
  19. Fleming, O., and Seager, C. Incidence of depressive symptoms in uses of the oral contraceptive. British Journal of Psychiatry, 1978, 132 (43); 430–440.Google Scholar
  20. Freeman, E. Influence of personality attributes on abortion experience. American Journal of Orthopsychiatry, 1977, 47 (3); 503–513.PubMedCrossRefGoogle Scholar
  21. Friedman, E. The psychological aspects of pregnancy. In M. Notman and C. Nadelson (Eds.), The woman patient, (Vol. I ). New York: Plenum, 1978.Google Scholar
  22. Gilligan, C. In a different voice: Women’s conception of the self and morality. Harvard Education Review, 1977, 47 (4), 481–517.Google Scholar
  23. Grover, J. Personal communication, 1978. Lectures given in Human Sexuality course, Harvard Medical School, 1979.Google Scholar
  24. Jaffe, F. The pill: A perspective for assessing risks and benefits. New England Journal of Medicine, 1977, 297 (11); 612–614.PubMedCrossRefGoogle Scholar
  25. Jessner, C., Weigert, E., and Foy, J. The development of parental attitudes during pregnancy. In J. Anthony and T. Benedek (Eds.), Parenthood: Its psychology and psychopathology. Boston: Little, Brown; 1970. Pp. 209–244.Google Scholar
  26. Kaltreider, N., and Margolis, H. Childless by choice: A clinical study. American Journal of Psychiatry, 1977, 134; 179–182.PubMedGoogle Scholar
  27. Klein, H., Potter, H., and Dyk, R. Anxiety in pregnancy and childbirth. New York: Hoeber (Harper), 1950.Google Scholar
  28. Lerner, J. Parental mislabeling of female genitals as a determinant of penis envy and learning inhibitions in women. Journal of the American Psychoanalytic Association, 1976, 24 (5); 269.Google Scholar
  29. Lidz, R. Conflicts between fertility and infertility. In M. Notman and C. Nadelson (Eds.), The woman patient (Vol. I ). New York: Plenum, 1978.Google Scholar
  30. Lipowsky, Z. (Ed.). Psychiatry in medicine, Vol. 5, Current trends in psychosomatic medicine I. 1975.Google Scholar
  31. Lipowsky, Z. (Ed.). Psychiatry in medicine, Vol. 6, Current trends in psychosomatic medicine II. 1974.Google Scholar
  32. Mann, E., and Armistead, T. Pregnancy and sexual behavior. In B. Sadock, H. Kaplan and A. Freedman, (Eds.), The sexual experience. Baltimore, Md.: Williams and Wilkins, 1976. Chap. 8, pp. 238–248.Google Scholar
  33. Marder, L. Psychiatric experiences with a liberalized therapeutic abortion law. American Journal of Psychiatry, 1970, 126, 1230–1236.PubMedGoogle Scholar
  34. Margolis, A., Rindfuss, R., Coghland, P., and Rochat, R. Contraceptive practice after abortion. Family Planning Perspective, 1974, 6: 55–60.CrossRefGoogle Scholar
  35. Masters, W. H., and Johnson, V. E. Human sexual response. Boston: Little, Brown, 1966.Google Scholar
  36. Mazor, M. The problem of infertility. In M. T. Notman and C. Nadelson (Eds.), The woman patient. New York: Plenum, 1978.Google Scholar
  37. McCauley, E., and Ehrhardt, A. Female sexual response. In D. Youngs and A. Ehrhardt (Eds.), Psychosomatic obstetrics and gynecology. New York: Appleton—Century—Crofts, 1980. P. 53.Google Scholar
  38. Mead, M., and Newton, N. Cultural patterning of prenatal behavior. In S. Richardson and A. Guttmacher (Eds.), Childbearing, its social and psychological aspects. Baltimore, Md.: Williams and Wilkins, 1967. Meikle, S. The psychological effects of hysterectomy. Canadian Psychological Review,1977, 18(2), 128–139.Google Scholar
  39. Meikle, S., Brody, H., and Pysh, F. An investigation into the psychological effects of hysterectomy. Journal of Nervous Mental Disorders, 1977, 164 (1), 36–41.CrossRefGoogle Scholar
  40. Menning, B. Infertility: A guide for the childless couple. Englewood Cliffs, N.J.: Prentice—Hall, 1977. Mester, R. Induced abortion and psychotherapy. Psychotherapy and Psychosomatics, 1978, 30, 98–104.CrossRefGoogle Scholar
  41. Moore, J. T., and Tolley, D. Depression following hysterectomy. Psychosomatics, 1976, 17, 86–89.PubMedGoogle Scholar
  42. Morganthau, J. E. Adolescent health care. Westport, Conn.: Technomics, 1977.Google Scholar
  43. Morgner, S. Sexuality after hysterectomy and castration. Women and Health, 1978, 3 (1), 5–9.Google Scholar
  44. Mozley, P. Emotional parameters of infertility. In D. Youngs and A. Ehrhardt (Eds.) Psychosomatic obstetrics and gynecology. New York: Appleton—Century—Crofts, 1980.Google Scholar
  45. Nadelson, C. Normal and special aspects of pregnancy. Obstetrics and Gynecology, April 1973, 41, 4. Norman, W. Postpartum disorders. In A. Freedman and H. Kaplan (Eds.), Comprehensive textbook of psychiatry. Baltimore, Md.: Williams and Wilkins, 1967.Google Scholar
  46. Notman, M., and Nadelson, C. Reproductive crisis. In A. Brodsky and R. Hare-Mustin (Eds.), Women and psychotherapy. New York: Guilford, 1980.Google Scholar
  47. Payne, E., Kravits, A., Notman, M., and Anderson, J. Outcome following therapeutic abortion. Archives of General Psychiatry, 1976, 33, 725–733.PubMedCrossRefGoogle Scholar
  48. Peck, A., and Marcus, H. Psychiatric sequelae of therapeutic interruption of pregnancy. Journal of Nervous and Mental Disorders, 1966, 143, 417–425.CrossRefGoogle Scholar
  49. Pitt, B. Maternity blues. British Journal of Psychiatry, 1973, 122, 431–433.PubMedCrossRefGoogle Scholar
  50. Richards, D. Depression after hysterectomy. The Lancet, 1973, 2, 429–433.Google Scholar
  51. Roe, V., 1973, Wade: U.S. Supreme Court 93: 705.Google Scholar
  52. Roeske, N. Hysterectomy. In M. Notman and C. Nadelson (Eds.), The woman patient. New York: Plenum, 1978.Google Scholar
  53. Rosenfield, A. Benefits still outweigh risks with OC’s and IUD’s. Modern Medicine, March—April 1978, 91.Google Scholar
  54. Sandberg, E. Psychological aspects of contraception. In B. Sadock, H. Kaplan, and M. Freedman (Eds.), The sexual experience. Baltimore, Md.: Williams and Wilkins, 1976.Google Scholar
  55. Sandler, B. Emotional stress and infertility. Quarterly Journal of Psychosomatic Research, 1968, 12, 51. Schaffer, C., and Pine, F. Pregnancy, abortion and the development tasks of adolescence. Journal of Child Psychiatry, 1975, 14, 511–536.Google Scholar
  56. Seiden, A. The sense of mastery in the childbirth experience. In M. T. Notman and C. Nadelson (Eds.), The woman patient. New York: Plenum, 1978. Pp. 87–107.Google Scholar
  57. Stoller, R. Primary feminity. Journal of the American Psychoanalytic Association, 1976, 24(5), 59–78.Google Scholar
  58. Tietze, C. Contraceptive practice in the context of a non-restrictive abortion law. Family Planning Perspective, 1975, 7 (3), 197–202.Google Scholar
  59. Vessey, M., McPherson, K., and Johnson, B. Mortality among women participating in the Oxford Family Planning Association Contraceptive Study, The Lancet, 1977, 2, 731–733.CrossRefGoogle Scholar
  60. Warnes, H., and Fitzpatrick, C. Oral contraceptives and depression. Psychosomatics, 1979, 20 (3), 187–194.PubMedGoogle Scholar
  61. Wilson, J., Barglow, P., and Shippman, W. The prognosis of post-partum mental illness. Comprehensive Psychiatry, 1972, 13, 305–316.PubMedCrossRefGoogle Scholar
  62. Wolff, B., and Langley, S. Cultural factors and the response to pain. Journal of American Anthropological Society, 1968, 70, 494–501.CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • Malkah T. Notman
    • 1
  1. 1.Department of Psychiatry, New England Medical CenterTufts University School of MedicineBostonUSA

Personalised recommendations