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 WHO
in collaboration with the Key Centre for Women’s Health in Society, WHO
Collaborating Centre in Women’s Health at the School of Population Health,
University of Melbourne, and UNFPA developed a Global Review on the Mental Health
Aspects of Women’s Reproductive Health. The Review responds to a prime
concern women around the world have expressed that the mental health implications
of certain reproductive events/problems are huge and compromise in multiple
ways their health and their wellbeing - but that in most countries mental health
as a component of reproductive health services remains inconspicuous, peripheral
and marginal. Furthermore, this lack of attention is unfortunate, given the
significant contribution both mental health and reproductive health make to
the global burden of disease and disability.
This Review is a unique document containing all available evidence regarding the relationship between women’s mental health and selected aspects of their reproductive health. It includes a discussion of the biopsychosocial factors that create vulnerability to poor mental health and those that might be protective and the types of programmes that could mitigate adverse effects and promote mental health.
The document is based on research on these subjects over the last 15 years from high, middle and low-income countries. Evidence from peer-reviewed journals has been used wherever possible but has been augmented with results of a specific survey initiated to gather state of the art information on reproductive and mental health issues from a variety of potential researchers and interested parties.
Valuable data from consultant reports, national programme evaluations and postgraduate research work was also compiled, analyzed and synthesized. Where evidence exists, suggestions are made regarding the most feasible ways in which health authorities could advance policies, formulate programmes and reorient services to meet the mental health needs of women during their reproductive lives. Where gaps in the evidence are identified, recommendations are made about the areas and topics of research that need to be investigated. It is hoped that this review will draw attention to the large and important overlap between mental health and reproductive health, stimulate much needed additional research and serve to advocate that policy makers and reproductive health services must expand the scope of existing services to embrace a mental health perspective. Data from developing countries is minimal and this need has been highlighted throughout the text. (Au)
Mental health aspects of women’s reproductive health; A global review of the literature
CONTENTS
Acknowledgements
Foreword
Chapter 1. Overview of key issues
The global burden of reproductive ill-health
Researchers’ views
Women’s views
Focus and framework of the current review
Reproductive rights
Gender, rights and reproductive mental health
Chapter 2. Pregnancy, childbirth and the postpartum period
Mental health and maternal mortality
Maternal deaths by inflicted violence
Mental health and antenatal morbidity
Mental health and postpartum morbidity
Biological risk factors for postpartum depression
Psychosocial risk factors for postpartum depression
Maternal mental health, infant development and the
mother-infant relationship
Summary
Chapter 3. Psychosocial aspects of family planning
Contraceptive use and mental health
Mental health and elective abortion
Summary
Chapter 4. Spontaneous pregnancy loss
Mental health and spontaneous pregnancy loss
Medical treatment of spontaneous pregnancy loss
Summary
Chapter 5. Menopause
Mental health and the perimenopausal period
Menopause: a time of increased risk for poor mental health
Well-being in midlife and the importance of the life course
Summary
Chapter 6. Gynaecological conditions
Non-infectious gynaecological conditions
Infectious gynaecological conditions
Malignant conditions
Summary
Chapter 7. Women’s mental health in the context of HIV/AIDS
Gender and the risk of contracting HIV/AIDS
Gender-based violence and HIV/AIDS
Migration and HIV/AIDS
Mental health and HIV/AIDS
Summary
Chapter 8. Infertility and assisted reproduction
Causes of infertility
Psychological causation of infertility
Psychological impact of fertility
Psychological aspects of treatment of infertility using assisted reproductive technology
Psychological aspects of pregnancy, childbirth and the postpartum period after assisted conception
Parenthood after infertility and assisted reproduction New technologies and their implications
Summary
Chapter 9. Female genital mutilation
Health effects of female genital mutilation
Summary
Chapter 10. Conclusions
Overview of key areas discussed
Annex. WHO survey questionnaire on the mental health aspects of reproductive health
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