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Active ImageWHO 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

Last Updated on Wednesday, 15 April 2009 16:32

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