Recently when I was giving a talk on the psychoeducation and support of our nervous systems, I began by introducing myself and as such I had to explain the letters after my name (SEP and PMH-C). As I began to say, “PMH-C stands for certified in Perinatal Mental Health” I realized that it wasn’t until relatively recently that I learned this word, perinatal. I had, as many of you have, heard of postpartum, but perinatal was new to me until a few years ago. And as I explained in my talk, perinatal is the period of time occurring from conception until the first year of life. It is a very specific time wherein immense changes occur within and outside a birthing person’s body and it should be of surprise to no one (!!) that this is also a period of time for increased risk for psychiatric illness.

 As a matter of fact, 10% to 15% of women and birthing persons will end up developing perinatal depression (not to mention possibilities of perinatal anxiety disorder, perinatal OCD, perinatal PTSD, and perinatal psychosis). This makes perinatal depression the most common medical complication of childbirth. Read that again. It is an incredible statistic. Perinatal depression is the most common medical complication of childbirth, and yet here we are, defining what the very word “perinatal” even means.

Now, this is not to shame anyone for not knowing what this word means (please refer back to the first paragraph- me, a specialist in this area, not even aware of this word until a few years ago). It is, however, to point out that this is an immensely understudied and under-treated population. According to the American Psychiatric Association:

The complex interactions among reproductive biology and physiology, biopsychosocial factors associated with reproductive transitions, and psychiatric illness have historically fallen into a gap in modern medicine. Obstetrician-gynecologists, psychiatrists, family physicians, and pediatricians are all involved in caring for women’s physical and mental health, but because of varied training and scope of practice, a holistic approach to women’s reproductive mental health is difficult to achieve by an individual in any of these siloed specialties. Beal et. al. (2022, September 23). Special Report: Women’s Reproductive Mental Health- A Clinical Framework. Psychiatric News. American Psychiatric Association. https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2022.10.10.33

Let’s look at this yet another way. Women and birthing persons, have interactions with many different health care providers, and yet, PMADs (perinatal mood and anxiety disorders) continue to be under-diagnosed and under-treated. Because of our lack of a universal and holistic approach that includes many different providers, people get “lost in the cracks” or some providers may think it’s another provider’s responsibility or specialty instead and thus do not provide treatment.

 Additionally, as we have so often talked about here at Embody + Mind Collective, there exists this very real and very powerful connection between the mind and body. To make matters even more significant, we have seen that mental illness is often co-morbid (happens alongside of) many other female body related illnesses (think chronic pelvis pain, endometriosis, sexual dysfunctions, etc.).  And we also know that when we physically don’t feel well, it is incredibly difficult (read: damn near impossible) to feel emotionally well.

Now, reproductive mental health is concerned with the unique mental health needs, psychosocial challenges and treatment of individuals who experience mental health struggles in relation to their reproductive cycles. Throughout our lives, hormones impact women in different ways in regards to our moods and our emotions. Some of the common conditions reported are premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), infertility, pregnancy, pregnancy loss, and perimenopause. According to Frontiers in Global Women’s Health, there is an association between poor reproductive health and increased rates of depression, anxiety, and suicidality. Making things more complex, these very mental health struggles may also impact the hormones that control ovulation, making it more difficult to get pregnant. This can be a circular and very frustrating process for some individuals trying to become pregnant.

Reproductive mental health isn’t only specific to those that are wanting to or that are reproducing. Simply put, reproductive mental health is concerned with what occurs mentally and emotionally from various hormonal changes. According to the American Psychiatric Association, 50% of the population will experience something that could be deemed as related to reproductive mental health at some point in their lives. Whether individuals have been assigned female at birth, or identify as female, it is normal for these reproductive hormonal shifts to impact one’s mental health. And yet, here we are again, possibly just hearing of this phrase “reproductive mental health” recently (or today as you read this blog!).

Although perinatal mental health and reproductive mental health might be more “new on the scene” to researchers (for a variety of reasons including funding, failure to assess, minimization in self-reporting, etc.), we can all agree that these are not new experiences to the myriad of us that have been dealing with them for lifetimes. Here at Embody + Mind Collective, we specialize in treating perinatal and reproductive mental health. We offer in-person and virtual sessions, utilizing traditional talk therapy, Somatic Experiencing Therapy and Art therapy. Please contact us to learn more or schedule your first appointment.

 

Yours in solidarity,

 Tesa