"How can you help with reproduction?" That is a question I get often when I tell people I specialize in reproductive mental health. While humans have been reproducing since...well...since the beginning of humankind, the ways in which we conceive, birth, and raise children has changed throughout our history.

From birthing in fields as they picked crops to birthing in hospitals surrounded by medical equipment and staff, the way we labor and birth children has developed from a community event to a medical one. We have seen a resurgence of women choosing to labor either in birthing centers or at home in the last several years as they seek to have a more control over their environment and experience. Other women prefer to schedule C-sections in order to control timing and their experience.

While the majority of humans still conceive via the old-fashioned route of sexual intercourse, we are now aware that one out of every 7 couples trying to conceive will experience infertility. Medical advancements have made it possible for us to fertilize eggs in laboratories and transfer embryos into the uterus. In addition, we have seen a few cases of uterus transplants to give women struggling with infertility the opportunity to experience pregnancy and childbirth. No two infertility journeys are the same. There is a lack of awareness by society regarding the amount of time, effort, finances, and sacrifice is required to pursue fertility treatments. These are very simplistic descriptions of very complex medical experiences and procedures that end in loss 50% of the time.

Reproductive loss occurs in several ways and is not uncommon. Yet, it is still a disenfranchised grief. Whether a loss occurs naturally in early pregnancy, via abortion, due to stillbirth, during birth, or in the first year after birth; women, men, and families may experience multifaceted reactions that can impact finances, relationships, spirituality, emotions, mental health, social interactions, legal situations, and their environments. Grief is a lifelong experience that is as diverse as those experiencing it.  These experiences become even more complicated when political, legal, and government systems become involved.

For some, the experience of infertility or reproductive loss is further complicated by vulnerabilities created by societal influences, lack of access to medical systems, and public debate regarding the legalities of these experiences. Whether someone has disabilities, financial insecurity, and/or is a part of the LGBTQ+ community, their reproductive experiences are not theirs alone. They may require additional support and resources to find solutions to reproductive complications. Shame and stigma regarding the structure of their family may make seeking healthcare more difficult. As our culture continues to debate societal factors involved in reproduction, those experiencing struggles need a place to explore their thoughts, feelings, beliefs, and behaviors regarding their reproductive journey.

Reproductive mental health seeks to acknowledge unique experiences, provide safe and neutral environments for exploration of how reproduction impacts all areas of health, and walk alongside patients as they seek healing and to make meaning of their experiences. No two days are the same in my specialty. I have the deep honor of seeing humans at the two most vulnerable and powerful experiences of their lives: birth and death. While birth and death are natural and universal experiences, they may also be profound. Not all experiences involve pathology or diagnosis. All experiences can impact mental wellness.

No, I am not involved in the process of reproduction, outside of my own experiences. I am involved in the processing of reproductive experiences. May your reproductive journeys enrich your life and deepen your relationships.