Difficult Issues in Pregnancy and Parenthood
This chapter examines some of the problems with conception, reproductive technologies, miscarriage and loss, disruption of treatment during pregnancy, and ongoing infertility and childlessness, as they impact the therapeutic process. It focuses on the meaning of pregnancy within a broader bio-psycho-cultural context. The chapter discusses the issues of infertility, then Assisted reproductive technology (ART), followed by an examination of clinical issues that arise during the process. Achieving parenthood confirms the couple's status as adults within their extended family. The response to pregnancy loss is highly individualized molded by cultural/political, familial and individual factors. Pregnancy loss can be further demarcated into miscarriage, genetic terminations and stillbirth. Consultation, mentorship, personal psychotherapy or a specialized support group offers the opportunity to continue exploration and thus healing. Patients with severe abandonment issues and a propensity to act out will have difficulty tolerating the sudden disappearance of their therapists.