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Psychological Aspects of Women's Health Care, Second Edition

The Interface Between Psychiatry and Obstetrics and Gynecology

Edited by Donna E. Stewart, M.D., F.R.C.P.C., and Nada L. Stotland, M.D., M.P.H.

  • ISBN 978-0-88048-831-0
  • Item #8831

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In the decade since the first edition of this work was published, an incredible array of reproductive technologies and associated issues has emerged. Obstetricians and gynecologists are hard-pressed to deal with the startling breadth and depth of these issues, which require mastery over a daunting combination of ever-increasing scientific knowledge, technical skills, long hours, legal liability, and exposure to clinical situations of overwhelming emotional intensity.

Psychiatrists have a vital role to play in helping obstetricians and gynecologists cope with a host of problems whose resolutions require not just technical skill, but also knowledge of biology, psychology, sociology, anthropology, ethics, and law. For example, to design and implement strategies to reduce the transmission of HIV, psychiatrists could work with public health workers to incorporate the psychology, sociology, and anthropology of female reproductive behavior. Psychiatrists could likewise improve the diagnosis and treatment of breast and pelvic malignancies by elucidating the factors that deter women from self-examination and regular medical screening and enhance treatment compliance.

Divided into three sections, this clinical and theoretical sourcebook addresses every major area of contemporary concern.

  • Pregnancy covers topics from the psychology of normal gestation to physical and psychiatric complications during and after pregnancy, including new prenatal diagnostic techniques and the dynamic issues that emerge when abnormalities are detected, and the use of psychotropic drugs and electroconvulsive therapy in pregnant and lactating patients.
  • Gynecology discusses not only common gynecologic problems but also more controversial issues such as induced abortion and the new reproductive technologies, including the role of the menstrual cycle in exacerbating and precipitating psychologic symptoms, the psychiatric aspects of menopause, the assessment and management of chronic pelvic pain, the psychosocial concomitants of gynecologic malignancies and the emotional demands on the oncology team, and the special implications of HIV/AIDS.
  • General Issues offers a broad, balanced view of topics rarely found in the literature, such as men's reactions to women's reproductive events, substance abuse and eating disorders, sexual and physical abuse (often part of the histories of patients with personality disorders and posttraumatic stress disorders), ethical and legal issues, and health care for lesbian patients. Of special significance is Dr. Stotland's chapter on how consultation-liaison services are provided to obstetrics and gynecology services.

      This practical and scholarly volume is exceptionally useful as a teaching reference for medical and other health care students and residents in psychiatry and obstetrics and gynecology. It also provides a valuable resource for the clinician working to improve the psychological well-being of women patients.


  • Foreword
  • Chapter 1. The Interface Between Psychiatry and Obstetrics and Gynecology: An Introduction
  • Part I: Pregnancy
  • Chapter 2. Normal and Medically Complicated Pregnancies
  • Chapter 3. Fetal Anomaly
  • Chapter 4. Psychiatric Disorders During Pregnancy
  • Chapter 5. Psychotropic Drugs and Electroconvulsive Therapy During Pregnancy and Lactation
  • Chapter 6. Adolescent Pregnancy
  • Chapter 7. Postpartum Disorders
  • Chapter 8. Perinatal Loss
  • Part II: Gynecology
  • Chapter 9. Psychological Aspects of the Menstrual Cycle
  • Chapter 10. Infertility and the New Reproductive Technologies
  • Chapter 11. Induced Abortion in the United States
  • Chapter 12. Menopause: Myths and Realities
  • Chapter 13. Chronic Gynecologic Pain
  • Chapter 14. Gynecologic Disorders and Surgery
  • Chapter 15. Gynecologic Oncology
  • Chapter 16. Women and HIV Infection
  • Part III: General Issues
  • Chapter 17. Reproductive Choices and Development:
  • Psychodynamic and Psychoanalytic Perspective
  • Chapter 18. Female Sexual Disorders
  • Chapter 19. Psychopharmacology in Women
  • Chapter 20. Alcohol and Substance Abuse in Obstetrics and Gynecology Practice
  • Chapter 21. Eating Disorders and Reproduction
  • Chapter 22. Breast Disorders and Breast Cancer
  • Chapter 23. Women and Violence
  • Chapter 24. Psychological Aspects of Lesbian Health Care
  • Chapter 25. Ethics and Women's Health
  • Chapter 26. The Male Perspective
  • Chapter 27. Collaborations Between Psychiatry andObstetrics and Gynecology
  • Chapter 28. What Is a Minority? Issues in Setting and Dialogue
  • Index

About the Authors

Nada L. Stotland, M.D., M.P.H., is Professor in the Departments of Psychiatry and Obstetrics and Gynecolog at Rush Medical College; and Chair of the Department of Psychiatry at Illinois Masonic Medical Center in Chicago, Illinois.

Donna E. Stewart, M.D., D.Psych., F.R.C.P.C., is University Professor in the Departments of Psychiatry, Obstetrics and Gynecology, Anethesia, Surgery, Medicine, and Family and Community Medicine at the University of Toronto; and Lillian Love Chair in Women's Health of the University Health Network in Toronto, Ontario, Canada.

Psychological Aspects of Women's Health Care: The Interface Between Psychiatry and Obstetrics and Gynecology, Second Edition should hold a prominent place on the bookshelf of every provider of health care to women. Whether used as an introductory text for students and residents or a ready reference for experiences clinicians, this volume will serve as a catalyst for improving the quality of care for women, and for that the editors and their contributors deserve our sincerest appreciation.—Catherine M. Piontek, M.D., Psychosomatics, 8/1/2003

[T]he book is amazingly readable considering the amount of information. It is written from the perspective of a practitioner, reviewing the literature in a clinical context and giving balanced treatment to controversial issues. Particularly outstanding are the chapters on violence, substance abuse, minorities, psychiatric disorders during pregnancy, gynecologic surgery, and the relationship between psychiatry and obstetrics-gynecology.—JAMA, 8/1/2003

This is a second edition of an outstanding book edited by Dr. Nada Stotland and Dr. Donna Stewart who both are nationally and internationally recognized for their expertise in women's healthcare. The book is an outstanding one with chapters devoted to the broad range of topics where psychiatry and obstetrics and gynecology interface. The authors are well versed in their subjects.This is a book that all psychiatrists should own. Physicians in other specialties should also possess this book as its information is indeed important to the majority of patients whom they see. (Women certainly seek medical care far more commonly than men). It is thus a privilege to so strongly recommend this book.—Thomas N. Wise, M.D.

Congratulations to Stotland and Stewart and their chapter authors for a magnificent second edition of their classic, Psychological Aspects of Women's Health Care: The Interface Between Psychiatry and Obstetrics and Gynecology! This book is unique in providing clearly written, contemporary, well-reference, user-friendly and richly academically informed information in 28 high quality chapters. The new edition will be enthusiastically welcomed because of its wisdom, breadth and depth by the wide audience of professionals caring for women.—Susan Abbey, M.D., F.R.C.P.C, Director, Program in Medical Psychiatry, University Health Network, Associate Professor, Department of Psychiatry, University of Toronto

This book is a 'must' for every clinician in medicine, psychiatry, obstetrics and gynecology who wishes to enhance the care of women patients with the latest scientific data on gender-specific aspects of psychiatry and reproductive physiology. The science and art of women's reproductive mental health care from puberty to post-menopause are deftly combined in this well written and timely text. This is an ambitious text that really makes a difference—applying the information contained in its chapters will have a positive impact on women's health care!—Vivien K. Burt, M.D., Ph.D., Associate Professor of Clinical Psychiatry, UCLA School of Medicine, And Director, Women's Life Center—UCLA Neuropsychiatric Institute and Hospital

Thanks to science, we can now decode the secrets of the human genome, allow infertile women to become mothers, and preserve the lives of our most fragile infants. Yet each advance brings new challenges to the emotional health of our patients and the clinical decision-making of those who care for them. This eagerly-awaited second edition of Psychological Aspects of Women's Health Care addresses these new issues while deepening our knowledge of more familiar concerns. The same sound scholarship and comprehensive understanding that defined the first edition are evident in this exciting and ambitious volume.—Linda S. Austin, M.D., Professor Psychiatry, Associate Dean for Professional and Public Education, Medical University of South Carolina

The book is thorough and well-rounded. While maintaining academic excellence it is easy-to-read and easily accessible, providing the practical information for clinical practice. As useful to the student as to the clinician, this book is very highly recommended.—Doody Publishing, 8/1/2003

I particularly appreciated information concerning sex differences in pharmacokinetics. It is educational to read a discussion of related processes offered from different perspectives. . . As we learn more about sex differences in metabolism, neurohormonal regulation, and brain wiring, a book that offers a responsible, readable, and up-to-date review of the issues at the interface of obstetrics and gynecology and mental health is a welcome reference.—Vera Lantos, M.D., F.R.C.P.C., Canadian Journal of Psychiatry, 8/1/2003

This second edition of the already classic Psychological Aspects of Women's Health Care, is a timely and welcome addition to the growing literature on women's mental health and its integral connection with the physical and emotional cycles of a woman's reproductive life. The editors have assembled a remarkable array of expert contributors, some of whom have revised chapters from the earlier edition and others who are new voices. Despite the variety of perspectives included, the volume as a whole has a lucid and unified style rarely encountered in a multi-authored text. . . . Whether used as an introductory text for students and residents or a ready reference for experienced clinicians, this volume will serve as a catalyst for improving the quality of care for women, and for that the editors and their contributors deserve our sincerest appreciation.—Catherine M. Piontek, M.D., Psychosomatics, 8/1/2003

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