Broad Reproductive Issues Need to Be Addressed

This letter is in reference to the article “Trainees Form New Reproductive Psychiatry Group to Learn, Network, Collaborate” in the March issue ("Trainees Form New Reproductive Psychiatry Group to Learn, Network, Collaborate"). The founders of the interest group on reproductive psychiatry are to be congratulated. I think perhaps the fellowships to which they refer were once called women’s health fellowships. I would like to offer some observations from my lifetime experience in the field.

First of all, reproduction requires both males and females. While women’s hormones and reproductive stages have been medicalized and pathologized for millennia, the psychological and social impacts of male hormones continue to be largely ignored. We have to balance the advantages of the focus on premenstrual and perimenopausal moods against the disadvantages of labeling women as disabled by normal physiology.

Secondly, women’s reproductive health care is grievously threatened right now by draconian laws criminalizing abortion and subordinating the lives of pregnant women to those of embryos and fetuses. While we should advise our patients about the risks of cannabis use during pregnancy, we must also be aware that there are women in prison right now, convicted of crimes based on unscientific claims of fetal endangerment by substance use. Not surprisingly, such prosecutions, like the loss of reproductive health care and the greatest burden of maternal morbidity and mortality, fall on women of color. The upcoming seminars and other educational opportunities inspired by these dedicated and creative young psychiatrists will provide welcome occasions for consideration of and advocacy for these crucial issues. ■

NADA STOTLAND, M.D., M.P.H.

Chicago, Ill.