Objective: Traditionally, adverse reproductive experiences have been described as stressful events for the individuals who experience them. However, a growing body of evidence suggests that the term "stress" minimizes this experience, and adverse reproductive experiences should be reconceptualized as reproductive trauma. Currently, there are few ways that clinicians have agreed are valid pathways to measure trauma symptoms within this population. The purpose of this study was to examine comparisons between a sample of individuals who have experienced reproductive trauma to a normative sample utilizing the Posttraumatic Checklist for the DSM-V (PCL-V). Method: This study utilized a descriptive observational design.Participants indicated what form of adverse reproductive events they had experienced (with options including infertility, miscarriage, stillbirth, premature birth, complicated pregnancy, and distress during delivery), and then completed the PCL-V regarding their experience with this event. These data were compared with a PCL-V normative sample using multivariate analysis of variance (MANOVA) models. Results: Significant mean differences between the reproductive trauma groups and the normative group were found for at least one subscale (intrusion, avoidance, arousal, or changes in mood and cognition) for the infertility group, multiple miscarriages, stillbirth, complicated pregnancy, premature birth, and distress during delivery. Premature birth, distress during pregnancy, and stillbirth groups also noted total trauma scores significantly higher than the normative group. Conclusions: Results validate the use of the term reproductive trauma, despite constraints presented by Criteria A of PTSD in the DSM-V. Results also present indications for clinical treatment and diagnosis for psychologists and health professionals working with this population.
Clinical Impact StatementResults from this study indicate that professionals working with individuals and couples who have experienced adverse reproductive events should reconceptualize this experience as trauma and should be mindful of how various trauma symptomology intersect with reproductive trauma. Psychological and medical professionals alike should be mindful of presentations of PTSD for individuals who have reproductive trauma. Normalizing this experience with this special population has implications for emotional validation, accurate assessment, as well as specialized treatment aligned with trauma-informed practices in both the medical and psychological communities.
The psychological and societal intersectionalities of infertility may give way to a complicated pattern of grief, anxiety, depression, and trauma for couples. Current literature on specific interventions for mixed gender couples undergoing infertility treatments notes significant improvements for couples who enact meaning-based coping mechanisms and who have more effective dyadic communication. Emotionally focused couples therapy provides an avenue to engage meaning-based coping strategies proposed by current research while also expressing the partners’ unique emotional experiences through their own stories. This article presents a specific, emotionally focused counseling approach for couples experiencing infertility; it also lists general implications for practice and makes recommendations for future research.
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