Question 1

Infertility Counseling

Accepted Answer

Services offered:
- Individual and Couples Counseling
- Consultation of Oocyte and Sperm Recipients 
- Evaluation of Egg Donors and Gestational Carriers
- Consultations with families guiding them through the process of disclosing to their children their use of donor eggs or sperm
 
Individual and Couples Counseling       
Infertility is diagnosed after one year of trying to conceive without achieving a pregnancy. The Centers for Disease Control (CDC) estimates this may effect up to 12% of women.
There are many possible causes of infertility and it is necessary to undergo a physical evaluation of both partners to try to identify the problem. This assessment may begin with blood work and ultrasounds to determine if there are hormonal or structural issues interfering with her ability to become pregnant or carry a pregnancy to term. He may provide a sperm sample to test if there are issues with his sperm. For many couples, experiencing infertility may strain their emotional and financial resources. You may disagree as to how to proceed, whether to intervene and how quickly, and for how long you will continue to try. Each of these decisions require open channels of communication during a time that may be highly stressful. 
 
I will teach you coping strategies that are effective for managing chronic stress, help you to improve your communication skills and maintain open lines of communication, and create a timeline that incorporates your goals and values as you move through your fertility journey. I will also help you learn to cope with the difficult waiting periods between treatment and waiting to learn the outcome of your treatment.
Third Party Reproduction
If you are planning on using donated oocytes, sperm or embryos, you may be asked or required to meet with a mental health professional (MHP) before the onset of treatment. 
This is a very important opportunity to discuss the process of building your family using donated eggs, sperm or with the assistance of a gestational carrier. Topics typically covered in this meeting include: learning about the process of in vitro fertilization, donor selection, and decisions about disclosure. Many people have questions about how to share with their friends, family and future child information about their use of donated gametes.
The purpose of this meeting is so I can provide you with information that will help you to feel comfortable and confident moving forward using third party assistance to build your family. 
Evaluation of Oocyte Donors and Gestational Carriers
 
I conduct assessments of oocyte donors and gestational carriers. These involve clinical interviews as well as psychological testing. Donors can be known or anonymous, gestational carriers may be friends or relatives or selected from an agency. Evaluating known donors or carriers involves helping everyone to understand their role expectations and the importance of healthy boundaries throughout the process.

Question 2

Perinatal and Postpartum Mood and Anxiety Disorders

Accepted Answer

Ideally, pregnancy can be a very exciting time in your life, as you experience many changes in your body and imagine yourself becoming a mother. Unfortunately, this ideal may not match your experience. For you, pregnancy, or the birth of your baby may actually be a time filled with tremendous fear, sadness, and distress. 
 
It is important to know what may put you at increased risk for experiencing perinatal (during your pregnancy) or postpartum (after the baby is born) depression or anxiety. Notify your medical team as soon as possible if you feel that you may be at higher risk, so that you can be informed of treatment options should a problem arise. All women are vulnerable to these conditions, regardless of their age, race, or socioeconomic status. 
 
Risk factors include:
* If you have experienced depression or anxiety prior to becoming pregnant, or if a family member has a history of mood disorders
* If you experienced depression or anxiety during or following a previous pregnancy
* If you are undergoing unusual stress or strain (for example losing a job, moving, a death in the family)
* If you are experiencing conflict in your relationship 
* If you have an unplanned or unwanted pregnancy
* If you have low self-esteem
* If you had complications in your pregnancy or delivery
 
What is the difference between the “baby blues” and postpartum depression?
    * The “baby blues” are normal feelings of sadness, worries about your baby’s health, or concerns about your ability to care for your newborn
* These feelings may begin and end within the first few weeks after the birth of your baby
* A postpartum mood or anxiety disorder can begin any time within your baby’s first year of life
* The symptoms will create a noticeable impairment in your ability to function in many areas of your life- including your ability to care for your baby and yourself
 
What are signs I may be experiencing a perinatal or postpartum mood disorder?
    * Excessive worry
* Difficulty focusing or concentrating 
* Change in appetite (either eating too much or lack of appetite)
* Change in sleep patterns (either sleeping too much or trouble falling or staying asleep)
* Irritability or increased frustration with others
* Feeling sad or crying more often
* Lack of interest or pleasure in things you used to enjoy
* Feeling incompetent to care for yourself or your baby
* Thoughts of harming yourself or your baby
 
If you have noticed that you are experiencing many of these symptoms please tell your doctor, midwife or doula, your partner or a friend. The sooner the problem is identified the faster you can begin treatment and start to experience relief. 
Postpartum mood disorders include: postpartum depression, postpartum anxiety, postpartum obsessive compulsive disorder, and, more rarely, postpartum psychosis. Each of these illnesses can have a significant impact on you, your partner, your relationship with your baby, and your infant’s cognitive, social and emotional development. If left untreated, there can be long-term consequences for your well-being and your relationship with your partner and your baby. 
 
How can I help?
I will work with you to help you:
* Regain your confidence and emotional strength
* Identify and activate your resources
* Reclaim your individual identity alongside your identity as a mother
I work with women while they are pregnant to help them manage their expectations of pregnancy, their delivery and the postpartum period. I will collaborate as a team with your OB/GYN, psychiatrist and internist if medication is also being used as a part of your treatment in combination with psychotherapy.

Question 3

Pregnancy Loss

Accepted Answer

Following the joy of discovering that you are pregnant, you may experience the devastation of miscarriage or recurrent pregnancy loss. Due to advances in modern technology, we are able to confirm a pregnancy before you even miss a menstrual cycle. Ultrasound imaging can provide a window into the womb, offering an opportunity to see your babies’ heartbeat as early as seven weeks gestation. Sadly, in the first trimester, between 10-15% of women will miscarry. During the second trimester the risk decreases, with only 1-5 out of 100 pregnancies ending in miscarriage. 
 
Women who suffer a pregnancy loss may experience a wide variety of emotions, including: shock, anger, self-blame, despair, longing, fear and shame. If you have experienced infertility or multiple pregnancy losses these feelings may be intensified. Due to our society’s lack of ritual and systematic responses to miscarriage, you may feel isolated and alone in your grief. You may be having difficulty communicating with your partner about your feelings, as well as receiving messages from well-meaning friends or family members that “it was for the best” or that once you have a baby you will feel better. 
 
Therapy can provide a safe environment to grieve this significant loss in your life. I will help you to understand and cope with your feelings, communicate with your partner, friends and family about your needs, and create a way to meaningfully memorialize your loss.

Question 4

Special Needs Parenting

My Services

Infertility Counseling

Perinatal and Postpartum Mood and Anxiety Disorders

Pregnancy Loss

Special Needs Parenting