P
uryear, a psychiatrist specializing in women's reproductive mental health and director of the Baylor Psychiatry Clinic at Baylor College of Medicine, notes that pregnancy and motherhood are hard work both physically and psychologically. Yet, the author points out, most obstetricians and gynecologists have no training in psychological disorders, and women are often left to attend to their emotional issues without support. Puryear offers an informative resource that takes women from before conception to postpartum, drawing on her own practice and personal wisdom as the mother of four as well as current research. With pregnancy comes a surge in hormones that can make women feel both physically ill and cognitively foggy, and when the first movements of the fetus are sensed, the impending reality can be overwhelming. The third trimester and postpartum period can also bring problems: worries about being a good mother, ambivalence about the baby, concerns about sex or anxiety about returning to work. Puryear reveals that medication and psychotherapy are both options for mothers in distress, pointing out that there are many medical choices moms can make that won't harm the baby. All women, she argues, need more information and support concerning emotional issues during pregnancy: this is a worthy place to start. (June)
