Psychiatric contraindications to pregnancy, with reference to therapeutic abortion and sterilization.

Pregnancy and parturition are not considered the basic causes of associated mental disorders, but as precipitating stresses. Pregnancy and parturition are thought to involve conflicts relating to dependency needs, homosexuality and hostility toward the child and husband. The incidence of psychoses related to pregnancy and childbirth appears to be declining. Therapeutic abortion and/or sterilization are indicated when continuance of pregnancy or future pregnancies would be likely to precipitate severe mental disease. Among the important factors to be weighed in considering a recommendation for abortion or sterilization are: the pattern of previous psychotic reactions (severity, duration, reversibility, relation to pregnancy), the physical constitution of the patient, the religious and other personal beliefs of the patient and her family, the desire for parenthood, and the number of living children.A physician would do well to consult the laws of his state with regard to abortion and to call upon suitable consultation in approved hospitals as safeguards against subsequent legal complications. The legal situation regarding sterilization appears to be less complex.