Infertility among the motives and factors of suicidal behavior in women

The aim of the article is to review literature data using our own clinical experience on infertility among the motives and factors of suicidal behavior in women. Material and methods: a search was conducted in scientific databases in elibrary.ru, PubMed using the keywords "infertility", "suicide", "suicidal attempt", "suicidal thoughts/ideas". Materials that met the main topic and aim of the study were included in the work. Results: The inability to give birth to a child places a heavy burden on the psychological state of a woman, negatively affects her social activity and quality of life, in many contributes to the development of depression with ideas of self-blame, and increases the risk of suicide by two to seven times. Unfavorable potentiating factors are the often formed negative attitude and stigmatization of a woman on the part of her husband, close relatives, the threat of divorce, sexual disorders associated with infertility, gynecological and somatic diseases. A long period of infertility, ineffective treatment, including the use of additional obstetric technologies, exacerbate these phenomena. In order to correct mental disorders arising against the background of infertility, reduce suicidal readiness and prevent suicide, systematic multi-level work of specialists of various profiles is required. Help should be focused on the key motive, subject to the mandatory actualization of the basic factors of the anti - suicide barrier (the value of one's own life, its importance to loved ones, the presence of unrealized plans, fear of death, etc.). It is necessary to work through ideas of self-blame, mystical ideas about the causes of infertility, existential issues, teach women various strategies for regulating emotions, alternative skills of positive coping. A prerequisite is the involvement of the spouse in the therapeutic circle. In case of confirmation of irreversible infertility, greater emphasis is needed on the woman's acceptance of this situation, the search for/formation of individually acceptable coping strategies and reorientation to other existentially significant goals in life and forms of behavior. Possible options include questions of acceptability of child adoption, foster care and/or focusing on other life goals, which may include volunteering, creative work, art, religious service, etc. Assistance after a suicide attempt is provided according to the same principles, but taking into account the nature of the emotional-cognitive exit and the stage/duration of the post-suicide period. In conclusion, the authors presume that it is necessary to expand psychological support for this category of women at all stages of observation, with mandatory assessment of suicide risk, as well as training of health workers providing assistance to them, including mid-level medical personnel.