Psychologists have been viewed in the past as “doctors who deal with mad people” but this is one of the many misconceptions which are still held even in modern times today. In Ghana, psychology is one of the recent and ever-growing fields which have gained much acceptance in health care delivery systems. Health as defined by World Health Organization (WHO) is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. A good support system, a calm state of mind and emotional stability are therefore essential when it comes to treatment and managing of physical health.

Recently, gynecologists have been partnering with psychologists due to increasing problems in childbirth, conception and sexual problems. Women will mostly visit a gynecologist with concerns and problems pertaining to the reproductive system (the vagina, uterus, ovaries, fallopian tubes, cervix and vulva) than a general practitioner. For instance a patient visits the gynecologist with complaints and is finally diagnosed with uterine fibroid. As a last resort, she will have to undergo surgery, hysterectomy, to remove the fibriod. After the surgery however, she has difficulty in coping with the fact that, she cannot have children. She withdraws from family and friends and her work is also affected. Another patient loses her unborn child after years of trying to conceive, she is unable to cope with the death of her unborn child. She is now depressed and has lost interest in things that were once interesting to her. There is obviously a problem here. What can be done to help these women?

Gynaecology is simply the science that deals with problems and management of diseases specific to the female reproductive system. The gynaecologist consults with other specialist such as urologist, oncologist, renal physicians and psychologists. Gynaecologists help in the early detection and treatment of cancers (ovarian cancer, cervical cancer and uterine cancer) vaginal infections such as bacterial infection (vaginitis) and viral infections (hepatitis B, gonorrhea and chlamydia) as well as diseases (amenorrhea, dysmenorrhea, fibroids and infertility). Gynaecologists also care and monitor pregnant women and the unborn child.

However, when the gynaecologist fails to adequately understand the psychological aspects of a woman’s presentation of the problem, research has it that this could leave the doctor feeling sometimes vulnerable, searching for the right thing to say. At times, doctors even go to the extent of avoiding the client in future. This often leaves women with poor health care.
Advancement in modern science has paved way for the integration of medicine towards a biopsychosocial approach. Therefore dealing with female health does not only consider the presence or absence of a disease and infirmity but focuses on the psychological and social well-being of the female as well. Psychology cannot be ignored when it comes to understanding the concept of gynaecological health. It is sad however, to sometimes see that psychologists are often left out of the “loop” until patients are mentally handicapped before referrals are made. In the US and UK, for instance, the psychologist works closely with gynaecologists.

The role of the psychologists in gynaecology can be seen in health care delivery systems when, detailed attention is given to issues such as: providing information and support before, during and after childbirth. The female body undergoes a lot of physical and emotional changes due to certain unique hormones, when pregnancy occurs. These changes range from mild to severe such as increase or decrease in appetite, fatigue, frequent urination, back pain, increase in body mass and weight, morning sickness, sometimes mood swings and depression befor and after birth. In light of this, expectant mothers should be counseled by a psychologist during the pregnancy on ways to cope with these changes so as to ensure safe and complication-free delivery of healthy babies.

This will in the long run reduce maternal and infant mortality rates at large and provide adequate coping resources to help manage any possible trauma if it occurs.
Again, psychologists can be consulted to psychologically prepare women for surgery such as cesarean sections, pregnancies with uterus, ectopic pregnancies, still birth, hysterectomy and hysteroscopy. Generally, people panic when they hear of surgeries, and women are no exception. It is therefore necessary the psychologist helps patients remain and maintain a calm and relaxed state of mind to reduce the stress the body undergoes. Also, for some major surgeries patients are counselled on changes in lifestyle regimen. This helps patients and family members understand and cope with the aftermath of surgeries, to improve treatment while reducing relapses and complications.

Psychologists should be made to provide psychological pain management and relaxation training for expectant mothers. Also, this pain management and relaxation should be exteded to women who have just had surgery and those who are battling with chronic pain associated with certain diseases and conditions like dysmenorrhea, cancers, miscarriages and so on. Pain management helps women to relax rather than focus on the intense pain they feel. Progressive relaxation therapy, mental imagery and mental travel are some techniques employed by the psychologist to help gynaechological clients cope with pain and stress. Psychologists also assess and manage emotional traumas related to abortions, miscarriages and sexual abuse. These situations are related to loss and predisposes women to stress, anxiety and depression.

The psychologist also provides grief counseling and psychotherapy for women who have lost babies at birth, mothers of children with birth defects such as blindness and limb deformities amongst others. At a point in time mothers experience some sort of negative emotion like fear, anger, extreme sadness, guilt and shock. This is normal, however these negative emotions become problematic when they are not managed properly such that it begins to disrupt daily functioning at home, work and school. Therefore it is important for mothers to understand their situations especially when there are no known cure for most birth defects. Psychologists offer psychotherapy to help mothers find reasonable and realistic ways of managing and balancing their lives to avoid stress, anxiety, panic and depression. Grief counseling helps grieving mothers deal with grief and focus on positive outcomes rather than being fixated on worst case scenarios only.

It can be comfortably said that, the role of psychologists in gynaecology is important in managing emotional, social and mental challenges associated with problems specific to the female reproductive system to improve quality of life and to assist and relieve gynaecologists who have been performing the functions of the psychologist together with their traditional roles. The end product is a holistic healthcare delivery for the female in need of healthcare.

1. Eric Howusu-Kumi; Mphil Clinical Psychology -The Trust Hospital
2. Sarah Turkson; BA Psychology -The Trust Hospital
RESOURCES:
American Psychological Association Journal. (2010). The role of psychologists in health centers. Online journal retrieved on 28/09/15 from www.apa.org/psychologists.
Obstetrics &Gynaecology Journal. (2001). What is OB/GYN?-Pregnancy. Online journal retrieved on 29/09/15 from http://www.healthcommunities.com.
Wahass, S. (2005). THE ROLE OF PSYCHOLOGISTS IN HEALTH CARE DELIVERY. Online journal retrieved on 28/09/15 from www.ncbi.nlm.nih.gov.