Infertility: Perspectives from Stress and Coping Research

As a researcher whose work focuses largely on the causes and conse­ quences of unwanted pregnancy, I may appear to be an unlikely candidate to write a foreword to a book on infertility. Yet, many of the themes that emerge in the study of unwanted pregnancy are also apparent in the study of infertility. Moreover, this volume is an important contribution to the literature on fertility, women's health issues, and health psychology in general, all topics with which I have been closely involved over the past two decades. Neither pregnancy nor its absence is inherently desirable: The occurrence of a pregnancy can be met with joy or despair, and its absence can be a cause of relief or anguish. Whether or not these states are wanted, the conscious and unconscious meanings attached to pregnancy and in­ fertility, the responses of others, the perceived implications of these states, and one's expectations for the future all are critical factors in determining an individual's response. In addition, both unwanted pregnancy and failure to conceive can be socially stigmatized, evoking both overt and subtle social disapproval. Fur­ ther, they involve not only the woman, but her partner, and potentially the extended family. Finally, both of these reproductive issues have been poorly researched. Because both are emotionally charged and socially stigmatized events, they are difficult to study. Much of the early literature relied on anecdotal or case reports.