Somatic Preoccupations of Future Pregnancy

Abstract

Ms. A is a 36-year-old, married woman, referred by her gynecologist to psychiatry because the patient was having a difficult time accepting her diagnosis of uterine agenesis. When Ms. A was initially seen by the consulting psychiatrist in the Women’s Health Center, she was working full time at a local retail chain and was married, though she and her husband had always lived separately with their families of origin. She had graduated from high school and had held her current job for 15 years. She reported that she and her husband had been married for 4 years, with no children. The patient described a childhood full of medical tests attempting to explain her constellation of symptoms, which included low body weight, alopecia, and precocious breast development. Ms. A was unable to explain her medical diagnosis and stated that she had undergone an extensive workup at Children’s Hospital, though “they could never figure out what was wrong.” Ms. A has two brothers born with congenital problems—one with severe cognitive impairment and one with abnormal brain vasculature.