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The Pillars of Reproductive Well-Being

Sexual Health

The Pillars of Reproductive Well-Being

Reproductive health is about more than just our sexual organs, it encompasses our entire physical, mental, and social well-being. Puberty, pregnancy, and menopause are all unique experiences that impact our reproductive health. Our sense of self and safety can be tied to how we experience our reproductive health and healthcare, and other people can impact our sexual health and family planning.

What is Reproductive Health: 

According to the World Health Organization, 

“Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.” (2023, WHO).

But there's good news - therapists can help promote reproductive well-being by supporting the Four Pillars of Reproductive Well-Being: autonomy, control, respect, and systems of support. This means making sure all people can make their own reproductive choices without judgment.

Essentially, reproductive health encompasses our sexual organs, hormones, sexuality, sex lives, pregnancy & family planning. Reproductive Health cannot be separated from Mental Health. This is because reproductive health can be physical, developmental, psychological, and relational. 


Physical because our entire body system can be impacted by the function of our sexual organs, hormonal fluctuations, and ability to have children.


Developmental because different ages experience different milestones, such as puberty, pregnancy, or menopause.


 Psychological because depending on how we feel about our bodies, our sense of self or safety can be greatly tied to how we experience our reproductive health & healthcare.


 Relational because sometimes other people can impact sexual health & family planning.


The Pillars of Reproductive Well-Being: 


"Empowerment is about change, it refers to the expansion in people's ability to make strategic life choices, in a context where this ability was previously denied to them."  -Nalia Kabeer


Many therapists are trained to promote the Four Pillars of Reproductive Well-Being (developed by the RHNTC, which are autonomy, control, respect & systems of support-basically making sure that all people can make their own reproductive choices, and can be treated without judgment. Listed are just some of the following ways a therapist can support one’s reproductive well-being:



The onset of puberty for a pre-teen or teen can be extremely challenging. This is because rapid physical changes, and emerging sexuality, accompanied by transitioning from childhood to adulthood-can create barriers in communication, impulse control, or self-esteem. Therapists can help children navigate how they feel about these challenges, and help parents take steps to ease tensions. 


Family Planning & Pregnancy 

Fertility planning, infertility, difficult pregnancies, miscarriages, and loss- all require support. Therapists can validate decision making, as well as treat pregnancy related mental health concerns such as postpartum depression & anxiety. 


STI/ Illness Coping

People who are diagnosed with an STI can receive non-judgemental emotional care and compassion from a trusted therapist, who can also connect them to various healthcare resources.

Remember, reproductive health is an important part of our overall well-being. By supporting the Four Pillars of Reproductive Well-Being, therapists can help individuals make strategic life choices, feel empowered, and lead fulfilling lives.

Siena Vaccara, MHC-LP Siena Vaccara received her master’s in Mental Health & Psychological Counseling from Columbia University. Siena believes in encouraging personal growth through education, cultural awareness, and building trusting relationships. She utilizes Feminist and Narrative treatment plans, as well as Cognitive Behavioral and Person-Centered techniques in session to incorporate an integrative psychotherapy approach that honors the unique needs of individuals. She understands the importance of the collaborative therapeutic space being non-judgemental, unbiased, open-minded, and strength-driven. Siena treats individuals with concerns ranging from personal transitions to family planning, identity, mood fluctuations, and stressful life events.

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