Psychiatric Disorders Among Low-Income Women and Unintended Pregnancies

Abstract

Research Question-Prevalence of both unintended pregnancy and psychiatric disorder in pregnancy is high and each is associated with compromised birth outcomes and challenges in childrearing. This study examines the relationship between mental illness and unintended pregnancy in seeking to improve the care provided to women and our ability to minimize the number of children born unwanted and ill-cared for.Methods-The sample consisted of 744 pregnant WIC participants with a stratified enrollment design by residence and representative by race for each WIC county. Analysis consisted of poststratification by developmental age group with logistic regression models estimating odds of unintended pregnancy among women with and without a psychiatric disorder. Covariates included race, education and marital status.Findings-Almost one-third (30.9%) had at least one psychiatric disorder with over two-thirds (67.3%) reporting their pregnancy as unintended. No grouped psychiatric disorder was associated with unintended pregnancy with all ages combined. However, adolescent women (age 15-19) with a substance disorder were less likely to have an unintended pregnancy (aOR 0.3, CI 0.1-0.7) than women without a substance disorder and emerging adult women (age 20-23) with an anxiety disorder were less likely to have an unintended pregnancy (aOR 0.4, CI 0.2-1.0) compared to those without the targeted disorder.Conclusions-Prevalence of unintended pregnancy is not associated with having a psychiatric disorder, although substance use disorders and anxiety disorders were associated with a decreased

The risk of unintended pregnancy among young women with mental health symptoms

“…In addition to contraceptive use, we are also currently examining the role of sexual behavior, including frequency of sexual activity and sexual partnerships, as additional mechanisms that may link mental health symptoms to pregnancy risk. While young women, including those wishing to avoid pregnancy, may have a variety of reasons for having more or less sex or for not using contraception (and indeed contraceptive nonuse is not uncommon (Frost & Darroch, 2008; Kost et al, 2008; Mosher & Jones, 2010; Trussell & Vaughn, 1999), our collective research suggests that mental health may be one factor which shapes women's family planning behaviors and outcomes. Among our adolescent women wishing to avoid pregnancy, those with moderate/severe mental health symptoms were at increased risk of behaviors that can lead to unintended pregnancy and for unintended pregnancy itself.…”

“…Given that inadequate contraceptive use accounts for 90% of the estimated 3.2 million annual U.S. unintended pregnancies, contraceptive (and sexual risk) behavior is indeed a primary mediating factor of unintended pregnancy (Finer & Henshaw, 2006; Kost et al, 2008; Trussell & Vaughn, 1999). Thus, research describing a link between mental health symptoms and family planning behaviors has been an important scientific contribution, one that appears to have theoretical validity.…”

Women’s demand for late-term abortion: A social or psychiatric issue?

“…Findings in the literature indicate that women with any psychiatric disorder are not more likely to have undesired pregnancy, compared with healthy ones 19,20 . They experience more often poverty, divorce, partner abuse and negative life events.…”

Are pregnancy planning and pregnancy timing associated with maternal psychiatric illness, psychological distress and support during pregnancy?

“…Previous studies have not found an association between unplanned pregnancy and anxiety (Sayil et al, 2006; Tenkku et al, 2009), but are limited by retrospective (postpartum) assessment of pregnancy planning (Sayil et al, 2006) or inconsistent assessment of pregnancy planning (Tenkku et al, 2009) that can bias results (Santelli et al, 2009). …”