Psychological Aspects of Contraception, Unintended Pregnancy, and Abortion

Abstract

The knowledge of important biopsychosocial factors linking women's reproductive health and mental health is increasing. This review focuses on psychological aspects of contraception, unintended pregnancy, and abortion because these are common reproductive health experiences in U.S. women's lives. This review addresses the mental-health antecedents and consequences of these experiences, mostly focusing on depression and depressive symptoms before and after unintended pregnancy and contraception. As mental-health antecedents, depressive symptoms predict contraceptive behaviors that lead to unintended pregnancy, and mental-health disorders have been associated with having subsequent abortions. In examining the mental-health consequences, most sound research does not find abortion or contraceptive use to cause mental-health problems. Consequently, evidence does not support policies based on the notion that abortion harms women's mental health. Nevertheless, the abortion-care setting may be a place to integrate mental-health services. In contrast, women who have births resulting from unintended pregnancies may be at higher risk of postpartum depression. Social policies (e.g., paid maternity leave, subsidized child care) may protect women from mental-health problems and stress of unplanned children interrupting employment, education, and pre-existing family care responsibilities.

Subsequent Unintended Pregnancy Among US Women Who Receive or Are Denied a Wanted Abortion

“…A history of depression at baseline was associated with an increased risk of subsequent unplanned pregnancy compared with no history of depression. Although the research regarding the effect of depression on contraceptive use is mixed, Steinberg and Rubin have suggested that because depression affects memory, information‐processing, motivation, and self‐efficacy, it is likely a predictor of behaviors that may lead to unintended pregnancy.…”

“…Other variables, such as history of depression and history of abuse, may also be associated with unintended pregnancy and contraceptive use . History of depression was defined as ever being told by a doctor or other health professional that the participant had a depressive disorder.…”

“…10,19 Other variables, such as history of depression and history of abuse, may also be associated with unintended pregnancy and contraceptive use. 20 History of depression was defined as…”

Could Elective Abortion Precipitate Mental Health Consequences in Its Recipients and Providers?

“…The relationship between induced abortion and mental health is an area of ongoing political and ethical controversy [1]. Many studies found no direct correlation between elective induced abortion and the development of mental consequences, and that the risk of mentalhealth problems is equal whether an unplanned pregnancy is carried to term or terminated with an elective abortion [1,2]. Since the 1973, US Supreme Court decisions legalizing abortions, more than one million abortions have been performed in the United States every year with the vast majority without a necessary medical reason [3].…”

Contraception: satisfaction with the method, effects on sleep and psychological well-being

“…Detecting and counselling women with psychological symptoms is important. Inconsistency with the use of contraception is increased in these women 5. Reducing the risk of unplanned pregnancies in this group of women through effective contraception is one problem less in their lives.…”