Unintended Pregnancies Can Worsen Mental Health Later in Life

Summary and Comment |
February 26, 2016

Unintended Pregnancies Can Worsen Mental Health Later in Life

  1. Joel Yager, MD

Women who had unintended pregnancies before abortions became legal in the U.S. reported more depressive episodes decades later.

  1. Joel Yager, MD

Unintended pregnancies, whether aborted or carried to term, may impose mental health burdens. To learn more, investigators examined data from the naturalistic, ongoing, 60-year Wisconsin Longitudinal Study, which has followed women who graduated from high school in 1957.

In 1975, only 2 years after Roe vs. Wade, they were asked about their pregnancy histories and intentions (mean age, 36); in 1992, they self-reported depressive episodes and completed a depression inventory (mean age, 53). Of 2749 white women with pregnancies, 94% married by 1975, 1218 reported only planned pregnancies, 563 had ≥1 unwanted pregnancy, and 966 had ≥1 mistimed pregnancy.

Analyses excluded women with self-reported prepregnancy depressive episodes and controlled for early-life socioeconomic status, town size, marital status, age at first pregnancy, number of children, high school academic performance, adolescent IQ, religious affiliation, and Big Five personality traits. Compared to women with only wanted pregnancies, women with unwanted pregnancies had higher depression scores in 1992 and were more likely to report a serious depressive episode (only planned pregnancies, 25%; unwanted pregnancies, 33%; mistimed pregnancies, 29%). Spacing intervals suggested that unwanted pregnancies tended to occur after women thought they had completed their childbearing (first pregnancies, 2%; last pregnancies, 40%); mistimed pregnancies decreased with birth order (first pregnancies, 27%; last pregnancies, 16%).

Comment

Women in this study had far fewer birth-control options than women today, when 40% of unintended pregnancies are terminated. The greater depression rates might reflect, among other factors, the social and economic burdens these children impose, which affect women more than men. Another study has reported heightened risk for anxiety disorders 3 years later in women who are forced to carry unwanted pregnancies to term compared with women who had abortions (Am J Public Health 2015; 105:2557). Clinicians counseling women with unwanted pregnancies might wish to share this information.

Editor Disclosures at Time of Publication

  • Disclosures for Joel Yager, MD at time of publication Grant / Research support Agency for Healthcare Research and Quality Editorial boards Bulletin of the Menninger Clinic; Eating Disorders: Journal of Treatment and Prevention; Eating Disorders Review (Editor-in-Chief Emeritus); International Journal of Eating Disorders; UpToDate; FOCUS: The Journal of Lifelong Learning in Psychiatry Leadership positions in professional societies American Psychiatric Association (Chair, Council of Quality Care)

Citation(s):

Reader Comments (3)

KURTIS ELWARD Physician, Family Medicine/General Practice

What is doesn't tell us is why they were depressed - the article assume it was due to the unwanted pregnancy but it may have been due to problems in the relationship and other factors related to their lives in other ways. The article smacks of "political science" in that it portrays unwanted pregnancy as being a primary cause of depression. In the 30+ years of my practice, there have been hundreds of "unplanned" pregnancies that have given the mother and father (and of course the child) incredible value and joy.

Moreover, the majority of women were NOT depressed, and the range of depression was pretty close no matter whether the pregnancy was intended or not. (25% - 33%; not significantly different from a clinical sense, even if "statistically" different).

There other issues is the retrospective nature of the survey. If things turned out poorly (or well) with the birth and subsequent life events, there certainly might be significant bias present.

RICHARD THORNTON Physician, Obstetrics/Gynecology, Retired

I wish to withdraw my earlier comment. On re-reading it appears that data was collected in 1936 and in l992.. One wonders why it was not published earlier.

RICHARD THORNTON Physician, Obstetrics/Gynecology, Retired

I hope to review the entire study. It must have been a labor of love (no pun intended} to design this study from a cohort of women in their latter years, i.e. 77 or 78 years of age.

As a resident at then Milwaukee County Hospital (1962-66) I saw more than enough women who arrived in our Emergency Room after bungled "back alley" attempts to abort them.

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.