New research from Archives of Women’s Mental Health examines the psychological effects associated with different pregnancy outcomes. Study author Natsu Sasaki and her colleagues at The University of Tokyo compared four potential outcomes of pregnancy: wanted birth, abortion, adoption, or unwanted birth. Of the four outcomes, unwanted birth and adoption had the highest scores on a measure of psychological distress.
Research has found that unplanned or unintended pregnancy is related to postpartum depression and is also related to subsequent neglect, abuse, and poor child well-being. Research has also found that unintended pregnancies that result in abortion or adoption can have mental health consequences of their own.
The new study compares the consequences of four different pregnancy outcomes with subsequent psychological distress. These findings may help practitioners predict and take preventative measures to help women navigate the negative consequences of birth choices.
The study gathered information from 7,162 women who reported experiencing an unintended pregnancy that was either aborted or carried to term. Those with miscarriages or complications resulting in pregnancy termination were excluded from the study. Subjects were recruited through an internet survey company, QON Inc. The average age of participants was 39, with 18% having had an unintended pregnancy before 20.
Of the 7,162 women, 3971 reported wanting to have the baby (a wanted birth), 2960 chose abortion, 130 chose adoption, and 101 reported giving birth but not wanting to (unwanted birth).
Subjects were then assessed for psychological distress using a Japanese version of the Kessler 6. The Kessler 6 assesses “nervousness, hopelessness, restlessness or fidgeting, feelings of sadness, and perception that everything requires great effort, as experienced in the last four weeks.”
The research team also collected data on demographic and situational variables like educational attainment, marital status, and age during the unintended pregnancy. They were also asked about their social support during the time in question.
The psychological distress scores were lowest for those who experienced a wanted birth (14%), then went up slightly for those who chose abortion (20.3%). Distress went up again for those choosing adoption (31.5%) and those experiencing an unwanted birth (30.7%). All results were higher than a control group who had intended and wanted pregnancies.
Demographically, one-third of those choosing abortion, adoption, or unwanted birth were in their teens when the unintended pregnancy occurred. Most participants reported that an unintended pregnancy had less than a high school diploma, and most reported economic situations ranging from “very bad” to “normal.” Less than 10% reported economic circumstances that were “good” or “very good.”
The research team acknowledged a few limitations to their study. First, they sent over a million invitations to complete their survey and received only 50,000 responses. Consequently, their data may not entirely represent the experience of unintended pregnancy. Second, the study design was cross-sectional, making cause and effect difficult to establish.
The researchers do not feel these limitations should mean the results are disregarded. Understanding who is most at risk for distress after discovering an unintended pregnancy can lead to better health care for women.
Additionally, the study concludes with these thoughts, “This study showed that among women who experienced an unintended pregnancy, the unwanted birth and adoption group had worse long-term psychological distress consequences. Abortion did not lead to negative psychological consequences. Therefore, it is important to ensure equal and safe abortion opportunities and providing more support to women with unwanted birth.”
The study, “Long‑term influence of unintended pregnancy on psychological distress: a large sample retrospective cross‑sectional study“, was authored by Natsu Sasaki, Mari Ikeda, and Daisuke Nishi.
