New research from Archives for women’s mental health examines the psychological effects associated with various pregnancy outcomes. Study author Natsu Sasaki and her colleagues at the University of Tokyo compared four potential pregnancy outcomes: 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 resulting in abortion or adoption can have their own psychological consequences.
The new study compares the consequences of four different pregnancy outcomes with subsequent psychological distress. These findings can help practitioners predict and take preventive 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 terminated or terminated. Those with miscarriage or complications resulting in termination of pregnancy 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, 3,971 reported that they wanted to have the child (a desired birth), 2,960 chose abortion, 130 chose adoption and 101 reported that they gave birth but did not want it (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 restlessness, feelings of sadness, and perception that everything requires great effort, as experienced in the past four weeks.”
The research team also collected data on demographic and situational variables such as education level, marital status and age at the time of the unintended pregnancy. They were also asked about social support at the time in question.
The psychological problems were lowest for those who experienced a desired birth (14%), and then increased slightly for those who chose abortion (20.3%). The need increased again for those who chose adoption (31.5%) and those who experienced an unwanted birth (30.7%). All results were higher than a control group who had intended and desired pregnancy.
Demographically, a third of those who chose abortion, adoption or unwanted birth were in their teens when the unintended pregnancy occurred. Most participants reported having an unintended pregnancy with less than a high school diploma, and most reported financial situations ranging from “very poor” to “normal.” Less than 10% reported financial conditions that were “good” or “very good”.
The research team acknowledged a few limitations of their study. First, they sent over a million invitations to complete the survey and received only 50,000 responses. Consequently, their data may not fully represent the experience of unintended pregnancy. Secondly, the study design was cross-sectional, which made it difficult to determine cause and effect.
The researchers do not believe that these limitations should mean that the results are ignored. Understanding who is most at risk of distress after discovering an unintended pregnancy can lead to better health care for women.
In addition, 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. Abortion did not lead to negative psychological consequences. Therefore, it is important to ensure equal and safe abortion options and give more support to women with unwanted births.”
The study, “Long-term impact of unintended pregnancy on psychological distress: a large sample retrospective cross-sectional study”, was authored by Natsu Sasaki, Mari Ikeda and Daisuke Nishi.