Research into the impact of unintended pregnancy on the wellbeing of women tends to focus on pregnancies ending in either termination or lone motherhood. Unintended pregnancy is common in partnered women, but little is known about the association between unintended pregnancy and postpartum affective disorders, such as depression and anxiety in this group. Poor relationship quality and lack of social support are considered risk factors for psychological distress (PD). We examined the association between unplanned motherhood and subsequent PD in partnered women, for whom evidence is sparse, accounting for the role of relationship quality and social support.
Data for 12,462 partnered mothers were drawn from the first survey of Millennium Cohort Study, completed at 9 months postpartum. Women reported whether their baby was planned, and how they felt when they discovered that they were pregnant. Pregnancy intention is categorised as “planned”, “unplanned/happy”, “unplanned/ambivalent” and “unplanned/unhappy”. PD was assessed using the modified 9-item Rutter Malaise Inventory. Social support was measured by a composite score for perceived support, and a measure of actual support from friends and family. Relationship quality was assessed using a modified Golombok-Rust Inventory of Marital State. The effect of pregnancy intention on the odds of PD at 9 months was estimated, adjusting for potential confounding factors. All analyses were weighted for response and design effects.
In total 32.8%(weighted) (4343/12462) of mothers reported an unplanned pregnancy: 23.3 wt% (3087) of mothers felt happy, 3.5 wt% (475) ambivalent, and 6.0 wt% (781) unhappy upon discovery. Unplanned pregnancy was associated with a significantly increased odds of PD compared to planned (OR 1.73 (95%CI: 1.53, 1.95)). This was more pronounced among women who reported negative or ambivalent feelings in early pregnancy (OR 2.72 (95%CI:2.17, 3.41) and 2.56 (95%CI:1.95, 3.34), respectively), than those who reported positive feelings (OR 1.39 (95%CI:1.21, 1.60)). Adjustment for relationship quality, in particular, reduced odds of PD after unplanned pregnancy (e.g. from 2.19 (95%C: 1.74, 2.74) to 1.63 (95% CI: 1.29, 2.07 in the unplanned, unhappy group compared to the planned).
A third of partnered mothers reported that their pregnancy was unintended, yet this group is under-researched. Unplanned motherhood was associated with increased risk of PD at 9 months postpartum, particularly among women who felt unhappy or ambivalent at the start. The roles of relationship quality and social support require further investigation, as possible means to intervene and improve maternal wellbeing.
Mosher WD, Jones J, Abma JC. Statistics NCfH: intended and unintended births in the united states: 1982–2010. 2012.
Sedgh G, Singh S, Hussain R. Intended and unintended pregnancies worldwide in 2012 and recent trends. Stud Fam Plan. 2014;45(3):301–14. CrossRef
Kost K, Landry DJ, Darroch JE. Predicting maternal behaviors during pregnancy: does intention status matter? Fam Plan Perspect. 1998;30(2):79–88. CrossRef
Wellings K, Jones KG, Mercer CH, Tanton C, Clifton S, Datta J, Copas AJ, Erens B, Gibson LJ, Macdowall W, et al. The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third national survey of sexual attitudes and lifestyles (natsal-3). Lancet. 2013;382(9907):1807–16. CrossRefPubMedPubMedCentral
Henderson J, Redshaw M. Anxiety in the perinatal period: antenatal and postnatal influences and women’s experience of care. J Reprod Infant Psychol. 2013;31(5):465–78. CrossRef
Bener A, Gerber LM, Sheikh J. Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: a major public health problem and global comparison. Int j women’s health. 2012;4:191–200. CrossRef
Forman DN, Videbech P, Hedegaard M, Salvig JD, Secher NJ. Postpartum depression: identification of women at risk. Brit J Obstet Gynaec. 2000;107(10):1210–7. CrossRef
Glazier RH, Elgar FJ, Goel V, Holzapfel S. Stress, social support, and emotional distress in a community sample of pregnant women. J Psychosom Obstet Gynaeco. 2004;25(3–4):247–55. CrossRef
Dex S, Joshi H. London: centre for longitudinal studies, Bedford group for lifecourse & statistical studies. London: Institute of Education, University of London; 2004.
Plewis I. The millennium cohort study: technical report on sampling. In: London: centre for longitudinal studies, Bedford group for lifecourse and statistical studies. 4th ed. London: Institute of Education, University of London; 2007.
Rutter M, Tizard J, Whitmore K. Education, health and behaviour. London: Longmans; 1970.
Johnson J, editor. Millenium cohort study: psychological, developmental and health inventories. London: Centre for Longitudinal Studies, Institute of Education, University of London; 2012.
Rust J, Bennun I, Crowe M, Golombok S. The grims - a psychometric instrument for the assessment of marital discord. J Fam Ther. 1990;12(1):45–57. CrossRef
Dennis C-L, Dowswell T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev. 2013;2:CD001134.
Rosenzweig MR, Wolpin KI. Maternal expectations and Ex post rationalizations - the usefulness of survey information on the wantedness of children. J Hum Resour. 1993;28(2):205–29. CrossRef
- Unplanned pregnancy and subsequent psychological distress in partnered women: a cross-sectional study of the role of relationship quality and wider social support
Maria A. Quigley
- BioMed Central
Neu im Fachgebiet Gynäkologie und Geburtshilfe
Meistgelesene Bücher aus dem Fachgebiet
e.Med Kampagnen-Visual, Mail Icon II