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Long-term influence of unintended pregnancy on psychological distress: a large sample retrospective cross-sectional study

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Abstract

This study examined the associations between childbirth decisions in women with unintended pregnancies and long-term psychological distress. An online survey of women selected from a representative research panel was conducted in July 2021. Among participants who experienced an unintended pregnancy, the childbirth decision was categorized: (i) wanted birth, (ii) abortion, (iii) adoption, and (iv) unwanted birth. Participants who made childbirth decisions more than 1 year ago were included. ANCOVA was conducted with psychological distress (Kessler 6) as the dependent variable and education, marital status, years from the decision, age of the first pregnancy, economic situation at the unintended pregnancy, and the number of persons consulted at the unintended pregnancy as covariates. Logistic regression analysis was conducted for high distress (K6 ≥ 13) by adjusting the same covariates. A total of 47,401 respondents participated in the study. Women with an experience of unintended pregnancy experienced more than 1 year before the study were analyzed (n = 7162). Psychological distress was the lowest for wanted birth and increased for abortion, adoption, and unwanted birth. In the adjusted model, abortion was associated with lower distress scores than both adoption and unwanted birth. Compared to the wanted birth, adoption and unwanted birth showed significantly higher levels of distress (adjusted odds ratio [aOR] = 2.03 [95% CI 1.36–3.04], aOR = 1.64 [95% CI 1.04–2.58], respectively). Long-term effects on psychological distress differed according to the childbirth decisions in unintended pregnancy. Healthcare professionals should be aware of this hidden effect of unintended pregnancy experience on women’s mental health.

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Data availability

The data supporting this study’s findings are available from the corresponding author, D. N., upon reasonable request.

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Funding

Japan Society for the Promotion of Science under a Grant-in-Aid for Scientific Research (A) (19H01073 to D. N.) funded this work.

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Authors and Affiliations

  1. Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1Bunkyo-ku, HongoTokyo, 113-0033, Japan

    Natsu Sasaki & Daisuke Nishi

  2. Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Mari Ikeda

Authors
  1. Natsu Sasaki
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  2. Mari Ikeda
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  3. Daisuke Nishi
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Contributions

D. N. was in charge of this study, supervising the process and providing his expert opinion. N. S. and D. N. designed the study and analyzed the data. N. S. wrote the first draft of the manuscript. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Daisuke Nishi.

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Ethics approval and consent to participate

The research ethics committee of the Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Japan (No. 2021061NI), approved this work.

Informed consent

Online informed consent was obtained from all participants after full disclosure and explanation of the purpose and procedures of this study. We explained that their participation was voluntary, and they could withdraw consent for any reason simply by not completing the questionnaire.

Conflict of interest

D. N. received personal fees from Startia, Inc.; en-power, Inc.; MD.net; Mitsubishi Heavy Industries Kobe Shipyard; and AIG General Insurance Company, Ltd., outside the submitted work.

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Sasaki, N., Ikeda, M. & Nishi, D. Long-term influence of unintended pregnancy on psychological distress: a large sample retrospective cross-sectional study. Arch Womens Ment Health 25, 1119–1127 (2022). https://doi.org/10.1007/s00737-022-01273-1

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  • DOI: https://doi.org/10.1007/s00737-022-01273-1

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