文章基本信息

标题：The Implications of Unintended Pregnancies for Mental Health in Later Life
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作者：Pamela Herd ; Jenny Higgins ; Kamil Sicinski 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2016
卷号：106
期号：3
页码：421-429
DOI：10.2105/AJPH.2015.302973
语种：English
出版社：American Public Health Association
摘要：Despite decades of research on unintended pregnancies, we know little about the health implications for the women who experience them. Moreover, no study has examined the implications for women whose pregnancies occurred before Roe v. Wade was decided—nor whether the mental health consequences of these unintended pregnancies continue into later life. Using the Wisconsin Longitudinal Study, a 60-year ongoing survey, we examined associations between unwanted and mistimed pregnancies and mental health in later life, controlling for factors such as early life socioeconomic conditions, adolescent IQ, and personality. We found that in this cohort of mostly married and White women, who completed their pregnancies before the legalization of abortion, unwanted pregnancies were strongly associated with poorer mental health outcomes in later life. Because of its prevalence, potential consequences, and political salience, unintended pregnancy has been a source of significant research and policy concern for decades. Current estimates indicate that half (51%) of all US pregnancies are unintended, 1 and North America is the only region of the world in which rates have not declined in the past decade. 2 Strikingly, however, although a robust literature documents the well-being repercussions for women who terminate pregnancies, as well as the consequences for the well-being of children who result from unplanned pregnancies, we know relatively little about the ramifications for the well-being of women who continue unplanned pregnancies to term. Having a child and raising that child are key events in the life course. What are the long-term mental health implications for mothers who bear children resulting from unplanned pregnancies? Furthermore, do these implications differ according to whether the pregnancy was simply mistimed or unwanted altogether? We addressed 2 key limitations of the research. First, the few previous investigations of pregnancy intention and mental health have focused on births that occurred after Roe v. Wade (1973). Because 40% of unintended pregnancies are terminated, 1 women who carried these children to term after Roe v. Wade are different—and potentially different in ways that confound the relationship between unintended pregnancies and mental health outcomes. Second, the studies have focused on the link between unintended pregnancies and mothers’ mental health outcomes only when the children that resulted from these pregnancies were relatively young. We don’t know if this influence on mental health is sustained into midlife. A large body of life course research shows how early life course experiences, such as poverty and family conflict, have independent and long-ranging effects on mental health in mid and later life. 3–7 More generally, we do know that children influence parental outcomes long after they become adults. 8 Consequently, having and raising a child of an unwanted pregnancy may result in similar long-lasting effects on mental health. For example, there is evidence that some parents of children with disabilities don’t start exhibiting higher levels of mental and physical health strains until they reach later life. 9 Evidence also suggests that the negative mental health effects associated with raising children are greater for mothers than for fathers. 8–11