Mental health after unintended pregnancy: insights from a context with available abortion care

IF 3.2 3区医学 Q2 PSYCHIATRY

Archives of Women's Mental Health Pub Date : 2026-07-04 DOI:10.1007/s00737-026-01745-8

Wieke Y Beumer, Tessa J Roseboom, Jenneke van Ditzhuijzen

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引用次数: 0

Abstract

Purpose

To investigate how unintended pregnancy (UP) is associated with the occurrence of mental health (MH) problems one year later among womxn, while also considering pregnancy outcome (abortion/continuation), co-occurring risks and protective factors. We examine this in the Dutch context, given available abortion care up to 24 weeks gestation and high diversity in people’s pregnancy intentions. We hypothesized that MH problems are more prevalent among those whose pregnancy was more unintended.

Methods

Data from the Dutch BluePrInt study included both womxn who had an abortion (AB, n = 152) and who continued their UP (CT, n = 212). They filled out an online survey shortly after their abortion (AB) or around 14 weeks gestation (CT), and at follow-up one year later. Key variables included pregnancy intendedness (continuously measured), anxiety/depression symptoms (measured with a screening tool based on the CIDI), social- and partner support, abuse experiences, UP-related variables (difficulty deciding, uncertainty, pressure, and negative emotions) and socioeconomic position.

Results

26.5% developed MH symptoms one year after their UP, with no significant differences between AB and CT groups. Pregnancy intendedness and -outcome (abortion vs. continuation), as well as their interaction, were not related to MH symptoms one year later. Previous MH was the strongest predictor of MH risks (OR: 3.54), while perceived social support from family/friends was associated with a lower risk (OR: 0.66).

Conclusions

In a context where abortion care is available, pregnancy intendedness and -outcome do not increase people’s risks of MH symptoms one year after experiencing an UP. Instead, previous MH and support from family/friends are important for MH after experiencing an UP. Positioning UP as inherently problematic is not warranted. Policy and practice should center people’s lived reproductive experiences and care needs.

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意外怀孕后的心理健康：从现有堕胎护理的背景下的见解

目的探讨意外妊娠（UP）与一年后妇女心理健康（MH）问题发生的关系，同时考虑妊娠结局（流产/继续）、共同发生的风险和保护因素。我们在荷兰的背景下研究这一点，考虑到24周妊娠和人们怀孕意图的高度多样性。我们假设MH问题在那些意外怀孕的女性中更为普遍。方法来自荷兰BluePrInt研究的数据包括流产妇女（AB, n = 152）和继续妊娠妇女（CT, n = 212）。她们在流产后不久（AB）或怀孕14周左右（CT）填写了一份在线调查，并在一年后进行了随访。主要变量包括妊娠意向（连续测量）、焦虑/抑郁症状（基于CIDI的筛查工具测量）、社会和伴侣支持、虐待经历、UP相关变量（决策困难、不确定性、压力和负面情绪）和社会经济地位。结果26.5%的患者在UP后一年出现MH症状，AB组和CT组之间无显著差异。妊娠意向和结局（流产与继续）及其相互作用与一年后的MH症状无关。先前的MH是MH风险的最强预测因子（OR: 3.54），而来自家庭/朋友的感知社会支持与较低的风险相关（OR: 0.66）。结论：在可获得流产护理的情况下，妊娠意图和结局不会增加人们在经历UP一年后出现MH症状的风险。相反，以前的MH和家人/朋友的支持对经历UP后的MH很重要。将UP定位为固有问题是没有根据的。政策和实践应以人们的生育经验和护理需求为中心。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Women's Mental Health 医学-精神病学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.