Abstract
Unintended pregnancy is a stressful life event with important implications for women's health. Little research has examined sexual minority women's (SMW; lesbian, bisexual, mostly heterosexual) experiences of unintended pregnancy, and no studies have examined the relationship between unintended pregnancy, mental health, and negative coping behaviors in this population. We used the Chicago Health and Life Experiences of Women (CHLEW) Study (n = 454), a diverse sample of SMW, to examine the relationship between self-reported unintended pregnancy, depressive symptoms, and hazardous drinking. We used generalized linear model-building techniques and adjusted for key sociodemographic controls, as well as unintended pregnancy risk factors, including childhood physical and sexual abuse and age of sexual debut. Twenty-four percent of the sample reported an unintended pregnancy. SMW who reported unintended pregnancies also reported significantly more depressive symptoms and greater risk of hazardous drinking. Adjusting for childhood abuse explained the relationship between unintended pregnancy and depressive symptoms, but not the relationship between unintended pregnancy and hazardous drinking. Unintended pregnancy among SMW is an understudied topic. Our results suggest that unintended pregnancy is not uncommon among SMW and highlight the need for more research to investigate the mechanisms that link unintended pregnancy to depression and to hazardous drinking within this population.
Highlights
Unintended pregnancies, typically defined as pregnancies that are mistimed, or unwanted at the time of pregnancy, are stressful life events that have important implications for both women’s and infants’ health
Close to half (44%) of women who reported an unintended pregnancy reported sexual abuse compared to 32% of women without an unintended pregnancy, and 27% of women with an unintended pregnancy reported physical abuse compared to 19% of women without an unintended pregnancy
Age of sexual debut differed across the groups: unsurprisingly, women who had not had consensual sex had a lower prevalence of unintended pregnancy, but among women who reported an unintended pregnancy, 50% reported that their first consensual sexual experience occurred before the age of 16 compared to 27% of women without an unintended pregnancy
Summary
Unintended pregnancies, typically defined as pregnancies that are mistimed, or unwanted at the time of pregnancy, are stressful life events that have important implications for both women’s and infants’ health. Recent data suggest that 49%–51% of all pregnancies[1,2] and 37% of all births[3] in the United States are unintended. Such high rates of unintended pregnancy are troubling, given numerous associated negative outcomes, including inadequate prenatal care,[4,5] negative birth outcomes,[6,7,8] and adverse maternal outcomes such as postpartum depression and anxiety.[7,9,10]. Preconception and childhood exposure to stressful life events, lack of social support, and/or experiences with social discrimination have been found to impact pregnancy and infant outcomes.[13,14,15] Based on this perspective, an unintended pregnancy or the termination of an unintended pregnancy does not necessarily lead to depression or other negative mental health outcomes,[16] but rather it may be associated with exposure to psychosocial stressors that increase the risk of both an unintended pregnancy and other adverse health-related outcomes such as depression and negative coping behaviors.[17,18,19,20]
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