STUDY OF PREGNANCY INTENTIONS AND MENTAL HEALTH

Researchers at the University of California, San Francisco Bixby Center for Global Reproductive Health are conducting a
study to understand and document the mental health consequences of unintended pregnancy. This study explores the
experiences and outcomes of women who suspect pregnancy and seek a pregnancy test. We will follow women who have
a positive pregnancy test as well as those who have a negative result to examine the effect of pregnancy and pregnancy
intentions on women’s mood, mental health, and decision-making. Although our primary focus is on women’s
experiences, we will also gather information about the health and wellbeing of children born to women who have a
positive test result and continue their pregnancies.
The Study of Pregnancy Intentions and Mental Health has four major aims:
1. To understand the effects of women’s mental health, including mood, anxiety and depression, on their desire for
and ability to make decisions about pregnancy and contraception.
2. To assess the impact of unintended pregnancy on women’s mental health.
3. To evaluate the relationship, if any, between mental health status and decisions to continue or terminate
unintended pregnancies.
4. To document the physical and psychological responses to abortion compared to carrying an unintended pregnancy
to term.
Why is this study important?
Approximately half of pregnancies and a fifth of pregnancies leading to birth were unintended at the time of conception.
Although there is a substantial literature on psychological responses to pregnancy and abortion, there are few studies
which examine the effect of pregnancy intentions on gestational and postpartum mental health and pregnancy outcomes.
The National Institute of Health has announced the availability of R21 grant money to study Women’s Mental Health in
Pregnancy and the Postpartum Period. This is an excellent opportunity to design a study to examine the effects of
unintended pregnancy on mental health.
A pregnancy test at a clinic or center is an opportunity to examine women’s reproductive intentions and mental health.
Many women experience a ‘pregnancy scare’ when their menstrual period is late and they believe that that they could be
pregnant. The full effect of unintended pregnancy on mental health can be ascertained by comparing women who have a
positive test result with women with negative test results. Since fertilization and implantation are complex events, largely
unrelated to women’s characteristics, the result may be similar to randomization to unintended pregnancy and control
groups.
A 1989 study by Zabin followed 360 teenage African American women seeking pregnancy tests and followed three
groups – those with a negative test result, those with a positive result who sought an abortion and those with a positive
result who chose to carry the pregnancy to term. This study found that teenagers who obtained an abortion experienced
similar levels of psychological stress compared to the two other groups over the two year period. This study, now two
decades old, only followed teenagers. This R21 is a great opportunity to test the feasibility of repeating this study with a
diverse population of women including both teenagers and adults.