Unintended Pregnancies More Likely to Result in Postpartum Depression
The study, led by Dr. Rebecca Mercier and her team at the University of North Carolina, examined the occurrence of postpartum depression among 688 women. At between 15 and 19 weeks of gestation the women were asked whether their pregnancies were “intended,” “mistimed” or “unwanted.”
Two-thirds, of 64 percent, of the pregnancies were intended, 30 percent were mistimed and six percent were unwanted. The mistimed and unwanted pregnancies were considered unintended for the purposes of the study.
The disorder can affect a woman in the first few weeks following delivery, but in some cases symptoms may not appear until several months later. Postpartum depression is often not detected or diagnosed.
At three months following delivery 11 percent of those that reported unintended pregnancies met criteria for postpartum depression, determined through the use of the Edinburgh Postpartum Depression Scale. Among those with an intended pregnancy, the rate of postpartum depression was five percent.
The researchers followed up with the women again after a year and found that 12 percent of those in the unintended group had postpartum depression, while only three percent of those in the intended group had the disorder. The rates translate to 2.1 times the risk at three months, and 3.6 times the risk for unintended pregnancies resulting in postpartum depression when compared with those that had intended pregnancies.
The rates remained relatively steady once the researchers controlled for factors such as poverty, age and education levels, with women with unintended pregnancies twice as likely to have postpartum depression a year after delivery.
The research team notes that while there are many factors that can contribute to the development of postpartum depression, unintended pregnancy could also play an important role.
In addition to unintended pregnancy, inability to breastfeed, a history of mental illness such as depression or anxiety, a lack of financial resources or marriage problems can lead to postpartum depression. Even the baby’s health and temperament can contribute.
The researchers say that the findings provide support for a discussion with women when they arrive at initial prenatal visits. Physicians could ask women how they are feeling about the pregnancy as a way to screen for potential postpartum depression. This early screening may only lead to another screening following childbirth, but for those that are showing postpartum signs it may make a significant difference in providing early detection tools and treatment.