Every year in the United States, an estimated 3.2 million unintended pregnancies occur and inadequate contraceptive use accounts for 90% of these unintended pregnancies. A great volume of research has associated women’s mental health with risky contraceptive behaviors, sex behaviors and relationships. Risky contraceptive behaviors include contraceptive nonuse, misuse, discontinuation, and less effective method use while risky sex behaviors include having sex under the influence of alcohol and drugs, intimate partner violence and non-consensual sex. From a biological and cognitive framework, mental health symptoms have been found to affect women’s cognitive capabilities for decision-making, risk assessment and planning and have been found to distort their perceived susceptibility to an outcome like pregnancy. Naturally, many researchers have wondered whether there was a direct link between mental health and unintended pregnancy.
Drs. Hall, Kusunoki, Gatny and Barber, researchers from the University of Michigan, wanted to know exactly whether depression and stress symptoms directly translate to an actual effect on women’s risk of unintended pregnancy. They collected data from 992 young women ages 18-20 years old who reported a strong desire to avoid pregnancy. The researchers conducted interviews and analyzed journal entries over one year. They measured contraception use, relationships and pregnancy outcomes and looked at a variety of factors such as race/ethnicity, educational attainment, relationship status, religion, birth control usage and etc.
The researchers found that:
- Women with baseline stress symptoms had a 1.6 times higher risk of becoming pregnant over one year than women without stress symptoms.
- Women who had co-occurring stress and depression had 2 times the risk of pregnancy than women without symptoms.
- The sole effect of depression on pregnancy risk remains unclear
This research study highlights the negative impact of mental health symptoms, especially stress and co-occurring depression and stress, on young women’s risk of unintended pregnancy over one year. This is important, especially for healthcare providers, who may want to consider young adults’ mental health during discussions about choosing the best form of contraception. This is also important for health educators who may want to educate young women about the importance of stress management and provide resources and/or referrals to young adults who are experiencing mental health symptoms.
Hall, K.S., Moreau, C., Trussell, J., Barber, J. Young women’s consistency of contraceptive use–does depression or stress matter? 2013. Contraception. 88:5. 641-649.