Psychiatric disorders among low-income women and unintended pregnancies

The prevalence of both unintended pregnancy and psychiatric disorders in pregnancy is high. Each is associated with compromised birth outcomes and challenges in child-rearing. This study examines the relationship between mental illness and unintended pregnancy in seeking to improve the care provided to women and our ability to minimize the number of children born unwanted or ill-cared for.

The sample consisted of 744 pregnant Women, Infants, and Children (WIC) participants with a stratified enrollment design by residence and representative by race for each WIC county. Analysis consisted of post-stratification by developmental age group with logistic regression models estimating odds of unintended pregnancy among women with and without a psychiatric disorder. Covariates included race, education, and marital status.

Almost one third (30.9%) had at least one psychiatric disorder with over two thirds (67.3%) reporting their pregnancy as unintended. No grouped psychiatric disorder was associated with unintended pregnancy with all ages combined. However, adolescents (ages 15-19) with a substance disorder were less likely to have an unintended pregnancy (adjusted odds ratio [aOR], 0.3; 95% confidence interval [CI], 0.1-0.7) than women without a substance disorder and emerging adult women (ages 20-23) with an anxiety disorder were less likely to have an unintended pregnancy (aOR, 0.4; 95% CI, 0.2-1.0) compared with those without the targeted disorder.

The prevalence of unintended pregnancy is not associated with having a psychiatric disorder, although substance use disorders and anxiety disorders were associated with a decreased likelihood for an unintended pregnancy in a specific age group. Importantly, targeted efforts are needed to identify and counsel women with mental illness about pregnancy planning.