Unintended pregnancy and the psychosocial well-being of pregnant women

A recent report by the Institute of Medicine focused attention on the problem of unintended pregnancy in the United States.' Unintended pregnancies are those that are either not wanted at all (unwanted) or those that occurred earlier than desired (mistimed).The Institute of Medicine report estimated that 60% of all pregnancies in the United States are either mistimed or unwanted.'Prior research has demonstrated that unintended pregnancy has important negative health consequences for infants.Women with unintended pregnancies are more likely to initiate prenatal care late in the pregnancy and to have increased risk of poor pregnancy outcomes such as low birth weight.'c2Women with unintended pregnancies are also more likely to use alcohol and cigarettes during pregnancy than their counterparts with intended pregnancies.l,=Little is known about the consequences for the physical and psychosocial health of women with unintended pregnancies.Clearly, engaging in deleterious health behaviors, such as smoking and alcohol use, is harmful to women.Beyond these behavioral risks, unintended pregnancy may be associated with psychosocial risks.An unintended pregnancy may create problems in many areas of a woman's life, including family relationships, work, education, and finances.An unintended pregnancy may, therefore, increase overall exposure to psychosocial stressors, decrease support provided to her by the father of the baby, increase her level of depressive symptoms, and decrease her overall life satisfaction.0 1997 bv The lambs Institute We conceptualized and defined, for this research, psychosocial stressors as Of Women's Hea1th a set of life conditions that necessitate some adaptive or coping behavior on the Publ i shed by Elsevier Science Inc 1049-3867/97/$17.00part of the affected individual.As noted by Pearlin and Schooler, exposure to PI1 s1049-3867(96)ocO17-5 38 WOMEN' S