Stressful Life Events Around the Time of Unplanned Pregnancy and Women's Health: Exploratory Findings from a National Sample

• Type of Material: Article
• Authors: Kelli Stidham Hall, Emory University; Vanessa K. Dalton, University of Michigan; Melissa Zochowski, University of Michigan; Timothy R.B. Johnson, University of Michigan; Lisa H. Harris, University of Michigan
• Language: English
• Date: 2017-06-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017, Springer Science+Business Media New York.
• Final Published Version (URL): http://dx.doi.org/10.1007/s10995-016-2238-z
• Title of Journal or Parent Work: Maternal and Child Health Journal
• ISSN: 1092-7875
• Volume: 21
• Issue: 6
• Start Page: 1336
• End Page: 1348
• Grant/Funding Information: This work was supported by National Institute of Child Health and Human Development grants #K01HD080722-01A1 (KSH), #K12HD001438 (KSH, P.I. TRBJ), and by the Program on Women’s Health Care Effectiveness Research in the Department of Obstetrics and Gynecology at the University of Michigan (Director VD).
• Keywords: UNINTENDED PREGNANCY; PSYCHOLOGICAL STRESS; Stressful life events; CONTRACEPTIVE USE; BEHAVIORS; Stress; Chronic disease; Reproductive health; Unintended pregnancy; SYMPTOMS; Mental health; DISTRESS; MENTAL-HEALTH; COMORBIDITY SURVEY; BLACK-WOMEN; Life Sciences & Biomedicine; Science & Technology; ABORTION; Public, Environmental & Occupational Health
• Research Categories: Education, Health; Health Sciences, Obstetrics and Gynecology; Health Sciences, Public Health

Abstract

Objective Little is known about how women’s social context of unintended pregnancy, particularly adverse social circumstances, relates to their general health and wellbeing. We explored associations between stressful life events around the time of unintended pregnancy and physical and mental health. Methods Data are drawn from a national probability study of 1078 U.S. women aged 18–55. Our internet-based survey measured 14 different stressful life events occurring at the time of unintended pregnancy (operationalized as an additive index score), chronic disease and mental health conditions, and current health and wellbeing symptoms (standardized perceived health, depression, stress, and discrimination scales). Multivariable regression modeled relationships between stressful life events and health conditions/symptoms while controlling for sociodemographic and reproductive covariates. Results Among ever-pregnant women (N = 695), stressful life events were associated with all adverse health outcomes/symptoms in unadjusted analyses. In multivariable models, higher stressful life event scores were positively associated with chronic disease (aOR 1.21, CI 1.03–1.41) and mental health (aOR 1.42, CI 1.23–1.64) conditions, higher depression (B 0.37, CI 0.19–0.55), stress (B 0.32, CI 0.22–0.42), and discrimination (B 0.74, CI 0.45–1.04) scores, and negatively associated with ≥ very good perceived health (aOR 0.84, CI 0.73–0.97). Stressful life event effects were strongest for emotional and partner-related sub-scores. Conclusion Women with adverse social circumstances surrounding their unintended pregnancy experienced poorer health. Findings suggest that reproductive health should be considered in the broader context of women’s health and wellbeing and have implications for integrated models of care that address women’s family planning needs, mental and physical health, and social environments.