Mental Health After Unintended Pregnancy: Insights from the Netherlands

Purpose To investigate how unintended pregnancy (UP) is associated with the occurrence of mental health (MH) problems one year later among womxn in the Netherlands, while also considering pregnancy outcome (abortion/continuation), co-occurring risks and protective factors. We hypothesized that MH problems are more prevalent among those whose pregnancy was more unintended. Methods Data from the BluePrInt study included both womxn who had an abortion (AB, n = 152) and who continued their UP (CT, n = 212). They filled out an online survey shortly after their abortion (AB) or around 14 weeks gestation (CT), and at follow-up one year later. Key variables included pregnancy intentions (continuously measured), anxiety/depression symptoms, social- and partner support, abuse experiences, UP-related variables and socioeconomic position. Results 26.5% developed MH problems post-UP, with no significant differences between AB and CT groups. Pregnancy intentions and -outcome, as well as their interaction, were not related to MH risks one year later. Previous MH was the strongest predictor of MH risks (OR: 3.54), while perceived social support was associated with a lower risk (OR: 0.66). Conclusions In the Dutch context where abortion care is available, experiencing an UP does not increase the risk of future MH problems. Instead, previous MH and social support are important for MH after an UP. Given the evidence that denying abortions has bigger effects on MH, findings highlight the importance of reproductive autonomy. Positioning UP as inherently problematic is not warranted. Policy and practice should adopt more holistic approaches in considering people's reproductive experiences.