PNDNew mothers who have an unplanned pregnancy are four times more likely to experience postnatal depression in the 12 months after birth, scientists have claimed.

The researchers, who have published their findings in BJOG: An International Journal of Obstetrics and Gynaecology, studied the pregnancies of 688 women, and followed up with 550 women at 12 months.

Mistimed and unwanted pregnancies
The women were classified as to whether the pregnancy was intended (433 women, or 64%), mistimed (207 women, or 30%) or unwanted (40 women, or 6%). Unintended pregnancies were defined as both mistimed and unwanted pregnancies.

The researchers, from the University of North Carolina, found that postpartum depression was more likely in women with unintended pregnancies at both 3 months (11% vs 5%) and 12 months (12% vs 3%). They believe this indicates a long-term risk of depression, and that an unintended pregnancy may have a long-term effect on maternal wellbeing.

Long-term effect of unintended pregnancy
Dr Rebecca Mercier, from the Department of Obstetrics and Gynaecology, University of North Carolina, and co-author of the research, said: “While many elements may contribute to postpartum depression, the results of this study show that unintended pregnancy resulting in live birth could also be a contributing factor.

“Unintended pregnancy carried to term may have a long-term effect on women. Healthcare professionals should therefore consider asking about pregnancy at early antepartum visits to screen for unintended pregnancy as women who report that their pregnancy was unintended or unwanted may benefit from earlier or more targeted screening both during and following pregnancy.

“Simple, low-cost screening interventions to identify women at risk could allow targeted intervention when appropriate and could potentially prevent complications from future unintended pregnancies.”
Importance of early access to midwives
Commenting on the findings, Louise Silverton, director for midwifery at the Royal College of Midwives, said: “Whilst this research was done in a country with a very different system to the UK, it does flag-up the importance of early access to midwives and maternity services for pregnant women. It also demonstrates the importance of postnatal care and the continued involvement of the midwife after the birth so that any problems can be identified and treated.

“We are seriously short of midwives in England and we know that postnatal care is suffering because of this. We are hearing of midwives having to make fewer postnatal visits, if at all. This is a concern because the problems this research highlights may go undetected and the consequences of this can be serious, for the women, for families and for the health service.”