FATE OF UNPLANNED PREGNANCIES AND THEIR PSYCHOLOGICAL EFFECTS

Abstract

Objective: To identify the prevalence of unplanned pregnancies and obstetric outcomes and psychological effects in pregnant women using a standardized depression screening tool. Materials and Methods: The study was a cross-sectional study carried out in the Obstetrics and Gynecology Unit of Dow University of Health Sciences/Dr. Ruth K.M. Pfau Civil Hospital, Karachi for six months. The sampling technique used in the study was non-probability consecutive sampling with a total of 217 pregnant women aged 18-35 years. Baseline data was collected, such as education, parity, residence, employment status, pregnancy intention and contraceptive use at conception. A cohort of women with unplanned pregnancies was tracked for pregnancy outcomes, such as the mode of delivery, premature labour and abortion. Psychological impact was evaluated by the Edinburgh Postnatal Depression Scale (EPDS) wherein a score of ≥13 was taken to represent depression. Results: Of the 217 respondents, 123 (56.7%) experienced an unplanned pregnancy. Majority of the participants were multiparous (59.0%), had formal education (65.4%), were residing in urban area (71.9%) and were housewives (83.4%). Of women with unplanned pregnancies, 76 (61.8%) had vaginal births, 47 (38.2%) had cesarean deliveries, 21 (17.1%) had preterm births and 12 (9.8%) had abortions. 38 (30.9%) women with unplanned pregnancies were identified as being depressed by EPDS screening. Unplanned pregnancy was significantly associated with lack of contraceptive use and higher parity. Conclusion: Unplanned pregnancy was high among women attending a tertiary care hospital with psychological distress being high, which included depression symptoms.