Pregnancy Decision Making for Women With Mental Health Conditions: The Roles of Distress, Lay Beliefs, and Self-Efficacy

Abstract

Millions of people face unintended pregnancy each year, including thousands who are living with a mental health disorder, and must decide to terminate the pregnancy, become a parent, or place a child for adoption. While people of various genders, such as nonbinary people and transgender men, also face pregnancy, the current study highlighted the perspectives of women in particular, seeking to understand what unique circumstances may predict their pregnancy decision making in the context of mental health concerns. A sample of 327 women of reproductive age who self-identified as having a mental health condition were asked to consider the hypothetical situation of an unintended pregnancy and completed measures of psychological distress, parenting self-efficacy, and likelihood of choosing abortion. Qualitative data was transformed into two composite lay belief variables (perceived harm from pregnancy and mental health resilience) for inclusion in the model. Indirect effects revealed that psychological distress was related to higher likelihood of choosing an abortion through greater perceived harm from pregnancy and to lower likelihood of choosing an abortion through greater mental health resilience and higher parenting self-efficacy. The findings provide a nuanced view of pregnancy decision making from the perspective of women with mental health concerns.