Unintended Pregnancy, Depression, and Hazardous Drinking in a Community-Based Sample of Sexual Minority Women

Abstract

Context: Unintended pregnancy is a stressful life event with important implications for women's health. Little research has examined sexual minority women's (SMW; lesbian, bisexual, mostly heterosexual) experiences of unintended pregnancy, and no studies have examined the relationship between unintended pregnancy, mental health, and negative coping behaviors in this population. Methods: We used the Chicago Health and Life Experiences of Women (CHLEW) Study (n = 454), a diverse sample of SMW, to examine the relationship between self-reported unintended pregnancy, depressive symptoms, and hazardous drinking. We used generalized linear model-building techniques and adjusted for key sociodemographic controls, as well as unintended pregnancy risk factors, including childhood physical and sexual abuse and age of sexual debut. Results: Twenty-four percent of the sample reported an unintended pregnancy. SMW who reported unintended pregnancies also reported significantly more depressive symptoms and greater risk of hazardous drinking. Adjusting for childhood abuse explained the relationship between unintended pregnancy and depressive symptoms, but not the relationship between unintended pregnancy and hazardous drinking. Conclusions: Unintended pregnancy among SMW is an understudied topic. Our results suggest that unintended pregnancy is not uncommon among SMW and highlight the need for more research to investigate the mechanisms that link unintended pregnancy to depression and to hazardous drinking within this population.

Prevalence of alcohol use in pregnant women with substance use disorder

“…This may be at least partly attributed to the fact that drinking before pregnancy recognition was specifically queried and included in our estimates, whereas national surveys do not specifically inquire about drinking after LMP but prior to pregnancy recognition. In this study, pregnant women seen in the SUD clinic had somewhat later pregnancy recognition (by approximately 2 weeks) compared to the general obstetrics population, which is consistent with other reports (Campo et al, 2010; Everett et al, 2016; Heil et al, 2011; Jones et al, 2011; Terplan et al, 2014; Than et al, 2005). Thus, higher alcohol consumption in pregnant women with SUD might, in part, be due to delayed pregnancy recognition.…”

Demographic, Healthcare, and Contextual Factors Associated with Smoking Status Among Sexual Minority Women

“…Eligibility criteria for these additional sexual minority participants in the longitudinal CHLEW study included lesbians who were between the ages of 18 and 24, lesbians of any age who belonged to a racial or ethnic minority group and, bisexually identified women of any age group or racial or ethnic background. 18 This additional sample was recruited using an adaptation of respondent-driven sampling. 19 As the new cohort recruitment was specifically designed to oversample Black, Latina, and younger lesbians (ages [18][19][20][21][22][23][24], as well as women who identified as bisexual, participants in the third wave of data collection differed from the earlier cohorts on these factors (younger, more racial and ethnic minority SMW, and more bisexual women, analyses not shown).…”

“…18 This additional sample was recruited using an adaptation of respondent-driven sampling. 19 As the new cohort recruitment was specifically designed to oversample Black, Latina, and younger lesbians (ages [18][19][20][21][22][23][24], as well as women who identified as bisexual, participants in the third wave of data collection differed from the earlier cohorts on these factors (younger, more racial and ethnic minority SMW, and more bisexual women, analyses not shown). This third wave of participants will be included in future longitudinal follow-ups and analyses.…”

Is Periconceptional Substance Use Associated with Unintended Pregnancy?

“…Previous research has demonstrated an increased risk of alcohol use and unintended pregnancy, 11,26,27 although alcohol exposure is often assessed as patterns of heavy or binge drinking. 11,27 Studies have also reported an association between preconception and prenatal smoking and unwanted pregnancy 15,28 ; however, we observed no association with tobacco smoking and unwanted pregnancy but rather an increased likelihood of undesired or ambivalent pregnancy, and Bold text indicates a statistical significance with a p-value of <0.05; Variables including employment, age, gestational age, education, marital status, race/ethnicity, parity, chronic medical problem, language, previous abortion, previous miscarriage, history of depression, history of anxiety, other substance use in addition to exposure of interest, and recruitment site evaluated as potential confounders in multivariable modeling using backwards selection.…”