Depressive symptoms and contraceptive method effectiveness among women seeking abortions

The focus on whether abortion causes depression has resulted in neglecting an examination of the extent to which depressive symptoms contribute to unintended pregnancies. Understanding psychosocial barriers to using effective contraceptive methods is important to reducing unintended pregnancy. Little research has focused on whether psychological health is associated with using more versus less effective contraceptive methods. Sampling 462 women seeking abortions at three reproductive health clinics, we examine the extent to which more depressive symptoms are associated with self-reported past and intended contraceptive use. Women experiencing more depressive [OR = 0.96, 95% CI: 0.94-.99] symptoms were less likely to report having used long-acting reversible contraceptive methods [LARC] in the past compared to women experiencing more depressive and anxiety symptoms. Those experiencing more depressive symptoms were less likely to plan to use moderately effective methods (i.e., pill, patch, ring, or shot) [OR = 0.97, 95% CI: 0.95-0.99] and marginally less likely to plan to use LARC methods [OR = 0.98, 95% CI: 0.96-1.00] post-abortion compared to low effective methods (e.g., no methods or condoms). In contrast to similar research with women obtaining abortions, these results suggest that women experiencing more pre-abortion depressive symptoms may be at higher risk for subsequent unintended pregnancies. Consequently, helping women reduce their depressive symptoms may prevent future unintended pregnancies.