title: Mental health consequences of unintended childlessness and unplanned births: gender differences and life course dynamics.
abstract: The discordance between fertility intentions and outcomes may be associated with mental health in the general population. This requires data directly linking individuals' fertility intentions with their outcomes. This study brings together two streams of research on fertility and psychological distress to examine whether unintended childlessness and unplanned births are associated with psychological distress, compared with intended childlessness and planned births. We also examine whether unintended childlessness and unplanned births are differently associated with distress at two stages of the individuals' life course: in early and late 30s. As women are more directly affected by the decline in fertility with age and the experience of motherhood is more central to women's identity, we also examined gender differences in these associations. Thus, we examined the association between four possible fertility events (planned and unplanned births, intended and unintended childlessness) and psychological distress of men and women, at two different stages over the life course (early and late 30s). We used longitudinal data from the US National Longitudinal Study of Youth 1979 (N=2524) to link individuals' fertility intentions and outcomes to evaluate the association of depressive symptoms (CES-D) with four possible fertility events occurring in two-year intervals, for men and women separately. Contrary to our first hypothesis, unintended childlessness and unplanned births were not associated with psychological distress for women. Among men, only unplanned births in their early 30s were associated with increases in psychological distress. We did not find support for our second hypothesis that unintended childlessness and unplanned births have a different association with psychological distress for men and women and as a function of the stage of life. These findings are discussed in the context of previous literature in this area.
authors.affiliation: Department of Epidemiology and Biostatistics, McGill University, Montréal, Canada. katerina.maximova@mcgill.ca
authors.forename: Katerina
authors.initials: K
authors.lastname: Maximova
authors.forename: Amélie
authors.initials: A
authors.lastname: Quesnel-Vallée
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000523:psychology*; D012044:Regression Analysis; D043762:Reproductive Behavior / Q000523:psychology*; D012647:Self-Assessment; D017678:Sex Distribution; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology