“If I Can’t Take Care of Myself Then Why Should I Have a Child?” Women’s Lay Beliefs About Mental Health and Unintended Pregnancy

About half of all pregnancies experienced in the U.S. are unintended. Women who have mental health conditions may be more likely to become pregnant unintentionally, yet very little research has examined how they conceptualize their mental health and reproductive decision-making. In this study, 349 women living with a mental health condition responded to an online questionnaire about the intersection of their mental health and a hypothetical unintended pregnancy. Using a content analysis approach, we identified eight qualitative themes from their responses: (a) Cannot care for child, (b) Continuing pregnancy would worsen mental health, (c) Genetic heritability of mental health, (d) Impact of medication, (e) Adoption or abortion would worsen mental health, (f) Mental health makes me resilient, (g) Mental health has no impact, and (h) Mental health impact on decision-making process. These themes highlight participants’ concerns about their own mental health, beliefs about pregnancy and parenting, and consideration of their family’s well-being. These findings suggest the importance of therapist attunement to the various beliefs and related challenges facing women with mental health disorders who experience unintended pregnancy.