Finding meaning in unintended pregnancy and motherhood: Exploring decision-making processes and the importance of prenatal attachment for postnatal mother-infant bonding and postpartum depressive symptomatology

Abstract

The aim of this mixed-methods dissertation was to examine the experience of unintended pregnancy and motherhood; including relevant processes and outcomes associated with the event, in relation to pregnancy continuation vs. termination, prenatal attachment, postnatal mother-infant bonding, and levels of postpartum depressive symptomatology in a state that has notable issues with poor mother-infant outcomes. Two different data sets were used and both qualitative and quantitative data analysis were employed to provide a comprehensive overview of the experience of unintended motherhood. The qualitative portion of this dissertation sought to examine the meanings women attribute to their unintended pregnancies and how narratives differ for women who chose to continue their pregnancies versus those who opted for termination in a sample of women with at least some college education. The quantitative portions of this dissertation aimed to examine what happens after a woman decides to continue her unintended pregnancy as she may be faced with additional challenges, such as disrupted mother-infant bonding and a greater risk of postpartum depressive symptoms. Pregnancy and the postpartum period were investigated in union with one another to better understand the operation and development of constructs such as prenatal attachment, postnatal mother-infant bonding, and postpartum depression during the transition to motherhood; with special focus on multiple dimensions of pregnancy intentions (wantedness, timing, and happiness). Qualitative findings highlight the importance of cognitive appraisal of contextual factors, particularly that of perceived support, personality/attitudinal characteristics, and ability to visualize the future (ideal life vs. life as a mother), in the decisions women make regarding their unwanted or mistimed pregnancies. Quantitative findings indicate that pregnancy intentions are significantly associated with prenatal attachment, which is significantly associated with postnatal mother-infant bonding, as such we can infer that pregnancy intentions impact postnatal mother-infant bonding through prenatal attachment. Additionally, wanting a baby and higher levels of happiness about expecting a baby were predictive of lower levels of postpartum depressive symptoms and higher levels of depressive symptoms were predicted by mistimed pregnancy. Higher levels of prenatal attachment were also predictive of lesser postpartum depressive symptomatology; which was found to have a mediation effect on pregnancy wantedness and timing, suggesting a potential protective quality.