The Psychological Concerns of Women - Essay Example

Psychological and Social Issues in Pregnancy Although pregnancy is considered to be a wonderful experience in itself that produces a pleasant outcome, it has a number of psychological and social issues surrounding it that may cause emotional and psychological pain to the woman. Hormone levels are intermittent during pregnancy and the post partum period, which can lead to mood swings between anxiety and depression, sadness and elation, and confusion as well ("Psychological consequences of pregnancy," 2007). Among the psychological concerns of women regarding pregnancy are feelings of inadequacy, emotional liability, self-esteem issues, and body image issues. It is believed that depression is one of the major psychological concerns in pregnancy. These issues arise whether the pregnancy is wanted or not. However, issues are more profound and more difficult to resolve especially when the pregnancy is unwanted or unintended. This is especially true in teenage pregnancies. Unintended and teenage pregnancy is also closely related to a lot of other social issues-out of wedlock births, responsible parenthood, welfare dependence and overall child well-being, workforce development, and abortion (The National Campaign to Prevent Teen Pregnancy, 2002). In addition, pregnancy for adolescents is not a difficult endeavor. The emotional and psychological effects are not limited to deciding whether to keep the baby or not, or motherhood and adoption. The adolescent also has to cope with the unfamiliar changes that are happening to her body, and may experience depression as well. There are many issues that can be named surrounding pregnancy. However, this paper will focus itself on depression, unintended pregnancies, teenage pregnancies, abortion, and the various concerns surrounding them. Depression Depression that occurs during pregnancy is called perinatal depression, while depression occuring within a year after the child is born is called post-partum depression (National Women's Health Information Center, 2005). The manifestations are sadness, feelings of helplessness and uselessness, tiredness, uncontrollable mood swings, and the like (NWHIC, 2005). During and after pregnancy, there are hormonal changes in a woman's body that greatly affects the onset of these symptoms. Most people deem that these symptoms are easily treatable and manageable. However, women with post-partum depression may experience severe lack of energy and loss of functioning and well-being for a longer period of time. When undergoing a depressive state, the mother will not be able to properly care for herself while pregnant, or for her newborn in the case of post-partum depression. In addition to the fluctuations of hormones in a woman's body, another factor that can contribute to depression during and after pregnancy is the physical changes that the body undergoes. The alteration in a woman's body image may make her feel less attractive, thus giving her extra concerns about her pre-pregnancy figure (NWHIC, 2005). It may, indeed seem like a menial concern. However, for a pregnant woman whose hormones are fluctuating, this may be overwhelming. Experts claim various attributes in the cause of postpartum depression, either to hormonal changes after child birth or to the sudden greater responsibilities of caring for a newborn, or a combination of both (Ainsworth, 2000). Since new mothers are often sleep-deprived, fatigued, and utterly busy with caring for their newborn, it is difficult for them to realize if they have postpartum depression, and distinguish their symptoms from being mild to severe. Ainsworth (2000) cited the case of Jane D., who was admitted for psychiatric care after the death of her infant son (p.32). Two months after her delivery, Jane started staying up all night, checking on her son every few mnutes, and then became moody and suspicious of other members of the family. She refused to eat and would just sit for hours holding her baby. One day Jane saw her husband and father in law digging a hole. She then became very fearful that they were digging a hole for her baby. So she rushed to the kitchen and stabbed her infant son to death. Upon admission to the hospital, she was not aware that her son was dead. Jane's case is a perfect example of how dangerous postpartum depression can be. It is a very common illness affecting around 15 percent of women. It is a very dangerous illness that needs to be put into attention and awareness among women because if it remains untreated, it can develop into a very advanced psychosis. Despite what some mothers undergoing depression think, postpartum depression does not result from a flaw in character or poor motherhood skills and capabilities. Other reasons may be the sudden changes in lifestyle, the feeling of isolation, apetite disturbance, or a sense of disappointment after a period of excitement, or even some physical, medical and surgical factors (Ainsworth, 2000). Hyperthyroidism, for instance, can cause racing thoughts, mental confusion, and even psychosis. Although both pharmacologic and nonpharmacologic treatments are available and found to be effective, both the mothers and their caregivers usually overlook the onset of the illness, resulting to the further severity of the disease, and considerable effects on child development and behaviour (Nonacs, 2005). Thus, prompt recognition and early treatment of the depression are recommended to avoid placing the mother and the infant at risk of any serious injury or diseases. Unintended Pregnancies in Adults Contrary to popular belief, there are more unintended pregnancies among adults than teenagers. Each year, there are about a total of 3.1 million pregnancies in the United States, and around three-fourths of these pregnancies occur in adults (Rowland-Houge, 1997). Despite the fact that these women are adults, there are still a lot of burdens that they experience as a result of the pregnancy. Unintended pregnancies are not just limited to unwanted pregnancies. They also include mistimed pregnancies that happen too soon or too late, which can disturb career plans, work schedules, or educational and vocational goals (Rowland-Houge, 1997). Most children born from unintended pregnancies are also usually raised by a single parent. No mater what the age, social, and economic status of the single parent is at the time of conception, there are still social, emotional, and psychological pressures that the parent faces. In addition, it has been said that many children born from unintended pregnancies are born into poverty, which may lead to problems in the costs of pregnancy, childbirth, and the actual raising of the child. It also bears a high cost in terms of social welfare, as Aid to Families with Dependent Children (AFDC), Medicaid, and food supplement programs spend more than one-third for children who were unwanted at birth (Rowland-Houge, 1997). If more programs were to be delivered to adult women in terms of preventing unwanted and untimed pregnancy, then there would be fewer costs for social welfare. In another study using women from less prominent socio-economic environments, it has been observed that if a pregnancy is unintended, there is lesser chance of the mother seeking and receiving prenatal care (Remez, 2003). This study also assessed whether children conceived out of unintended pregnancies received complete vaccination coverage. The study found that the less the parent wants the child, the less chances of having the child vaccined. However, it has also been found that aside from the lack of intention of the occurrence of the pregnancy, other factors more strongly influenced the vaccination chances of the child, like financial status and health care provisions of the community (remez, 2003). Furthermore, Maclean reported that it has been found that there is a relationship between the lack of intention in a pregnancy with the growth of a child (2005). The study has discovered that 29 percent of the children whose conceptions were unwanted had stunted growth, while only 19 percent of children born from intended conception had stunted growth (Maclean, 2005). Thus, the likelihood of growth stunting was greater in children who were unintended in their conception. Teenage Pregnancy In the United States, 750,000 teenagers aged 15 to 19 get pregnant each year (Guttmacher Institute, 2006). Teenage or adolescent pregnancies are among the major social issues in the United States, and are currently being addressed, and as such, the number of births to teenagers has considerably decreased over the past few decades (Women's Health Queensland Wise, 2006). However, it may be argued that this decrease may not be due to the decreased sexual activity, but rather to the increase in the availabilty of contraceptions and abortion. For the young woman, facing an unplanned pregnancy may be difficult to accept, since there are a lot of changes that are to happen in her life such as physical bodily changes, as well as an alteration in her lifestyle. A pregnant teenager may also feel that the future seems bleak for her. Thus, pregnancy for teenagers can be scary, confusing, and may be considered a burden. In relation to this, some developmentalists claim that "the pregnancy period is a time of crisis during which the woman undergoes not only psychological upheaval, but a revision of her sense of self and identity." (Trad, 1999). In an adult woman, these changes are already significant. On the other hand, these effects could be devastating in an adolescent and may result in depression during or after pregnancy. Moreover, there is risk for the infant of being neglected or abused, since the adolescent mother is uncertain of her new and sudden role in motherhood. There are various consequences of pregnancy to an adolscent. At the top of the list is that these young women's education is interrupted, and more often than not, the teenage girl drops out of school and never resumes her education. Since adolescence is the developmental phase between childhood and adulthood, when a teenager becomes pregnant, the continuity of both the physical and the psychological growth is abruptly interrupted and constrained (Trad, 1999). Thus, the teenager will not be able to realize her full potential and may not get a good-paying job, being very preoccupied with the limitations of her pregnancy and her new responsibilities. In addition, for a young girl whose hormones are just beginning to mature, the fluctuations of the hormones during pregnancy will be more overwhelming than in an adult woman. Pregnancy may greatly jar an adolescent's sense of self and control and may thus lead to anxiety or depression. The expectant adolescent may become extremely sad and may feel worthless, utterly confused and angry towards the father and uncertain about whether to keep the baby or not. It is also highly possible that suicide or abortion may be considered. It has also been found that teenage pregnancies and deliveries have higher complication rates, which may be associated with poor prenatal care, smoking and inadequate diet, and biological immaturity (WHQW, 2006). This may result to premature birth, low birth weight, and even congenital diseases among infants. The WHQW has also identified a number of risk factors in teenage pregnancy (2006). They have observed that circumstances surrounding family situations greatly contribute to a teenager's pregnancy such as dysfunctional family situations, violence and sexual abuse in childhood, father's absence, and unstable housing arrangements. Low socoieconomic background and poor school performace are also among the risk factors, while self-esteem is also of great relevance. In 1989, it was claimed that the teenagers who are most likely to become pregnant are those who are poor, those who were raised by a single parent, those who get poor grades, and those whose parents did not graduate High School (Wattleton and Wright, 1989). However, since the advent of government programs and school campaigns to decrease the rate of teenage pregnancy, it has indeed, decreased by 36 percent (WHQW, 2006). Despite this decrease, teenage pregnancy remains to be a constant concern among the government, schools, and religious insititutions and communities. In a magazine article by Wattleton and Wright, they said that "high rates of teen pregnancy are as all-american as apple pie." (1989). The United States still has the highest teenage pregnancy rate among all industrialized coutnries, with three out of 10 girls getting pregnant at least once in their lives (The National Campaign to Prevent Teen Pregnancy, 2007). Thus, organizations within the government have further pushed their abstinence-only campaigns, along with schools that are holding sex education classes. For instance, the department of Health and Human Services is continually committing itself to efforts to prevent out-of-wedlock teen pregnancies and to promote abstinence among adolescents (U.S. Department of Health and Human Services, 2002). The HHS continually funds local communities in abstinence programs. Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy, stated that "when teen pregnancy declines, we all gain - overall child and family well-being improves, the U.S. work force is stronger, school performance gets better and poverty is directly attacked." (Wetzstein, 2004). Conclusion A pregnant woman experiences a lot of hardships during pregnancy, and is always at risk for emotional turmoil due to the extreme hormonal changes in the body. Furthermore, there are underlying concerns that a woman contemplates upon during and after pregnancy that may further contribute to feelings of sadness or depression. Changes in body image and lifestyle are among the usual concerns of women, in addition to the care of the newborn, which can lead to perinatal depression or postpartum depression. Regardless of age, readiness in mental, psychological, emotional and physical state is very important in dealing with the hormonal havoc that pregnancy will result to. Thus, an adolescent, being in an awkward phase between childhood and adulthood, may find it more difficult to deal with the difficulties and hardships that pregnancy entails. The psychological consequences of teenage pregnancy are broad and diverse in range. There are radical alterations in the emotion and personality of a pregnant woman, and when the expectant mother is a teenager and the pregnancy is unplanned, then the changes in emotions and perceptions are greatly exaggerated (Trad, 1999). Hence, teenage mothers have a higher risk for postpartum depression. On the other hand, it seems that the rate of unintended pregnancy is significantly higher in adults than that in adolescents. This issue seems to be overshadowed by the efforts of the government to decrease the rate of teenage pregnancy. However, unintended pregnancies in adults do lead to important issues like high social welfare costs, as a large number of children born from unintended pregnancies are supported by social welfare. Central to the concern of pregnancy is whether the conception is intended, timed, or wanted. Given these circumstances, more social and psychological issues follow, such as stunted growth among infants, perinatal and postpartum depression, which is more likely among mothers who are not ready, and the financial burden of raising a child. Another essential issue to be looked at is the increasing rate of illegitimate children and the diminishing importance of marriage in society. 80 percent of teenage pregnancies and 75 percent of these births are to unmarried girls (Popenoe, 1998). As the rate of unintended conceptions increase, the importance of marriage decreases. In fact, ther ehas been a marked increase in the births of children to single mothers who were unmarried at the time of conception, and have no plans of marrying in the near future (Abrahamson, 1998). It seems that people are putting less importance to bearing children within the sanctity of marriage, and more women are seeing less need for marriage during pregnancy. References Abrahamson, M. (1998). Out-of-wedlock births: the United States in comparative perspective. Connecticut: Praeger. Edelman, M.W., and Wattleton, F. (1989, July 24). Teen-Age Pregnancy: The Case for National Action. 249, 4, 138. Guttmacher Institute. (2006). U.S. Teenage pregnancy statistics: National and state trends and trends by race and ethnicity. Retrieved 22 April 2007, from, http://www.guttmacher.org/pubs/2006/09/12/USTPstats.pdf Maclean, R. (2005). Childhood Stunting Is Linked to the Pregnancy Intentions of Both Parents. International Family Planning Perspectives. 31(2), 95. National Women's Health Information Center. (2005). Depression during and after pregnancy. Retrieved 22 April 2007, from, http://www.4woman.gov/faq/postpartum.pdf Nonacs, R.M. (2005). Postpartum depression. Retrieved 22 April 2007, from, http://www.emedicine.com/med/topic3408.htm "Psychological consequences of pregnancy." (2007). Women's Health Care Topics. Retrieved 21 April, 2007, from http://www.womenshealthcaretopics.com/psychological_consequences_of_pregnancy.htm Popenoe, D. (1998). Teen pregnancy: An American dilemma. The National Marriage Project. Retrieved 23 April 2007, from, http://marriage.rutgers.edu/Publications/pubteenp.htm Remez, L. (2003). Unintended Pregnancy Is Linked to Inadequate Prenatal Care, but Not to Unattended Delivery or Child Health. International Family Planning Perspectives. 29(3), 146. Rowland-Houge, C.J. (1997, Summer). Missing the boat on pregnancy prevention: Teenage pregnancy grabs the headlines, but most unintended and unwanted pregnancies occur among adults. Issues in Science and Technology. 13, 4, 41. The National Campaign to Prevent Teen Pregnancy. (2002). Not just another single issue: Teen pregnancy prevention's link to other social issues. Retrieved 21 April, 2007, from, http://www.teenpregnancy.org/resources/data/pdf/notjust.pdf The National Campaign to Prevent Teen Pregnancy. (2007). National campaign to prevent teen pregnancy statement on abstinence-only program evaluation. Retrieved 23 April 2007, from, http://www.teenpregnancy.org/press/pdf/abstinence_04_07.pdf Trad, P.V. (1999). Assessing the patterns that prevent teenage pregnancy. Adolescence. 34(133), 221. U.S. Department of Health and Human Services. (2002). Preventing teenage pregnancy. Almanac of Policy Issues. Retrieved 23 April 2007, from, http://www.policyalmanac.org/health/archive/hhs_teenage_pregnancy.shtml Wetzstein, E. U.S. (2004, February 20). Teen Pregnancy, Birth and Abortion Rates Decline; District Still Led One Statistic in 2000 despite Drop. The Washington Times, A08. Women's Health Queensland Wise. (2006). Teenage Pregnancy: Student factsheet. Retrieved 22 April, 2007, from, http://www.womhealth.org.au/studentfactsheets/teenagepregnancy.htm Read More