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Fertility Desire Achievements and Women's Mental Health in Rural India

Hillman, Emily (2011)
Master's Thesis (86 pages)
Committee Chair / Thesis Adviser: Stephenson, Robert
Committee Members:
Research Fields: Health Sciences, Public Health
Partnering Agencies: Does not apply (no collaborating organization)
Keywords: fertility; mental health; India
Program: Rollins School of Public Health, Hubert Department of Global Health
Permanent url: http://pid.emory.edu/ark:/25593/92f4b

Abstract

Although India is experiencing a demographic transition, an emphasis on fertility continues to shape a woman's value in society. This study examines the association between self-reported fertility intentions and mental health symptoms among 4245 married women aged 15-49 in Bihar, Jharkhand, Maharashtra, and Tamil Nadu India as reported in the National Family Health Survey-2 and the National Family Health Survey Follow-up Survey. After adjusting for covariates, regression models indicate an association between unmet fertility desires and mental health, whether through a wanted pregnancy in the next two years which does not come to fruition and the respondent becomes sterilized (mental health problem OR 2.13, 95% CI 1.22-3.69; any mental health symptom OR 1.65, 95% CI 1.19-2.29) or an unwanted pregnancy and poor mental health (any mental health symptom OR 1.43, 95% CI 1.09-1.87). These results provide support for accurate, quality, and a choice of affordable family planning services to women and their partners. Screening for mental health in primary care and reproductive health settings can identify women at-risk for poor mental health who could benefit from integrated mental health and family planning interventions. Finally, continued research can inform programs and policies designed to empower women and increase mental health awareness.

Table of Contents

Chapter 1: Introduction.............................................1 -- Objective..................................................................4 -- Aims.........................................................................5 -- Study Setting............................................................5 -- Chapter 2: Comprehensive Review of the Literature....8 -- Mental Health............................................................8 -- Unwanted pregnancy.................................................15 -- Definition and measurement of unintended pregnancy......20 -- Fertility goals and failure to meet these goals.................22 -- Intersection of mental health and fertility......................24 -- Chapter 3: Manuscript.............................................28 -- Abstract..................................................................32 -- Introduction.............................................................33 -- Background..............................................................35 -- Study setting...........................................................37 -- Data and methods.....................................................38 -- Results....................................................................41 -- Discussion................................................................44 -- Conclusion...............................................................49 -- Tables and Figures....................................................51 -- Chapter 4: Public Health Recommendations..............59 -- I. Raising awareness and de-stigmatizing mental health at the community level...59 -- II. Comprehensive education and provision of family planning methods...60 -- III. Incorporation of men in the family planning discussions...61 -- IV. Integration of mental health screening in the primary care and reproductive health setting...62 -- V. Integration of mental health and family planning interventions to empower women...64 -- VI. Continued research translating into programs and policies designed to address discrimination and promote women's rights... 64 -- References.............................................................67 -- Letter of Approval from the IRB....................................77

Files

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