Effect of Pregnancy Intention on Child Well-Being and Development: Combining Retrospective Reports of Attitude and Contraceptive use

Prior research has documented a relationship between unintended pregnancy and negative consequences for infants and children. Much of this research is based on retrospective reports of intention, but this method has been critiqued as subject to biases in recall and reporting. Non-retrospective measures have also been employed, but these are less widely available and tend to be hindered by limited samples. Using the 1988 National Maternal and Infant Health Survey and its 1991 Longitudinal Follow-Up, a composite measure of reported pregnancy intention and birth control use is constructed to attempt to overcome some limitations of the use of retrospective reports of intention. This composite measure is compared to more conventional measures through analyses predicting the effects of pregnancy intention on child health, activity, and development. Across the different constructions of the pregnancy intention measure, children from unintended pregnancies have poorer outcomes. They are more likely to have less than excellent health, undesirable activity levels, and below median scores on a development assessment. The composite measure predicts similarly to the more conventional measures of intention, but provides an additional dimension that helps address some of the concerns about bias in retrospective reporting, while maintaining the benefit of application in existing large and representative samples. Researchers and policy makers need to continue their concern about the effects of unintended pregnancies, and need widely available measures to understand determinants, consequences, and prevention strategies.