February 18, 2022
By Valeryia Pratasava, MS4, Drexel University College of Medicine

It has been shown that unintended pregnancies in the United States account for half of the pregnancies each year.¹ The rates of unintended pregnancies vary based on the relationship status with the highest among those who are unmarried but cohabiting.² There are two categories of unintended pregnancies: mistimed and unwanted. The former describes a pregnancy that has occurred earlier than desired, while the latter refers to the situation when a woman wanted no children at all.¹

Women with unplanned pregnancies that were unwanted are more likely to smoke, use illicit drugs and be at greater risk for maternal anxiety and depression.¹ The risk factors for unintended pregnancies are low socioeconomic status, maternal drug abuse, less education, sex trade, type of contraceptive used and younger age.³ Some research studies have also shown that unwanted pregnancies have been associated with poor maternal and child outcomes.¹ For example, children born of unwanted pregnancies are at risk of behavioral and psychological issues in adolescence.⁴ There are multiple reasons unwanted pregnancies are associated with worse outcomes for children, and it is important to be aware of these risk factors in order to address the root cause of the problem.

Women who delivered a child as a result of unwanted pregnancy tend to exhibit a more authoritarian parenting style and report experiencing more parenting stress postpartum. Another important factor associated with worse outcomes for children is the challenge of secure attachment formation between mother and her child.⁵ The effect on early development has also been investigated by researchers. The stress associated with unintended pregnancy itself along with parenting challenges and commonly coexisting maternal depression influence children’s early development. Lack of sufficient interaction between mother and child may result in insecure attachment and delay of cognitive, motor and emotional development.⁵ As such, children born as a result of unwanted pregnancies are more likely to suffer from domestic violence and witness parental intimate partner violence.⁴ It has also been shown that these children are more likely to experience conduct and attention problems at ages 7-9 than those children whose mothers reported a planned pregnancy.⁴ Last but not least is breastfeeding, the benefits of which are well known for both mother and child. Multiple studies have shown that infants of unwanted pregnancies are less likely to be breastfed and, if they are, the time is significantly shorter than in infants of intended pregnancies.⁶

In summary, the association of unintended pregnancies that were unwanted with worse children’s outcomes compared to intended pregnancies warrants the implementation of programs that emphasize the importance of pregnancy planning, free sexual education, accessible medical services and provision of support for those mothers who are already carrying an unintended pregnancy to term.⁴

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Sources/Resources:

• Aztlan-James, E. A., Mclemore, M., & Taylor, D. (2017). Multiple Unintended Pregnancies in U.S. Women: A Systematic Review. Womens Health Issues, 27(4), 407-413. doi:10.1016/j.whi.2017.02.002
• Finer, L. B., & Zolna, M. R. (2016). Declines in Unintended Pregnancy in the United States, 2008–2011. Obstetrical & Gynecological Survey, 71(7), 408-409. doi:10.1097/ogx.0000000000000340
• Flink-Bochacki, R., Meyn, L., Chen, B., Achilles, S., & Borrero, S. (2016). Examining pregnancy intendedness among pregnancies ending in spontaneous abortion. Contraception, 94(4), 419. doi:10.1016/j.contraception.2016.07.134
• Boden, J. M., Fergusson, D. M., & Horwood, L. J. (2015). Outcomes for children and families following unplanned pregnancy: Findings from a longitudinal birth cohort. Child Indicators Research, 8, 389–402. https://doi-org.ezproxy2.library.drexel.edu/10.1007/s12187-014-9241-y
• Claridge, A. M. (2021). Pregnancy Intentions of First‐Time Mothers and Their Childrens Outcomes: Unraveling Reciprocal Pathways. Journal of Marriage and Family, 83(4), 942-960. doi:10.1111/jomf.12757
• Gipson, J. D., Koenig, M. A., & Hindin, M. J. (2008). The Effects of Unintended Pregnancy on Infant, Child, and Parental Health: A Review of the Literature. Studies in Family Planning, 39(1), 18-38. doi:10.1111/j.1728-4465.2008.00148.x