The stability of pregnancy intentions and pregnancy-related maternal behaviors. Maternal and Child Health Journal, 4, 171-178

Department of Economics and Finance, Baruch College, City University of New York, New York 10010, USA.
Maternal and Child Health Journal (Impact Factor: 2.24). 10/2000; 4(3):171-8. DOI: 10.1023/A:1009571313297
Source: PubMed

ABSTRACT Our objectives were to characterize the stability of pregnancy intention and to examine whether stability is associated with the timing of prenatal care initiation, smoking during pregnancy, and breastfeeding.
We use a sample of women from the National Longitudinal Survey of Youth (NLSY) for whom information on pregnancy intention was collected both during pregnancy and after delivery. In bivariate analyses we compare outcomes and characteristics of women whose pregnancy intention changed between the prenatal and postpartum periods. With multivariate methods, we analyze the correlates of switching pregnancy intention as well as the association between switching and maternal behaviors.
Women whose pregnancy intention changes between the two assessments are similar in marital status and socioeconomic background to those who report both during pregnancy and after delivery that the pregnancy is unintended. Disagreement during pregnancy between the parents' pregnancy intentions is the most important predictor of instability in the mother's pregnancy intention. Effects of unintended pregnancy on the timing of initiation of prenatal care, smoking during pregnancy, and breastfeeding based on reports after delivery are smaller than those based on reports during pregnancy, although differences are not statistically significant. Adverse effects of unintended pregnancy are greater when pregnancies reported by the mother to be unintended at either assessment are combined into a single category for unintended pregnancy.
Unstable pregnancy intention may be a marker for adverse maternal behaviors related to infant health.

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    • "At the population level, unintended pregnancy rates in the United States differ sharply by demographic and socioeconomic subgroup (Finer and Zolna 2014). At the individual level, pregnancy intentions are strongly related to women's basic demographic characteristics (age, marital status, race, ethnicity, and parity) as well as socioeconomic characteristics (educational attainment, income, and poverty status) (D'Angelo et al. 2004; Hayford and Guzzo 2010; Joyce et al. 2000b; Kost and Forrest 1995; Pulley et al. 2002; Williams 1991; Williams et al. 1999). These same individual-level characteristics can also predict late recognition of pregnancy (Ayoola et al. 2009); later initiation or lower levels of prenatal care (Ayoola et al. 2010; Centers for Disease Control and Prevention 2002; Taylor et al. 2005); initiation, continuation, and exclusive use of breast-feeding after delivery (Ahluwalia et al. 2003; Centers for Disease Control and Prevention 2002; DiGirolamo et al. 2005; Jones et al. 2011; Li et al. 2005; McDowell et al. 2008; Merewood et al. 2006; Singh et al. 2007; Thulier and Mercer 2009); and poor birth outcomes, such as small for gestational age (McCowan and Horgan 2009), low birth weight (Ashdown-Lambert 2005; Blumenshine et al. 2011; Keeton and Hayward 2007), or preterm births (Afable-Munsuz and Braveman 2008; Blumenshine et al. 2011; El-Sayed et al. 2012; Keeton and Hayward 2007). "
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    ABSTRACT: The premise that unintended childbearing has significant negative effects on the behavior of mothers and on the health of infants strongly influences public health policy and much of current research on reproductive behaviors. Yet, the evidence base presents mixed findings. Using data from the U.S. National Survey of Family Growth, we employ a measure of pregnancy intentions that incorporates the extent of mistiming, as well as the desire scale developed by Santelli et al. (Studies in Family Planning, 40, 87–100, 2009). Second, we examine variation in the characteristics of mothers within intention status groups. Third, we account for the association of mothers’ background characteristics with their pregnancy intentions and with the outcomes by employing propensity score weighting. We find that weighting eliminated statistical significance of many observed associations of intention status with maternal behaviors and birth outcomes, but not all. Mistimed and unwanted births were still less likely to be recognized early in pregnancy than intended ones. Fewer unwanted births received early prenatal care or were breast-fed, and unwanted births were also more likely than intended births to be of low birth weight. Relative to births at the highest level of the desire scale, all other births were significantly less likely to be recognized early in pregnancy and to receive early prenatal care.
    Demography 01/2015; 52(1). DOI:10.1007/s13524-014-0359-9 · 1.93 Impact Factor
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    • "Because each subsequent assessment is more distant from the conception event, adolescents' memory of their motives and desires likely becomes increasingly clouded as more time elapses since conception. The limitations associated with retrospective reports of pregnancy intentions and wantedness, which are ubiquitous to the field of unintended childbearing, have been discussed elsewhere (Joyce et al., 2000b, 2002), with research nevertheless able to predict infant health and child well-being on the basis of pregnancies that were subsequently described as unwanted or unintended (Brown & Eisenberg, 1995; Hummer, Hack, & Raley, 2004; Joyce, Kaestner, & Korenman, 2000a). Thus, despite being retrospective, such reports have known predictive clinical significance and likely reflect mothers' satisfaction with and adjustment to parenting. "
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    ABSTRACT: The authors used cross-lagged analyses to examine the across-time influences on and consequences of adolescents' pregnancy intentions, wantedness, and regret. One hundred pregnant Latina adolescents were studied during pregnancy and at 6 and 12 months postpartum. The results revealed 4 main findings: (a) similar to what has been found in adult women, adolescents' lower prenatal pregnancy intendedness and wantedness predicted initial difficulties in parenting; (b) frequent depression symptoms predicted subsequent lower pregnancy intendedness and wantedness; (c) adolescents' poor mental health and harsh parenting of their child predicted subsequent higher childbearing regret, and (d) high childbearing regret and parenting stress were reciprocally related across time. In addition, adolescents' wantedness of their pregnancy declined prenatally to postbirth, and strong pregnancy intendedness and wantedness were not concurrently related to adolescents' poor prenatal mental health. The findings reveal how adolescents' thoughts and feelings about their pregnancies are influenced by and predictive of their mental health and parenting experiences.
    Journal of Marriage and Family 02/2012; 74(1):167-185. DOI:10.1111/j.1741-3737.2011.00885.x · 3.01 Impact Factor
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    • "Because a woman's feelings toward conception are likely to change, such retrospective measures may reflect inaccurate recollections of past emotions, or emotions that arose after learning about the pregnancy or after giving birth (Bachrach and Newcomer 1999). In fact, emotions concerning a pregnancy have been shown to change both over the course of the pregnancy and following the birth of the child, although studies have yielded mixed findings regarding such changes in intentions (Joyce et al. 2000; Poole et al. 2000; Barrett et al. 2004). Few studies have quantified the stability of intentions among nonpregnant women (Bankole and Westoff 1998; Roy et al. 2008), and even these studies focus on the stability of intended completed family size among married women. "
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    ABSTRACT: Using data from a prospective cohort of 555 adolescent girls and boys from a predominantly Latino neighborhood of San Francisco, we examined how well four survey questionnaire items measuring pregnancy intentions predicted the incidence of pregnancy. We also compared consistency of responses among items and assessed how intentions fluctuated over time. Girls experienced 72 pregnancies over two years (six-month cumulative incidence = 8 percent), and boys reported being responsible for 50 pregnancies (six-month cumulative incidence = 10 percent). Although the probability of becoming pregnant generally increased with higher intention to do so, the risk of becoming pregnant was elevated only at the highest response categories for each item. Most pregnancies occurred among teenagers reporting the lowest levels of intention: for instance, 73 percent of pregnancies occurred among girls who reported that they definitely did not want to become pregnant. Considerable change in respondents' intentions were found over short periods of time: 18 percent and 41 percent of responses to the wantedness and happiness items, respectively, changed between six-month survey visits. The development of appropriate strategies to reduce pregnancy among adolescents would benefit from a more nuanced understanding of how teenagers view the prospect of pregnancy and what determines whether they actively protect themselves from unintended pregnancy.
    Studies in Family Planning 09/2010; 41(3):179-92. DOI:10.2307/27896263 · 1.28 Impact Factor
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