When Pregnancies are Unwanted
By Nancy Felipe Russo, Ph.D., Arizona State University and Henry P. David, Ph.D., Transnational Family Research Institute
3/05/02

Bonding and love between parent and child is a crucial foundation for family integrity and wholesome child development. It is sometimes said that parenthood, particularly motherhood, is a 'natural' condition in which 'there is always room for one more.' But can all parents learn to love a child who was unwanted during pregnancy? Further, even if a woman does love a child born after an unwanted pregnancy, is love ever enough to ensure wholesome child development? Although it is true that unwanted pregnancy does not always translate into unwanted births, research on the development of children who were unwanted during pregnancy suggests that when women say they cannot adequately care for a child, it is important to listen to them.

Both unintended and unwanted childbearing can have negative health, social, and psychological consequences. Health problems include greater chances for illness and death for both mother and child. In addition, such childbearing has been linked with a variety of social problems, including divorce, poverty, child abuse, and juvenile delinquency. In one study, unwanted children were found less likely to have had a secure family life. As adults they were more likely to engage in criminal behavior, be on welfare, and receive psychiatric services. Another found that children who were unintended by their mothers had lower self-esteem than their intended peers 23 years later.

The adverse health consequences of teenagers' inability to control their childbearing can be particularly severe. Teenage mothers are more likely to suffer toxemia, anemia, birth complications, and death. Babies of teenage mothers are more likely to have low birth weight and suffer birth injury and neurological defects. Such babies are twice as likely to die in the first year of life as babies born to mothers who delay childbearing until after age 20.

Although high?quality prenatal care can largely prevent the physical health problems of these children, research has established that their social and psychological problems persist, partially because the mothers are themselves from disadvantaged backgrounds, but also due to the lack of future education and poor employment prospects of teenage mothers. Children born to teenagers are more likely to have lower achievement scores and poorer school adjustment and problem behaviors than children born to older women.

The burden of unintended and unwanted childbearing often compounds social disadvantage, falling disproportionately on women who are young, poor, or members of ethnic minority groups. In 1994, 49 per cent of pregnancies in the U.S. were unintended, with the highest rates of such pregnancies found in women who were between 18-24 years of age, poor, unmarried, Black, or Hispanic. The portrait could be worse: About 54 per cent of those unintended pregnancies were terminated by abortion. When abortion is legal, women who are the most motivated to avoid unwanted childbearing are most likely to seek this option. If they are able to exercise it, the correlation between unwanted childbearing and negative outcomes in the remaining population giving birth is reduced (albeit not eliminated).

Access to abortion continues to play a major role in the prevention of unwanted births around the world. In developed countries (where average desired family size is small), of the 28 million pregnancies occurring every year, an estimated 49 per cent are unplanned; 36 per cent end in abortion. In developing countries (where average desired family size is larger), of the 182 million pregnancies occurring every year, an estimated 36 per cent are unplanned; 20 per cent end in abortion.

Longitudinal research has found that when abortion is denied, the resulting children are more likely to have a variety of social and psychological problems, even when they are born to adult women who are healthy with intact marriages and adequate economic resources. A long term study of children born in 1961-63 to women twice denied abortion for the same pregnancy and pair matched control children born to women who did not request abortion showed significant differences, always in disfavor of the unwanted children. All the children were born into complete families with similar socioeconomic circumstances. Being 'born unwanted' carried a risk of negative psychosocial development, especially for only children who had no siblings. At age nine they did poorer in school (despite no differences on intelligence tests), were less popular with classmates, and were more frequently described by mothers and teachers as being difficult. By age 21 -23 they reported less job satisfaction, more conflict with coworkers and supervisors, and more disappointments in love. By age 35 they had experienced more mental health problems.

In summary, there is a substantial literature that documents the serious health, social, psychological, and economic consequences of unintended and unwanted childbearing. These consequences can include increased maternal and infant death and illness, unstable marriages, and the restriction of educational and occupational opportunities leading to poverty and limited roles for women. These adverse effects are not shared equally by all segments of society, and in the United States fall more heavily on those who are poor, young, or members of an ethnic minority group. Further, evidence suggests that even in advantageous social and economic circumstances, when a pregnancy is unwanted and the women requests an abortion, to deny it forces her to bear a child at risk for psychological problems that are long lasting. In this context, the watchword of the family planning movement - 'Every Child a Wanted Child' has particular meaning for health professionals.

This essay draws upon and updates an essay titled 'When Children are Unwanted' by the authors that was previously published as a Social Issue release from the Board of Social & Ethical Responsibility for Psychology of the American Psychological Association (n.d.).

Additional references:

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David, H.P. (1992). Born unwanted: Long-term developmental effects of denied abortion. Journal of Social Issues, 48, 163-181.

Henshaw, S. K. (1998). Unintended pregnancies in the United States, Family Planning Perspectives, 30 (1), 24-29, 46.

Kost, ., Landry, D. J., & Darroch, J. E. (1998) Predicting Maternal Behaviors During Pregnancy: Does Intention Status Matter? Family Planning Perspectives, 30(2), 79-88.

Kubicka, L., Matejcek, Z., David, H.P., Dytrych, Z., Miller, W.B., and Roth, Z. (1995). Childrenfrom unwanted pregnancies in Prague, Czech Republic revisited at age Thirty. Acta Psychiatrica Scandinavica, 91, 361-369.

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Russo, N. F. (1992). Psychological aspects of unwanted pregnancy and its resolution. In J. D. Butler & D. F. Walbert (Eds.). Abortion, Medicine, and the Law. 4th Edition (pp. 593-626). NY: Facts on File.

Denious, J. & Russo, N. F. (2000). The Socio-Political Context of Abortion and its Relationship to Women's Mental Health. In J. Ussher (Ed.). Women's Health: Contemporary International Perspectives (pp. 431-439). London: British Psychological Society.

David, H.P., Dytrych, Z., Matejcek, Z., and Schuller, V. (1988). Born unwanted: Developmental effects of denied abortion. New York: Springer Publishing Co.