Women who conceive accidentally are less prone to breast- feed their babies, opening the door a little wider to a variety of ills more likely to befall children who receive only formula or bottled milk. The results are reported in the October issue of the American Journal of Public Health, released November 4.
"Children who are unintended at conception have higher rates of poor outcomes in a variety of ways," says Timothy Dye, the University of Rochester epidemiologist who led the study. "When a doctor is faced with a woman who has an unplanned pregnancy, there should be some extra effort at helping the woman bond with the child, and to encourage breast-feeding. Instead, oftentimes doctors skirt around the question of whether the pregnancy was planned."
To do the analysis, Dye and his colleagues compiled the largest database of unwanted pregnancies ever. The team tracked all births in a 15-county area of central New York for 19 months beginning in January 1995. They interviewed more than 27,000 new mothers and found that nearly 30 percent of births were unintended at conception -- either the children were not wanted at all, or the mothers were unhappy with the timing of the pregnancy. In this study 63 percent of women who planned their pregnancy breast-fed their infants, compared to about half whose pregnancies were accidental.
Children who breast-feed typically gain weight more quickly and are more resistant to infection than other children, and the process also strengthens infant-maternal bonding, Dye says. In the U.S., about half of new mothers typically breast-feed their children. While the percentage is higher than it used to be, it's still low compared to European countries like Finland and Sweden, where rates are 80 to 90 percent.
Scientists have previously noted a variety of effects on children who were unwanted at conception. Dye says these children are more likely to have developmental problems, poor bonds with their mothers, and lower educational achievement later in life. This is the first study to look specifically at breast-feeding behaviors for such children. Next week at the annual Conference of the American Public Health Association, Dye's group is presenting data on yet another outcome: Such children are much more likely to be placed in foster care.
"We know very little about women who go ahead and have a mis-timed or unwanted child," says Dye. "Oftentimes this type of research becomes caught up in the abortion debate, but there's a separate set of issues that needs to be addressed. For women who choose to carry the pregnancy and whose pregnancies were unwanted, what kinds of interventions might help to improve the health of that baby and to improve the wanted-ness of that child at birth?"
Dye led the study while director of the Women's and Children's Health Care Research Center at the State University of New York (SUNY) Health Science Center at Syracuse. The group moved to the University of Rochester in September and is now the Division of Public Health Practice, part of the Department of Community and Preventive Medicine at the University's Medical Center. Dye heads the group and is an associate professor.
Also working on the project were economist Martha Wojtowycz and obstetrician Richard Aubry from SUNY Syracuse, and Jacqueline Quade and Harold Kilburn of the New York State Department of Health, which funded the study.
Journal
American Journal of Public Health