Context: Women's behavior during pregnancy, which can affect the health of their infant, may be influenced by their attitude toward the pregnancy.
Methods: Multivariate analyses of data from the 1988 National Maternal and Infant Health Survey and the 1988 National Survey of Family Growth were conducted to investigate whether women with unplanned births differ from other women in their pregnancy behavior, independent of their social and demographic characteristics.
Results: Women with intended conceptions are more likely than similar women with unintended pregnancies to recognize early signs of pregnancy and to seek out early prenatal care, and somewhat more likely to quit smoking, but they are not more likely than women with comparable social and demographic characteristics to adhere to a recommended schedule of prenatal visits once they begin care, to reduce alcohol intake, or to follow their clinician's advice about taking vitamins and gaining weight. Social and demographic differences in these behaviors are largely unaffected by planning status, indicating that these differences are independently related to pregnancy behaviors.
Conclusions: Both the intendedness of a pregnancy and the mother's social and demographic characteristics are important predictors of pregnancy-related behavior.
PIP: The hypothesis that women's behaviors during pregnancy that have the potential to influence their baby's health are influenced by their attitudes toward the pregnancy was examined through use of data from two US surveys: the 1988 National Maternal and Infant Health Survey (n = 9122 births) and the 1988 National Survey of Family Growth (n = 2586 births). Specifically, it was explored whether women with unintended (mistimed or unwanted) pregnancies make less use of prenatal care services and conform less closely to recommended practices such as those related to smoking and weight gain than women with planned pregnancies, independent of their social and demographic characteristics. Multivariate analysis indicated women with planned pregnancies were 12 percentage points more likely than women with unintended births to recognize their pregnancy in the first 6 weeks, 16 percentage points more likely to have initiated prenatal care in the first 8 weeks, and 8 percentage points more likely to have adhered to medical advice to quit smoking. Once the effects of social and demographic factors were controlled, these differences were reduced by 49%, 46%, and 32%, respectively. Contrary to expectations, once prenatal care was initiated, women with an unintended pregnancy were as likely to meet the recommended number of visits, reduce alcohol consumption, take vitamins, and gain weight per advice as women with a planned pregnancy. These results indicate a need to pay attention to social and demographic factors that contribute to late recognition of pregnancy, delayed entry into prenatal care, and continued smoking during pregnancy as well as the wantedness of the pregnancy in the design of maternal-child health programs.