Adolescent girls' perception of their pregnancy can influence the health and well-being of their babies, according to research conducted by the Women's Studies Project at FHI.
In a three-year study in Fortaleza, Brazil, researchers at the Maternidade Escola Assis Chateaubriand (MEAC) and FHI examined 259 infants, measuring motor (movement of muscles), personal-social and language skills. Investigators found that whether a pregnancy was wanted or not had little adverse effect on infant development. Maternal ambivalence, however, played a much greater role.
Young mothers who were ambivalent about their pregnancies -- who changed their minds during the study about whether they wanted the pregnancy -- were more likely to have infants who scored below a specified target level on tests that measure child development. Infants were tested at about one year of age. Nearly 14 percent of infants with ambivalent mothers scored below target, compared with 7 percent in the group who consistently said their pregnancy was unintended and 5 percent in the group who consistently said their pregnancy was intended.1
"Those young women who were really adamant that they wanted the baby at first interview, then changed their minds, had the most problems. Those who acknowledged that their pregnancy was poorly timed seemed to rally and do their best to provide good child care," said Dr. Patricia Bailey, an FHI expert in maternal and child health, who supervised the research.
"It is encouraging to find that infants born to mothers who said the pregnancy was unintended do no worse than those whose mothers said the pregnancy was intended. However, these results show that as time passes, an increasing number of young women wish they had delayed their pregnancies."
A correlation was also observed between mothers' perceptions of pregnancy and infants who scored above target. Contrary to previous research in the United States, which indicates that women who wanted their pregnancies typically have healthier babies, adolescents in the "unintended pregnancy" group were twice as likely to have infants who scored above a specified target, compared with mothers who said their pregnancies were intended. Thirty-eight percent of infants in the unintended group scored above target, compared with 18 percent in the intended group and 31 percent in the ambivalent group.
Other factors did not appear to play a significant role in infant development. The mother's age, work or school status, marital status, self-esteem and postpartum contraceptive use did not affect infant development, nor did premature delivery, complications during pregnancy or delivery, attendance at well-baby clinics or breastfeeding.
Program implications
Since the majority of women in the study did not intend to become pregnant, the findings indicate a need for more information about sexuality, contraception and decision-making.
Programs that encourage young women to delay pregnancy until they are older should also consider the role of self-esteem. The proportion of young women with high self-esteem rose from 30 percent to 53 percent a year later. Self-esteem increased for both new mothers and abortion patients.
While adults view teenage pregnancy as risky to the mother and infant's health and detrimental to the mother's education and employment prospects, many young women find that having a baby boosts their sense of self-worth. Consequently, they do not see pregnancy as detrimental to their future. "Adolescents need pregnancy prevention, and they need to see they have other options for their future before taking on the role of motherhood," said Dr. Bailey.
The Brazil study surveyed more than 367 women ages 12 to 18 seeking prenatal services at MEAC clinics in Fortaleza and 196 women seeking treatment for abortion complications. Among other findings:
- School enrollment dropped from 52 percent to 31 percent over one year. Abortion patients were more likely to be in school.
- At first interview, many of the pregnant teens said their families and partners were excited about the pregnancy, and they believed their relationships would improve. At one year, the quality of relationships with parents had not changed significantly. Relationships with partners deteriorated for both the prenatal and abortion groups.
- At conception, contraceptive use was 3 percent among girls who said their pregnancy was intended and 17.6 percent among girls who said their pregnancy was not intended. After a year, two-thirds of all adolescents were using contraception, with highest use among mothers whose pregnancies had been unintended (75 percent).2
-- Barbara Barnett
References
- Bailey P, Bruno ZV, Cox A. Pregnancy intentions and their effect on infant development. Presentation at the Population Association of America Meeting, New York, March 25-27, 1999.
- Bruno ZV, Bailey P. Brazil: Adolescent Longitudinal Study, Summary Prepared for the Women's Studies Project. Research Triangle Park, NC: Family Health International, 1998; Bailey PE, Bruno ZV, Chen M. Adolescent pregnancy one year later: the effects of abortion versus motherhood in northeast Brazil. Unpublished paper. Family Health International, 1999.
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