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.
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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