Volume 45 - Article 17 | Pages 547–576

Women’s health decline following (some) unintended births: A prospective study

By Sara Yeatman, Emily Smith-Greenaway

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Date received:17 Sep 2020
Date published:05 Aug 2021
Word count:6511
Keywords:fertility, Malawi, panel studies, unintended fertility, women's health


Background: As many as one in three unintended births occur in Africa. These births have the potential to adversely impact women’s health, but data and design limitations have complicated efforts to understand their consequences. Moreover, there is growing evidence that women often feel happy about an unintended pregnancy, and this heterogeneity may be important for identifying the births that are – and those that are not – harmful to women’s health.

Objective: To assess whether having an unintended birth precipitates health declines for young women in a high-fertility, high-morbidity context and whether a woman’s emotional reaction to a pregnancy foreshadows the consequences of the resulting birth.

Methods: We use closely spaced panel data from 896 young women in Malawi that include prospective measures of fertility timing desires captured only months before conception and a contemporaneous measure of emotional reaction to the pregnancy. We run lagged dependent variable regression models of self-rated health that account for health and sociodemographic conditions prior to pregnancy and compare women with unintended births to women with intended births and to an alternative comparison group: women who avoid unintended births. We then disaggregate unintended births by women’s emotional reactions after learning of the pregnancy.

Results: Women who had an unintended birth but initially had a positive reaction to the pregnancy did not experience a decline in health after birth. Women who had a more negative reaction, however, experienced marked reductions in self-rated health, even years after the birth.

Contribution: Our findings highlight meaningful heterogeneity in the consequences of unintended fertility for women’s health and offer insights into the unintended births that put women at greatest risk of health decline.

Author's Affiliation

Sara Yeatman - University of Colorado Denver, United States of America [Email]
Emily Smith-Greenaway - University of Southern California, United States of America [Email]

Other articles by the same author/authors in Demographic Research

» Educational attainment and adult literacy: A descriptive account of 31 Sub-Saharan Africa countries
Volume 33 - Article 35

» Sibling support and the educational prospects of young adults in Malawi
Volume 30 - Article 19

» Does the orphan disadvantage "spill over"? An analysis of whether living in an area with a higher concentration of orphans is associated with children’s school enrollment in sub-Saharan Africa
Volume 28 - Article 40

» Beyond denomination: The relationship between religion and family planning in rural Malawi
Volume 19 - Article 55

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