The effect of birth intention status on maternal and child outcomes in 59 low- and middle-income countries: A fixed effects analysis

Heini Väisänen, Ined / University of Southampton
Ewa Batyra, Center for Demographic Studies

Most studies on the impact of birth intentions on mothers’ and children’s wellbeing do not separate the effect of pregnancy intention status from the socio-demographic characteristics associated with it. There is a lack of studies on the topic in low and middle-income countries (LMICs) taking a multi-country comparative perspective. We analysed 59 Demographic and Health Surveys to examine the effect of birth intentions on child mortality, low birthweight, and place of delivery using sibling fixed-effects linear probability models accounting for confounding due to unobserved time-invariant individual characteristics. The probability of infant mortality was higher after an unwanted or mistimed than wanted birth in 45 countries. Mistimed pregnancies were more often associated with infant mortality than unwanted, perhaps due to variation in the concept of birth intentions between countries, length of birth intervals, or higher reporting of mistimed than unwanted pregnancies. Birth intention status often did not affect low birthweight or the likelihood of delivery in a health facility. Our next steps include an examination of the importance of contextual factors. To the best of our knowledge, this is the first cross-country comparative study in LMICs to analyse the effect of birth intentions on such outcomes using a fixed-effects approach.

Keywords: Cross-country comparative analyses, Demographic and social surveys, Fertility and childbirth, Sexual and Reproductive Health and Rights

See extended abstract.

  Presented in Session 16. Fertility: Preferences and Intentions