Abstract
This study examines the relationship between women’s prospective fertility intentions and child health, measured via access to healthcare facilities for children and postpartum maternal behaviors that are indicative of future child health. We analyze two waves of nationally representative data (2005 and 2012) from the India Human Development Survey (IHDS). The analytic sample includes 3,442 non-pregnant, currently married women aged 18–40 in 2005 who participated in both rounds of the IHDS, and had at least one birth between 2005 and 2012. We investigate the influence of women’s prospective fertility intentions on access to benefits from the Integrated Child Development Services (ICDS), indicators of breastfeeding as recommended by the World Health Organization, and official documentation of births via birth certificates or registration. We find that 58 percent of births among women in the sample were labeled as unwanted. We use an adaptation of propensity score matching—the inverse-probability-weighted regression adjustment (IPWRA) estimator—and show that, after accounting for maternal and household characteristics that are known to be associated with maternal and child health, children who resulted from unwanted births were less likely to obtain any benefits or immunizations from the ICDS, to be breastfed within one hour of birth, and to have an official birth certificate. Results from this study have direct policy significance given the evidence that women’s fertility intentions can have negative implications for child health and wellbeing in the short and longer term.
Highlights
Fertility intentions have emerged as an important determinant of maternal and child health in recent literature [1,2,3,4,5,6]
Our results show that fertility intentions have a significant influence on child health, even after accounting for women’s socio-demographic traits that are likely to be associated with both fertility intentions and child health
After employing a propensity score matching approach—the inverse-probability-weighted regression adjustment (IPWRA) estimator—we found that children that resulted from unwanted births in India were significantly less likely to receive any benefits or immunizations from Integrated Child Development Services (ICDS), to be breastfed within one hour of birth, and to have an official birth certificate
Summary
Fertility intentions have emerged as an important determinant of maternal and child health in recent literature [1,2,3,4,5,6]. Unintended births may negatively influence women and their families by imposing financial, social, emotional, and physical costs [2, 7]. Birth intendedness is associated with maternal postpartum behaviors that are known to influence child health, such as breastfeeding. Studies from the United States have found that children resulting from unwanted births were less likely.
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