Death and Desirability: Retrospective Reporting of Unintended Pregnancy After a Child's Death

• Published in: Demography Vol. 53; no. 3; pp. 805 - 834
• Main Authors: Smith-Greenaway, Emily, Sennott, Christie
• Format: Journal Article
• Language: English
• Published: New York Population Association of America (Springer) 01.06.2016; Springer US; Duke University Press, NC & IL
• Subjects: Adolescent; Adult; Africa South of the Sahara; Child Health - statistics & numerical data; Child mortality; Child mortality rates; Child nutrition; Child rearing; Children; Children & youth; Childrens health; Condoms; Correlation analysis; Cross-Sectional Studies; Data collection; Death; Death & dying; Demographics; Demography; Families & family life; Fatalities; Female; Females; FERTILITY AND BIRTH OUTCOMES; Geography; Growth retardation; Health; Health problems; Health surveys; Humans; Knowledge; Longitudinal studies; Low income groups; Married status; Medicine/Public Health; Middle Aged; Mortality; Mortality rates; Mothers; Population Economics; Pregnancy; Pregnancy, Unplanned - psychology; Reproducibility of Results; Retrospective Studies; Self Report; Social Sciences; Sociology; Studies; Trauma; Unwanted pregnancy; Women; Womens health; Young Adult; Sub-Saharan Africa; Measurement; Child mortality; Unintended pregnancy; Sub-Saharan Africa; Child health
• ISSN: 0070-3370; 1533-7790
• DOI: 10.1007/s13524-016-0475-9

Social scientists have long debated how to best measure pregnancy intentions. The standard measure relies on mothers' retrospective reports of their intentions at the time of conception. Because women have already given birth at the time of this report, the resulting children's health—including their vital status—may influence their mothers' responses. We hypothesize that women are less likely to report that deceased children were from unintended pregnancies, which may explain why some cross-sectional studies have shown that children from unintended pregnancies have higher survival, despite the fact that longitudinal studies have shown the opposite is true. Using Demographic and Health Survey data from 31 sub-Saharan African countries, we confirm that mothers are less likely to report that deceased children resulted from unintended pregnancies compared with surviving children. However, the opposite is true for unhealthy children: mothers more commonly report that unhealthy children were from unintended pregnancies compared with healthier children. The results suggest that mothers (1) revise their recall of intentions after the traumatic experience of child death and/or (2) alter their reports in the face-to-face interview. The study challenges the reliability of retrospective reports of pregnancy intentions in high-mortality settings and thus also our current knowledge of the levels and consequences of unintended pregnancies in these contexts.