Does unwanted pregnancy lead to adverse health and healthcare utilization for mother and child? Evidence from low- and middle-income countries

OBJECTIVES: Unwanted pregnancy is an important public health concern in low- and middle-income countries (LMICs). Using a pooled dataset from 48 Demographic Health Surveys conducted in Africa, Asia, Latin America and Europe (n = 494,778), we examined the effect of unwanted pregnancy on maternal and child healthcare utilization and child health outcomes in LMICs. METHODS: We used logistic regression models to estimate the effect of unwanted pregnancy on antenatal care use, supervised delivery, childhood vaccination and three indicators of child health, viz. stunting (height-for-age), underweight (weight-for-age) and wasting (weight-for-height). RESULTS: We found that mothers of children whose pregnancies had been unwanted had a lower probability of attending four or more antenatal care visits by 3.6% (95% confidence interval = 1.9–5.4%) compared to those whose pregnancy was wanted. We did not find significant impacts of unwanted pregnancy on supervised delivery, childhood vaccination uptake or child health indicators. CONCLUSIONS: Birth characteristics, household-level determinants and country-level characteristics seem to be more closely related to maternal and child healthcare utilization as well as child health outcomes than whether the pregnancy was wanted or unwanted in LMICs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00038-020-01358-7) contains supplementary material, which is available to authorized users.