Impeded Capabilities as a Consequence of Unintended Births: Evidence from a Longitudinal Study in India

Singh, Abhishek (1); Upadhyay, Ashish (2); Singh, Ashish (3); Kumar, Kaushalendra (4) (2016). 'Impeded Capabilities as a Consequence of Unintended Births: Evidence from a Longitudinal Study in India' Paper presented at the annual conference of the HDCA, Tokyo 2016.

abstract Despite an increasing awareness of reproductive rights and widespread use of modern contraceptive methods leading to an increase in pregnancy decision related capabilities of women, the problem of women not able to effectively plan or control births results in substantial number of children who are unintended (either unwanted or mistimed). Globally about 213 million pregnancies occurred in 2012 (Sedgh et al., 2014). Of these, 85 million pregnancies, representing 40 percent of all pregnancies, were unintended. Also, about 50 percent of the unintended pregnancies ended in abortions, 13 percent ended in miscarriages and 38 percent resulted in live births. Recent data from the Demographic and Health Surveys indicate that 14-62% of recent births in developing countries are unintended (Gipson et al., 2008). According to the Indian National Family Health Survey 2005-06, about 21% of the recent births in India were unintended and approximately 10% of them were not wanted at all. Pregnancy intention is an important determinant of both short and long term education and health related capabilities for the children. Education and health capabilities are extremely important for children because they not only have intrinsic value but also instrumental value. The basic premise is that pregnancy intention may affect attitudes and behaviour of parents towards the children which eventually leads to adverse impact on the development of a child in terms of physical health and academic capabilities (Bahk et al., 2015). For example, women with unintended pregnancy are more likely to smoke and consume alcohol and are less likely to attend ante natal care as well as less likely to consume iron folic tablets during pregnancy. Surprisingly little to no research has examined the effect of unintended births on children’s capabilities in developing countries including India. Research on the consequences of unintended births on child outcome in India have primarily emphasized on preterm birth, low birth weight, neonatal and infant mortality and child immunization (Singh et al., 2013). We use data from the first, second and third waves of the Young Lives Study (YLS), which were conducted in the state of Andhra Pradesh in India during 2001, 2006-07 and 2009. There are two cohorts in the study: younger and older. The younger cohort consists of children born in 2001-2002 and the older cohort consists of children born in 1994-1995. Overall, 2011 children in the younger cohort and 1008 children in the older cohort were included in the first wave of YLS conducted in 2002. The second wave took place between late 2006 and early 2007. Of the 2011 children (younger cohort), the second wave included only 1950 children (32 children died, 7 households refused to continue with the study and 22 children were untraceable). Third wave took place in 2009 and included 1930 children in the younger cohort (4 children died, 5 households refused to continue with the study and 11 were untraceable). The YLS collects data on a range of indicators related to child welfare including nutritional status, growth, physical health, cognitive development, social and emotional well-being and educational development. The capability measures included in our study are scores attained by child based on Peabody Picture Vocabulary Test (PPVT-Score), Maths Achievement Test and Early Grade Reading Assessment Test (EGRA-Score) scores and height for age scores. The information on each of the above was collected during the third wave. The key independent variable of interest is the birth intendedness (intended, unintended). During the first wave, the YLS asked women about the birth intention. Those children whose mothers were either no more or were not sure about the pregnancy intention were dropped from the analysis. Such children comprised only about 2.0% of the sample. We also included controls for a number of socio-economic, demographic and residence related variables such as, birth size, preterm birth, sex of child, ever breastfeed, serious illness/injury, height for age score at wave-1, child immunization, pre-schooling, type of school, mother’s height, mother’s age at birth of the child, mother’s education, mother’s working status, household head’s education, sex of household head, household sanitation condition, income shocks, wealth index, religion, caste and place of residence in the analysis. Each of the four capability measures were regressed on birth intendedness along with all the control variables. The preliminary results indicate that about 8% of births in the sample were reported as unintended. The mean ppvt-, maths- and egra- scores at the age of 7/8 years among the unintended children were 50.6, 10.7 and 4.8, respectively which are substantially lower than the scores 59.9, 12.2 and 5.6, respectively obtained by the children who were reported as intended. The mean height for age score was also lower among the unintended children than the intended children (-1.72 against -1.42). Results of multivariable linear regression analysis indicate that unintended births were significantly (at 95% level) more likely to have lower height for age scores as compared to intended births (Coefficient: -0.167). Similarly, unintended births were likely to achieve significantly (at 95% level) lower ppvt-score (Coefficient: -0.077) and egra-score (Coefficient: -0.582) than intended births. This is perhaps the first study that has examined the consequences of unintended births on children’s education and health related capabilities in India using a longitudinal dataset. References Bahk, J., Yun, S. C., Kim, Y. M., & Khang, Y. H. (2015). Impact of unintended pregnancy on maternal mental health: a causal analysis using follow up data of the Panel Study on Korean Children (PSKC). BMC Pregnancy Childbirth, 15, 85. doi: 10.1186/s12884-015-0505-4 Gipson, J. D., Koenig, M. A., & Hindin, M. J. (2008). The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann, 39(1), 18-38. Sedgh, G., Singh, S., & Hussain, R. (2014). Intended and unintended pregnancies worldwide in 2012 and recent trends. Stud Fam Plann, 45(3), 301-314. doi: 10.1111/j.1728-4465.2014.00393.x Singh, A., Singh, A., & Mahapatra, B. (2013). The consequences of unintended pregnancy for maternal and child health in rural India: evidence from prospective data. Matern Child Health J, 17(3), 493-500. doi: 10.1007/s10995-012-1023-x  

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