Unintended pregnancy: greater risk of poorer pregnancy outcomes

Does an unintended pregnancy affect the health of mother and baby at birth? To find out, researchers analysed data from over 9800 mother-child couples, all of whom received primary midwifery care. According to this study, an unintended pregnancy increases the risk of adverse health outcomes at birth.
Mother and child after birth

Maternal and newborn health outcomes

The study compared intended pregnancies with unintended pregnancies. The study found that in an unintended pregnancy, there was a slightly higher risk of preterm birth and of inducing labour. The newborns were slightly more likely for being too a small  for gestational age. The newborn babies in unintended pregnancies also fared slightly worse immediately after birth; they had a lower Apgar score, which reflects the baby's health status immediately after birth. On the contrary, they were slightly less likely to have a caesarean section.

In the case of an unintended pregnancy, women did not go to a midwife for care until later in the pregnancy. However, the latter was not the reason for the differences found in adverse maternal and newborn health outcomes.

No precise cause for health disparities

According to the researchers, there are several possible explanations for these health disparities. Possibly, structural and social inequalities such as differences in income and education play an important role. Stress during pregnancy may also influence outcomes. Moreover, it is possible that women who became unintentionally pregnant had an unhealthier lifestyle before pregnancy that may increase the risk of adverse health outcomes.

The researchers therefore argue that healthcare providers and policymakers should offer unjudgmental, tailored care. This regardless of whether the pregnancy was intended or not. Furthermore, good care and information prior to pregnancy should focus on reducing risk factors associated with adverse health outcomes of mother and newborns.

Analysis obstetric care in unintended pregnancy

This large-scale study used data of unintentionally pregnant women from VeCaS (Midwifery Case Registration System); this is a registration system in the Netherlands to collect data from primary care midwifery practices during the course of pregnancy, delivery and puerperium. This involved data from mothers with low-risk pregnancies who received primary midwifery care between 2012 and 2020. Using these data, researchers examined the association between  unintended pregnancies and adverse maternal and newborn health outcomes.

The study is published in the Journal of Midwifery and Women’s Health.

The study was conducted in a collaboration between researchers from the University Medical Center Groningen (UMCG), the Amsterdam University Medical Center, the Academy of Midwifery Amsterdam and Groningen (AVAG) and expertise centre Fiom.

This study is part of a larger ZonMW project that aims to improve cooperation between primary care providers in (after)care for unintended pregnancies. This will be investigated by finding out how often unintended pregnancies occur, what the risk groups are and what experiences and/or care needs women with unintended pregnancies, partners and care providers have.