Unintended Pregnancy and Prenatal Behaviors Among Urban, Black Women in Baltimore, Maryland: The Baltimore Preterm Birth Study

Purpose

We explored associations between intendedness of pregnancy with maternal prenatal behaviors, including smoking, use of alcohol, use of illicit drugs, and late initiation of prenatal care.

Methods

Pregnant black women ages 18 years or older (N = 913) were enrolled in the study at their first visit to prenatal clinics in Baltimore, Maryland, at which time data were obtained from the women about intendedness of pregnancy. Data on behavioral risks were abstracted from clinical records. Logistic regression was used to adjust analyses for maternal demographic characteristics.

Results

Women with unwanted pregnancies were significantly more likely than women with wanted or mistimed pregnancies, or who were unsure about intendedness, to smoke (odds ratio [OR], 2.0; 95% CI, 1.2–3.3), use alcohol (OR, 2.1; 95% CI, 1.1–3.9), and use illicit drugs (OR, 1.8; 95% CI, 1.0–2.9) during pregnancy, and to initiate prenatal care in the third trimester (OR, 5.7; 95% CI, 3.5–9.4).

Conclusions

Unwanted pregnancy is associated with prenatal behaviors that increase the risk of poor pregnancy outcomes. The facilitation of wanted pregnancies and reduction of harmful maternal behaviors may result in improved pregnancy outcomes in the United States.

Key Words: unintended pregnancy, pregnancy, prenatal behaviors

Selected Abbreviations and Acronyms: PRAMS, Pregnancy Risk Assessment Monitoring System, NSFG, National Survey of Family Growth, NMIHS, National Maternal and Infant Health Survey, OR, odds ratio, 95% CI, 95% confidence interval