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Cited by 127Reproductive Health and ContraceptionMaternal and Perinatal Health InterventionsGlobal Maternal and Child Health

Comparison of Health, Development, Maternal Bonding, and Poverty Among Children Born After Denial of Abortion vs After Pregnancies Subsequent to an Abortion

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Foster, Diana Greene, Biggs, M. Antonia, Raifman, Sarah, Gipson, Jessica, Kimport, Katrina, Rocca, Corinne H.·2018·JAMA Pediatrics
DOI 10.1001/jamapediatrics.2018.1785PMC PMC6248140
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Abstract

Importance: Evidence indicates that there are potential health, development, and maternal bonding consequences for children born from unwanted pregnancies. Objective: To examine the association of women receiving or being denied a wanted abortion with their children's health and well-being. Design, Setting, and Participants: A 5-year longitudinal observational study with a quasi-experimental design conducted between January 18, 2008, and January 25, 2016, examined women who received abortions just under the gestational age limit of 30 abortion facilities across the United States and women who were denied abortion just beyond the gestational age limit in these facilities. Analyses compared the children of 146 women who were denied an abortion (index children) with children born to 182 women who received an abortion and had a subsequent child within 5 years (subsequent children). Interview-to-interview retention averaged 94.5% (6895 of 7293) across the 11 semi-annual interviews. Exposures: Being born after denial of abortion vs after a new pregnancy subsequent to an abortion. Main Outcomes and Measures: Perinatal outcomes and child health, child development, maternal bonding, socioeconomics, and household structure. Results: This study included 328 women who had children during the study period (mean [SD] age at study recruitment, 23.7 [4.9] years). There were no differences by study group in consent to participate in the study, completion of first interview, or continuation in the study. Among the 328 children in the study (146 index children and 182 subsequent children), there were 163 girls and 165 boys. Perinatal and child health outcomes were not different between subsequent and index children, and there was no clear pattern of delayed child development. However, mixed-effects models adjusting for clustered recruitment and multiple observations per child revealed that poor maternal bonding was more common for index children compared with subsequent children (9% vs 3%; adjusted odds ratio, 5.14; 95% CI, 1.48-17.85). Index children lived in households with lower incomes relative to the federal poverty level than did subsequent children (101% vs 132% of federal poverty level; adjusted regression coefficient, -0.31; 95% CI, -0.52 to -0.10), and were more likely to live in households without enough money to pay for basic living expenses (72% vs 55%; adjusted odds ratio, 5.16; 95% CI, 2.34-11.40). Conclusions and Relevance: These findings suggest that access to abortion enables women to choose to have children at a time when they have more financial and emotional resources to devote to their children.

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  • The study relied on a maternal-reported measure of bonding difficulties (PBQ) with relatively low mean levels and focusing on maternal perceptions rather than dyadic relationships.

    “Third, we relied on a maternal-reported measure of bonding difficulties for which mean levels were relatively low (but similar to other studies; Foster et al. 2018; Kerstis et al. 2016) and that focuses on maternal perceptions rather than dyadic relationships.”

    From Longitudinal associations between prenatal internalizing symptoms and mindfulness traits with postnatal bonding difficulties. (2025) · cites this paper as Foster et al. 2018

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5 of the 57 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. US Department of Health and Human Services. Annual update of the HHS poverty guidelines. Fed Regist. 2012;77(17):4034-4035.
  2. Muñoz M, Poo AM, Baeza B, Bustos ML. Mother-newborn relational risk-study of prevalence and associated variables [in Spanish]. Rev Chil Pediatr. 2015;86(1):25-31.

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Authors
Foster, D. G., Biggs, M. A., Raifman, S., Gipson, J., Kimport, K., & Rocca, C. H.
Affiliations
  • University of California, San Francisco (US)
  • University of California, Los Angeles (US)
Corresponding author
Foster, Diana Greene
ORCID
Venue
JAMA Pediatrics
Publisher
American Medical Association (AMA)
Published
2018-11-01
Volume
172
Issue
11
Pages
1053
ISSN
  • 1072-4710 (ISSN-L)
  • 2168-6203
DOI
10.1001/jamapediatrics.2018.1785
PMC
PMC6248140
OpenAlex
W2892333483
Cited by
127
References
57
Citations by year
2026: 6 · 2025: 9 · 2024: 31 · 2023: 24 · 2022: 25 · 2021: 11 · 2020: 14 · 2019: 5 · 2018: 2
FWCI
7.63
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
unwanted pregnancy, maternal bonding, child development, child health, perinatal outcomes, household poverty, household composition, subsequent pregnancy, gestational age limits, abortion clinics, child well-being, maternal mental health, maternal anxiety, maternal stress, maternal substance use, maternal education, maternal income
MeSH terms
Abortion Applicants, Abortion, Induced, Adolescent, Adult, Child Development, Child Welfare, Family Planning Services, Female, Humans, Infant, Newborn, Longitudinal Studies, Male, Mother-Child Relations, Object Attachment, Poverty, Pregnancy, Pregnancy Outcome, Pregnancy, Unwanted, United States, Young Adult

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