‘I was an accident’. Long-term effects of unintended pregnancy on children: Findings from the Dutch prospective birth-cohort Amsterdam Born Children and their Development study

Background Several studies investigated short-term risks of children born from unintended pregnancies, however evidence about long-term risks is missing. This study aimed to examine whether children born from unintended pregnancies experience psychosocial problems up into adolescence. Methods This study is based on the birth cohort study ‘Amsterdam Born Children and their Development’ ( n = 7784). Unintended pregnancy was measured as a multidimensional construct. Children’s psychosocial problems were measured with the Strengths and Difficulties Questionnaire, at 5-6, 11-12 and 15-16 years old. Multiple Structural Equation Models were analyzed, examining associations between unintended pregnancy and children’s psychosocial problems, while controlling for co-occurring risks. Mediating effects via maternal mental health and bonding were assessed. Results Pregnancy mistiming was a significant predictor of internalizing (β = .10, p < .001) and externalizing problems (β = .07, p = .006) and unwanted pregnancy of internalizing problems (β = .13, p < .001) at 5-6 years. These associations were mostly mediated by maternal mental health and poorer maternal bonding. Associations were no longer present at 11-12 and 15-16 years. Conclusion Children born from unintended pregnancies experience more psychosocial problems at 5-6 years, but no longer in adolescence. Unintended pregnancies often coincide with maternal mental health problems, and the associations between unintended pregnancy and children’s psychosocial problems are influenced by maternal mental health and poorer bonding. Therefore it is important to improve maternal mental health and bonding for the benefit of both mother and child, rather than on the isolated effect of unintended pregnancy per se. Key messages What is already known on this topic Of the few studies that have been done, most showed that unintended pregnancy is associated with more psychosocial problems of children later in life, but others found no evidence. Especially evidence about long-term effects on children is missing. What this study adds People who carry a more unintended pregnancy to term experience more mental health issues and poor bonding to their child, which in turn negatively affects their young child. However, when children are older (in adolescence), they no longer face a higher risk of psychosocial problems. This was studied in a context with relative liberal abortion laws and context (i.e., the Netherlands). How this study might affect research, practice or policy It is important to build on maternal mental health and bonding when wanting to reduce children’s psychosocial problems, instead of focusing on the unintended pregnancy per se. Competing Interest Statement The authors have declared no competing interest.