Are women with an unintended pregnancy less likely to breastfeed?

OBJECTIVE To examine the association between unintended pregnancy and the initiation and duration of breastfeeding. STUDY DESIGN This was a secondary data analysis of the 1995 Cycle 5 of the National Survey of Family Growth. POPULATION We studied 6733 first singleton live births to US women aged 15 years to 44 years. OUTCOMES Using the 1995 Institute of Medicine definitions, pregnancies were classified as intended or unintended; unintended pregnancies were further categorized as either mistimed or unwanted. We measured initiation of breastfeeding and duration of nonexclusive breastfeeding for at least 16 weeks. RESULTS In this study, 51.5% of women never breastfed, 48.5% initiated breastfeeding, and 26.4% of all women continued breastfeeding for at least 16 weeks. US women with unwanted unintended pregnancies were more likely not to initiate breastfeeding (odds ratio [OR] = 1.76; 95% CI, 1.26-2.44) and more likely not to continue breastfeeding (OR = 1.69; 95% CI, 1.12-2.55) than women with intended pregnancies. White women with unwanted unintended pregnancies were more likely not to breastfeed than those with intended ones (initiation: OR = 2.50; 95% CI, 1.54-4.05; continuation: OR = 2.56; 95% CI, 1.34-4.87). This finding was not seen for black or Hispanic women. CONCLUSIONS In the United States, women with unwanted pregnancies were less likely either to initiate or to continue breastfeeding than women with intended pregnancies. A strong inverse association between unwanted pregnancies and breastfeeding was observed only for white women. Education for women with unintended pregnancies may improve breastfeeding rates and subsequently, the health of women and infants.