Wanted: Children Who Are Wanted

If no one got pregnant without intending to do so, what a huge difference it would make in the nation’s costly stew of social and economic problems.

Abortion would drop sharply from its current 1.5 million level, easing a hate-filled ongoing political and moral controversy.

Fewer babies would be born to unmarried women, especially teenagers. This, in turn, would cut the number of low-birth-weight babies and the expensive care they must have. It also would reduce the need for welfare, food stamps and Medicaid. There would be fewer dysfunctional families and abused children, fewer school failures and less crime and poverty.

It’s important to sift through the tangle of interlocking personal, economic and social problems that push people into poverty and to look at how those problems could be prevented or reduced. A primary cause, says a new report from the prestigious National Academy of Science’s Institute of Medicine, is unintended pregnancy - pregnancy that is not wanted or is mistimed.

More unintended pregnancies occur in the United States than in most Western democracies, the report stresses. Almost 60 percent of all pregnancies in this country are unintended at the time of conception - either not wanted at all or occurring at the wrong time in the mother’s or father’s life.

Some groups of women have an even higher rate of unwanted pregnancies. In 1990, 60 percent of the babies born to women in poverty, 73 percent of the babies born to women who never had married and 83 percent of the babies born to unmarried teens were not intended to have been conceived.

Of course, most babies who were not intended at the time they were conceived do turn out to be wanted and loved by the time they are born. But women who did not intend to become pregnant may be slower to get prenatal care and to follow precautions about not drinking or smoking or using drugs, adding risks to their baby’s prenatal development.

Unintended babies, even if they are loved, may impose serious financial or emotional strains on their parents’ relationship and job opportunities and may push them into an unhappy marriage. Or their mothers may resort to welfare, with all the problems that involves for them - and the nation. And unwanted babies are the most likely to be abused or neglected.

So serious are the results of unwanted pregnancies - for children, parents and society - that the Institute of Medicine urges the nation to adopt a new social norm: “All pregnancies should be intended - that is, they should be consciously and clearly desired at the time of conception.” The U.S. Department of Health and Human Services is working toward the same goal - but more realistically, hoping to reduce unintended pregnancies to about 30 percent by the year 2000.

How can more women - and men - be persuaded to take enough control over their lives to avoid pregnancies they don’t want and babies who will impose emotional and financial burdens the parents are not ready to take on?

The Institute of Medicine makes several obvious - and timid - recommendations.

It says the nation’s goals should be to improve knowledge about contraception and reproductive health, to increase access to contraceptives, to develop local programs to reduce unintended pregnancies and to push the development of new, more effective methods of birth control for both men and women.

But the report also notes that more teens are sexually active at younger ages, that more men and women are sexually involved and living together without being married and that traditional restraints on sexual involvement - and unintended pregnancy - have been greatly relaxed. “Things are not the way they used to be,” says the report. “But this diverse nation cannot yet seem to agree on what the new rules should be, particularly in the areas of sexual behavior.”

However, even without a public consensus about sexual behavior, this nation should be able to focus on the goal of avoiding unintended pregnancy and having all children being born wanted and welcomed, says the report.

But that seems more like a gasp of wishful thinking than of realistic possibility. Sex education in the schools has not been very effective in the face of rapidly changing sexual behavior. The reversible methods of birth control currently available still require individual responsibility. And the development of contraceptives that are easier to use and have a lower rate of failure is being slowed by risks of litigation.

Widely accepted social sanctions against bearing children out of wedlock and even against premarital sexual intercourse, at least by women, kept the percentage of unintended pregnancies quite low in earlier decades. Sexual morality also had heavy reinforcement by religious beliefs.

But sex drives are powerful. Sexual activity is exciting, compelling, addictive, endlessly attractive. Sex also saturates our social and cultural environment, soaks the media and sells products.

The steep increase in unintended pregnancies, with all the individual and national problems that result, is a price we are paying for turning away from traditional sexual morality and its religion-based sanctions.

We may not be able to reach that wonderful goal of having all children wanted and welcomed by two parents ready and able to care for them without a code of conduct that has the force of morality.

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