UNWANTED CHILDREN SUFFER LONG-TERM DIFFICULTIES

What is the fate of an unwanted child whose mother is unable to obtain an abortion she so desperately desires? A long-term study provides a grim answer: The child faces psychological suffering that continues well into adulthood and may set the stage for problems in future generations. Clinical psychologist Henry P. David gave the American Psychological Association's 97th annual convention the results in New Orleans yesterday of almost two decades of research on 110 Czechoslovakian children whose mothers had twice requested that they be aborted. The findings show that these children, reared under good socioeconomic conditions in their intact biological families, performed more poorly in school, had more psychological problems and more delinquency than did a matched group of children born at the same time to families who wanted them. "It shows that even under the best conditions, you find long-term psychological consequences for these children," said Nancy Felipe Russo, professor of psychology and women's studies at Arizona State University and president of the APA's division of the psychology of women. "The study is an extremely significant contribution to the scientific understanding of the consequences of unwanted and unintended childbearing." The study of 220 children -- half of them unwanted, half of them from families who planned their births -- grew out of a chance meeting at a cocktail party in Prague in the late 1960s. David, an American clinical psychologist now with the Transnational Family Research Institute in Bethesda, had just completed a project with the World Health Organization when he struck up a conversation with the director of Czechoslovakia's public health service. At the time, abortion was legal in Czechoslovakia, but to terminate a pregnancy, women had to apply to a three-member district committee comprised of a gynecologist, a social worker and a local representative of the trade union or the women's federation. Ninety-two percent of all requests were granted. When the committee denied a request, the woman had the right to appeal to the Regional Appellate Abortion Commission, where another 6 percent of requests were usually approved. Only 2 percent of those who applied for an abortion were ultimately denied. Requests were turned down if a woman was beyond 12 weeks of pregnancy, if she had terminated a pregnancy during the previous six months, if she supplied false information or if she simply didn't have a good enough reason to want to halt the pregnancy. The head of the public health service, whom David declined to identify, was also chairman of the Prague Appellate Abortion Committee. She told David that she was intrigued with the 2 percent of women who were twice denied an abortion, and proposed a study of their children. David agreed, provided that the development of the unwanted children be compared against a randomly selected group of children whose parents had wanted them. Each unwanted child would be matched against a wanted child for background, birth order and marital status of the parents. The study would date back to 1960, through the use of interviews and extensive checking of records. David obtained funds and teamed with three Czechoslovakian researchers, physician Zdenek Dytrych and psychologist Vrastislav Schuller, both of the Psychiatric Research Institute in Prague, and Zdenek Matejcek, a psychologist with the Postgraduate Medical Institute, also in Prague. The project has received financial support from the Czechoslovakian government, the U.S. National Institute of Child Health and Human Development, the World Health Organization, the World Federation for Mental Health and the Ford Foundation. It is reportedly the only scientific study that was allowed to continue during the Soviet occupation. Among the findings:Expectant mothers who were forced to continue their pregnancies obtained less prenatal care because they registered for treatment later than other women and visited the clinics less frequently, David and his co-authors report in a book on their study, "Born Unwanted: Developmental Efforts of Denied Abortion."Despite differences in prenatal care, there were no physical differences between the two groups of children at birth. "There was no additional prematurity among the group of unwanted children, no differences in birth weight or length," David said in an interview last week.Adoption was rarely pursued by mothers of unwanted children. Only 6 percent gave up their children. "Even after twice being denied an abortion, they still don't want to give up their babies," David said.Mothers of the unwanted children were less likely to nurse their babies and, when they did breast-feed, they did it for a shorter period of time.By preschool, both groups of children seemed to adapt equally well to the educational process, according to parental reports and school records, but the unwanted children were more frequently described by their mothers as being "naughty, stubborn and bad-tempered." By third grade, the unwanted children disliked school more than the control children. They were also rated by their teachers as being less diligent, showing less concentration, initiative and tidiness. Yet they scored as well as the control children on intelligence tests.At age 9, "there were considerable problems," David said. The unwanted children were generally "rejected as friends by their schoolmates." Boys were particularly at risk. "Mothers perceived their sons less favorably than {did} mothers of daughters," he said. If the children sensed differences between their family and others, they did not reveal it to researchers. Psychological tests revealed no major differences between unwanted children's perceptions of their family life and those of the control youngsters. "The findings suggest," Matejcek, Dytrych and Schuller reported, "that the unwanted pregnancy children do not see their family psychosocial and emotional situation as deviant." Yet, according to the ongoing study, the pattern of growing differences between the two groups of children continued during adolescence and well into adulthood. In 1977, when the children were ages 14 to 17, school performance differences became statistically significant. The unwanted children were substantially under-represented among students who earned average or above-average grades. "They practically never appeared on the roster of outstanding students in any subject," David said. "Yet they had identical intelligence scores to the control group." Few of the children from the unwanted group went to high school. "Most became apprentices for a trade or went into some other kind of vocational training," the researchers found. By their early twenties, the unwanted group was experiencing a growing number of psychological difficulties. Their names were more likely to appear on rosters of drug addicts, alcoholics, psychiatric patients and criminals. "They expressed less job satisfaction and more problems with their supervisors," David said. "They had fewer and less satisfying relationships with friends, and more disappointments in love." At the same time, their sexual experience was greater than others their same age. Most began sexual activity at age 15 and by their early twenties had engaged in intercourse with more than 10 sexual partners. Today, about half of both groups in the study are married, but the differences remain. "Those in the unwanted group who are married judged their marriage as less happy than those in the control group or wished that they had married someone other than their present partner," the researchers reported. Almost a third of each group have become parents. "Yet more of the unwanted children in the study indicated that the pregnancy {of their children} had not been welcome, so you have a repetition of their experience," David said. The findings confirm results of other studies, which were not as scientifically controlled. For example, one 35-year study of 120 Swedish children born from 1939-42 after their mothers were refused abortions also found significant differences between wanted and unwanted children. Swedish psychiatrist Hans Forssman and social worker Inga Thuwe found that by age 21, more than a quarter of the unwanted children had required psychiatric treatment, compared with 15 percent of the control children. Ten percent more unwanted children appeared on delinquency rolls than did the control youngsters, and they were more likely to have been on public assistance. But by 1977, when the participants in the Swedish study turned 35, there was a decrease in the differences between the two groups, leading the researchers to conclude that the biggest risk for unwanted children came during their developmental years. Whether that will be true for the Czechoslovakian study won't be known for several more years. David and his colleagues plan to evaluate the groups when they turn 30. They also hope to evaluate the children of the study participants to see whether differences emerge. "What we believe the findings show so far," David said, "is that . . . the odds of having a detrimental psychosocial development in such children is very, very great."