Social scientists have long debated how to best measure pregnancy intentions. The
standard measure relies on mothers’ retrospective reports of their intentions at
the time of their conception. Because women have already given birth at the time of this
report, the resulting children’s health—including their vital
status—may influence their mothers’ responses. We hypothesize that women
are less likely to report deceased children were from unintended pregnancies, and this may
explain why some longitudinal studies have shown that children from unintended pregnancies
have lower survival, but cross-sectional studies produce counter findings. Using
Demographic and Health Survey data from 31 sub-Saharan African countries, we confirm that
mothers are less likely to report deceased children resulted from unintended pregnancies
compared to surviving children, although the opposite is true for unhealthy children, who
mothers more commonly report were from unintended pregnancies compared to healthier
children. The results suggest that mothers (1) revise their recall of intentions after the
traumatic experience of child death and/or (2) alter their reports in the face-to-face
interview. The study challenges the reliability of retrospective reports of pregnancy
intentions in high mortality settings, and thus our current knowledge of the levels and
consequences of unintended pregnancies in these contexts.