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Child rearing is the most difficult and important task that most ordinary mortals will ever undertake. It is the first priority of this and every nation; costly to do well, and costlier to neglect. We are not doing a good enough job. We can do better, but the challenge is sobering.
Unwanted pregnancies result in handicapped children. This is a truism, if one accepts the premise that being unwanted is a psychological handicap: the newborn baby leaves life's starting gate with a substantial drag on its tiny ego. Some infants may do quite well in spite of this handicap; others clearly not. Strange that so little research has considered wantedness as a factor in life outcomes!
The usual focus on physical handicaps is easier to document. Pasamanick provides the useful concept, “continuum of reproductive casualty,” ranging from infant death through severe brain damage and mental retardation to minor learning or behavioral problems manifest years later.1 Infant mortality is shockingly high in this country, especially among the poor, the same population which is more likely to suffer the nonlethal casualties. It might appear that steps taken to reduce infant mortality would also reduce the other casualties, but this is not automatically true; it depends upon what steps are taken. Modern medical technology can save pregnancies that would have been aborted, or infants that would otherwise have died. Since some of these children have irreversible brain damage and other serious problems, we find that as infant mortality is reduced some forms of morbidity increase.