Together Forever? Romantic Relationship Characteristics and Prenatal Health Behaviors.

Using Fragile Families and Child Wellbeing Data (N = 4,871), this paper examines why relationship status matters for prenatal health behaviors. The paper argues that a mother's potential investments in her child's health are conditioned by socioeconomic and interpersonal resources, including the quality of her relationship with the child's father. Mothers in strained relationships may experience more stress, which is associated with poor prenatal health behaviors. Results show that married mothers exhibit the healthiest prenatal behaviors and that relationship characteristics and dynamics measures, including physical abuse and relationship conflict, predict poor prenatal health behaviors above and beyond confounding factors. In addition, these relationship characteristics explain some of the advantage in prenatal health behaviors married mothers have over unmarried mothers. Key Words: family data sets, family structure, Fragile Families and Child Wellbeing, parenting and parenthood, pregnancy quality, relationship processes. Current research on the relationship between family structure and children's outcomes primarily emphasizes developmental and physical health outcomes. An important determinant of those outcomes is maternal prenatal health behaviors. A mother's decisions about health behaviors while a child is in utero can have effects in terms of birth outcomes and throughout a child's life (Barker, 1994; Napiorkowski et al., 1996). Thus, the determinants of prenatal health behaviors for mothers should also be considered determinants of children's early health and development. Understanding the determinants of children's health disparities, given the close relationship between health early in Ufe and later (Hass, 2007; Hay ward & Gorman, 2004), may give insight into disparities in health over the life course. Family structure may be an important determinant of health disparities. The relationship between marital status and a variety of health behaviors is well documented (Umbereon, 1992; Umbereon, Williams, Powers, Liu, & Needham, 2006; Waite, 1995). Married mothers' children tend to have better birth outcomes, and married mothers have more positive pre- and postnatal health behaviors, such as not smoking and choosing to breastfeed (Kiernan & Pickett, 2006; Raatikainen, Heiskanen, & Heinonen, 2005). Beyond marital status itself, research demonstrates that expectant mothers living with their partners have more adequate prenatal care and better health behaviors (Albrecht, Miller, & Clarke, 1994; Kiernan & Pickett; Raatikainen et al.) and their babies have healthier birth weights (Padilla & Reichman, 2001). It is unknown what characteristics of these partner relationships may be influential for maternal health behaviors. Why might associations between relationship status and prenatal health behaviors persist, after adjusting for socioeconomic and other confounding factors? This paper seeks to answer this question by building a theory of relationship characteristics and prenatal investments. Do prenatal health behaviors differ by romantic relationship status? Does the quality of a romantic relationship influence prenatal health behaviors? Do relationship characteristics and dynamics, such as conflict and duration, mediate the associations between relationship status and prenatal health behaviors? This paper examines both the independent contribution of relationship quality measures to prenatal health behaviors and the relative contribution of relationship quality measures to differences in prenatal health behaviors among relationship status categories, after confounding factors have been taken into account. Background Receiving prenatal care is recognized as one of the most important things a pregnant woman can do to increase the likelihood of a healthy baby, and nearly 85% of U.S. women today have their first prenatal visit in the first trimester (National Center for Health Statistics, 2005). …