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Past research suggests that whether pregnancies are wanted, unwanted, or mistimed may influence breastfeeding behavior. The purpose of this chapter is to develop a more precise understanding of this relationship. Specifically, this chapter asks three questions: first, do pregnancy intentions matter most in sustaining breastfeeding for long or for short durations postpartum; second, at what time postpartum are rates of breastfeeding discontinuation most differentiated by pregnancy intentions; and third, how does poverty (measured here by Medicaid receipt) moderate the relationship between pregnancy intentions and breastfeeding duration.

Logistic regression analysis of survey data from a national sample representative of US mothers is used to determine the relationship of pregnancy intentions to whether breastfeeding continues for various durations and through various intervals after birth. Interaction terms between pregnancy intentions and mother’s Medicaid status are used to test for relationships specific to poor or nonpoor mothers between pregnancy intentions and breastfeeding duration.

Results show that pregnancy timing matters most for sustaining breastfeeding for durations past 6 months and that differences in rates of breastfeeding discontinuation between mothers with wanted, unwanted, and mistimed pregnancies are most pronounced in the 3–7 months postpartum period. In addition, findings show that Medicaid recipients (but not nonrecipients) are less likely to exclusively breastfeed for 6 months when their pregnancies are mistimed.

The literature on fundamental causes of health disparities typically suggests that poverty impairs access to resources necessary for effective planning to achieve desirable health outcomes. This study’s results, however, show that planning of pregnancies is more critical for poor mothers to sustain exclusive breastfeeding. Further research is needed to explain this relationship. The results also suggest that policy interventions to help mothers with unplanned pregnancies to sustain breastfeeding should target the period from 3 to 7 months postpartum.

These findings can help shape policies for facilitating the continuation of breastfeeding for durations recommended by health authorities and advance our understanding of the effects of poverty on health behaviors.

Purpose – Adapting local areas to climate change is a wicked challenge for local administrations. A participatory research is applied to explore how local experience shared by local experts can inform decision and adaptation planning by taking into account local area characteristics and their interrelationships.

Methodology/approach – We turned to local actors, who live or work in the city and who can be seen as urban experts. Their experiential knowledge has given us a better understanding of the characteristics of their communities. These experts are likely to possess a representation that reflects the local territorial sensitivities, which can help us determine how these characteristics might be impacted by climate change.

Findings – A participatory approach bears many benefits such as mobilizing local stakeholders to find collective solutions. It also allows us to focus on common practices in the urban context, which are likely to be altered by changes in mean temperatures, precipitations, etc. It offers the additional benefit of putting into perspective the relations between a variety of urban issues.

Research limitations – A participatory approach means relying on subjective assessments of the possible effects of climate change, which could challenge the relevance of perceived risks and the scope and types of actions taken.

Originality/value of paper – The number of the available adaptation planning processes involving community stakeholders and assessments of these processes is very limited. A participatory process such as the cross-sectoral initiative organized in Québec City can have significant repercussions on local engagement in climate change adaptation. This provides evidence of the potential of deliberation or interaction of territorial actors to improve their understanding of the issues and their adaptive capacity. On a methodological level, the participatory process in itself and the steps to organize it offered a planning frame that can be reproduced.