Although the Old Order Amish try to separate themselves from the surrounding American society, they are willing to be interviewed as part of research projects that may benefit themselves and others. Based on that willingness, Kirk Miller and six co-authors completed a thorough investigation of health risks, health status, and pregnancies of Amish women in Lancaster County, Pennsylvania. An article describing their research compares the results of their interviews with a comparable survey of non-Amish women in Central Pennsylvania. Some of the comparisons are most interesting.

 The researchers interviewed 288 Amish women of childbearing age—18 to 45—between November 2004 and June 2005, and compared the results with another survey done two years earlier of 2,002 Central Pennsylvania women from the general population. The article compares the health and childbearing experiences of women in the two populations. The authors sought to find out from each Amish woman her physical condition, exercise patterns, and stresses she experienced during her pregnancies; the amount of social support she felt she had; any intimate partner violence or unfair gender discrimination she might have experienced; and any possible sources of contaminants in her environment.

Some of the comparisons between the two populations are dramatic. None of the unmarried Amish women reported that they were living with a partner, while 13.6 percent of the mainstream women were cohabiting. Only 27.9 percent of the Amish women overall were employed outside the home, full-time or part-time, compared to 75.2 percent of the non-Amish women.

Since the social patterns of the Amish are so well known, some of the general results would have been easy to anticipate. For instance, none of the Amish women lived in households that had received government welfare payments; Pennsylvania Dutch was the primary language in their households; and only 0.7 percent of the sample had received a high-school diploma.

But the health and pregnancy differences between the two populations form the heart of the article. Over 80 percent of the Amish women surveyed had delivered at least one baby, while 68.4 percent of the women in the general population had delivered a child. At the time of the survey, 12.5 percent of the Amish women were pregnant, compared to 3.9 percent of the other women. These numbers suggest to the authors that having children is of greater importance to the Amish women than to Central Pennsylvania women in general. In terms of the percentages of women who had a pre-term delivery or a low birth-weight baby, the differences in the percentages of the two populations were not very large.

The Amish women were about the same height as the non-Amish women, but they weighed less and had a lower body-mass index than the others. The Amish and the non-Amish women believed that their physical health was at about the same levels, but the Amish rated their mental health more highly than the non-Amish did. The Amish women had fewer problems with depression, high cholesterol and urinary tract infections, but more problems with anemia, blood clots, and their thyroids than the non-Amish.

Behaviors and perceptions were also important to the researchers. Compared to the non-Amish respondents, the Amish women were more likely to think they were at an appropriate weight and less likely to try and lose weight. They were less likely to get involved in physical exercise other than physical work. Except for their pregnancies, the Amish women felt they had less problems with stress and far fewer difficulties with gender discrimination than the mainstream Central Pennsylvania women.

The survey also investigated some issues related to social relationships. Surprisingly, two of the Amish women reported intimate partner violence, 0.7 percent of the sample, compared to 7.0 percent of the other women in Central Pennsylvania. The Amish women reported a mean of 11.6 people to whom they could turn for social support, compared to 7.0 people for the non-Amish women. Although most Amish couples are believed to not use birth control, in fact, 20.9 percent of the Lancaster County Amish women are currently using some sort of birth control practice, compared to 59.6 percent in the non-Amish female population.

The authors conclude that Amish women are more likely than non-Amish women to welcome their pregnancies, to have better health before they conceive, less stress, less depression, and much better social support within their communities. They are less likely to drink, smoke, or use prescriptions drugs, which may help promote their better birth outcomes. The article concludes, “Amish women may be more prepared to become pregnant in that they expect it, desire it, lead a lifestyle that supports it, and have the social support necessary to have a successful outcome (p.170)”.

Miller, Kirk, et al. 2007. “Health Status, Health Conditions, and Health Behaviors among Amish Women: Results from the Central Pennsylvania Women’s Health Study (CePAWHS).” Women’s Health Issues 17(3): 162-171