Data from the Indian National Family Health Survey, 2005-06 were used to explore how pregnancy intention at the time of conception influences a variety of maternal and child health and health care outcomes. Results indicate that mistimed children are more likely than wanted children to be delivered without a skilled attendant present (OR = 1.3), to not receive all recommended vaccinations (OR = 1.4), and to die during the neonatal and postneonatal periods (OR = 1.8 and 2.6, respectively). Unwanted children are more likely than wanted children to not receive all recommended vaccinations (OR = 2.2), to be stunted (OR = 1.3), and to die during the neonatal, postneonatal, and early childhood periods (OR = 2.2, 3.6, and 5.9, respectively). Given the high levels of unintended fertility in India (21 per cent of all births), these are striking findings that underscore the importance of investments in family planning.