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Abortion: predicting the complexity of the decision-making process.

Abstract

This study sought to test a conflict theory model of decision-making in abortion. Complex, or conflicted, abortion decisions were defined as those occurring when the woman had desired pregnancy, when the abortion alternative was considered later, and when the decision process was lengthier and subjectively more difficult. Sets of personal and social variables, identified from previous research, were expected to require a more complex decision process. A second objective was to determine whether these variables would also predict previous contraceptive behavior. A large sample of abortion patients completed a survey of attitudes and behaviors related to the abortion decision and contraceptive usage. Results indicated that strong involvement with one's sexual partner tended to encourage contraception but complicated the abortion decision. Strong work commitment likewise encouraged contraception but appeared to simplify the abortion decision. While concern for personal health was significantly associated with contraceptive behavior, it was not related to the decision process in abortion. Interpretation suggested that prevention of unwanted pregnancy and the abortion decision are independent processes, both of which are affected by love and work but in opposite directions.

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BibTeXRIS

M L Friedlander, T J Kaul, C A Stimel. 1984. Abortion: predicting the complexity of the decision-making process.. https://doi.org/10.1300/j013v09n01_04

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Unintended pregnancy and use of emergency contraception among a large cohort of women attending for antenatal care or abortion in Scotland.

BACKGROUND: Unintended pregnancy is common. Although many unintended pregnancies end in induced abortion, up to a third of those proceeding to birth might be unplanned. Some of these pregnancies could be prevented by emergency contraception. We have sought to establish how many pregnancies ending in either childbirth or abortion are unintended, and what proportion of women use emergency contraception to try to prevent pregnancy. METHODS: 2908 women who attended an Edinburgh hospital for antenatal care and 907 attending for abortion fully completed a self-administered questionnaire including a validated measure of pregnancy intention and questions about emergency contraceptive use. FINDINGS: 814 (89.7%) of 907 pregnancies among women requesting abortion were unintended compared with only 250 (8.6%) among 2908 women who planned to continue pregnancy. However, only 1909 (65.6%) of continuing pregnancies were intended. The rest of the women were ambivalent about pregnancy intention. In women who continued with their pregnancies intendedness was related to age, with unintended pregnancy most probable in young women (p<0.0001). Emergency contraception was used by 113 (11.8%) of women who requested abortion but only 40 (1%) of those planning to continue pregnancy. In those whose pregnancy was continuing, the proportions reporting use of emergency contraception were higher in young women than in older women and in those who reported that their pregnancies were unintended than in those who meant to become pregnant (both p<0.0001). INTERPRETATION: Unintended pregnancy is common, even among women planning to continue pregnancy. However, EC use is low even among women with no intention of conceiving, and is thus unlikely to reduce unintended pregnancy rates. Rather, we need to find ways to improve the use of regular contraception.

Abortion Applicants↗

Legal abortion for mental health indications.

Where legal systems allow therapeutic abortion to preserve women's mental health, practitioners often lack access to mental health professionals for making critical diagnoses or prognoses that pregnancy or childcare endangers patients' mental health. Practitioners themselves must then make clinical assessments of the impact on their patients of continued pregnancy or childcare. The law requires only that practitioners make assessments in good faith, and by credible criteria. Mental disorder includes psychological distress or mental suffering due to unwanted pregnancy and responsibility for childcare, or, for instance, anticipated serious fetal impairment. Account should be taken of factors that make patients vulnerable to distress, such as personal or family mental health history, factors that may precipitate mental distress, such as loss of personal relationships, and factors that may maintain distress, such as poor education and marginal social status. Some characteristics of patients may operate as both precipitating and maintaining factors, such as poverty and lack of social support.

Abortion Applicants↗