Abortion Underreporting in Add Health: Findings and Implications

Tierney, Katherine

doi:10.1007/s11113-019-09511-8

Cited by 29 publications

(24 citation statements)

References 26 publications

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“…Another limitation may be that abortion clients underreported selfmanaged abortion. Survey underreporting of abortion among non-abortion clients is well-documented [14]; however, we are unable to estimate the possible magnitude of underreporting of self-managed abortion among abortion patients. Nevertheless, our findings most likely represent a conservative estimate of self-managed abortion, indicating that while not common, there is a need to ensure that those who choose to self-manage their abortion have the full resources and information they need to do so.…”

Section: Discussionmentioning

confidence: 81%

Texas women’s decisions and experiences regarding self-managed abortion

et al. 2020

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Background: Prior research has shown that a small proportion of U.S. women attempt to self-manage their abortion. The objective of this study is to describe Texas women's motivations for and experiences with attempts to self-manage an abortion. The objective of this study is to describe Texas women's motivations for and experiences with attempts to self-manage an abortion. Methods: We report results from two data sources: two waves of surveys with women seeking abortion services at Texas facilities in 2012 and 2014 and qualitative interviews with women who reported attempting to self-manage their abortion while living in Texas at some time between 2009 and 2014. We report the prevalence of attempted selfmanaged abortion for the current pregnancy among survey respondents, and describe interview participants' decisionmaking and experiences with abortion self-management. Results: 6.9% (95% CI 5.2-9.0%) of abortion clients (n = 721) reported they had tried to end their current pregnancy on their own before coming to the clinic for an abortion. Interview participants (n = 18) described multiple reasons for their decision to attempt to self-manage abortion. No single reason was enough for any participant to consider selfmanaging their abortion; however, poverty intersected with and layered upon other obstacles to leave them feeling they had no other option. Ten interview participants reported having a complete abortion after taking medications, most of which was identified as misoprostol. None of the six women who used home remedies alone reported having a successful abortion; many described using these methods for several days or weeks which ultimately did not work, resulting in delays for some, greater distress, and higher costs. Conclusion: These findings point to a need to ensure that women who may consider self-managed abortion have accurate information about effective methods, what to expect in the process, and where to go for questions and follow-up care. There is increasing evidence that given accurate information and access to clinical consultation, selfmanaged abortion is as safe as clinic-based abortion care and that many women find it acceptable, while others may prefer to use clinic-based abortion care.

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Section: Discussionmentioning

confidence: 81%

Texas women’s decisions and experiences regarding self-managed abortion

et al. 2020

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“…We started with 12,993 pregnancies reported by women who had valid survey weights. Due to underreporting of abortions in the Add Health data (Tierney, ), we excluded pregnancies that did not end in live birth ( n = 3,303) to focus on births. We also excluded births reported by women who were not White, Black, or Latina ( n = 590); births reported by women who did not answer the sexual identity question at all three waves or who consistently reported that they were not attracted to either men or women at all three waves ( n = 86); and births reported before the age of interview at Wave 1 ( n = 181).…”

Section: Methodsmentioning

confidence: 99%

Racial/Ethnic Differences in Unwanted Births: Moderation by Sexual Orientation

Everett

Mollborn²,

Jenkins

et al. 2020

J of Marriage and Family

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Objective The objective of this study was to explore sexual orientation disparities in unwanted births by race/ethnicity. Background Previous research has documented that sexual minority women (SMW) are more likely to report unintended pregnancy than heterosexual women and that Black and Latina women are more likely to report unintended pregnancy than White women. No research has examined how pregnancy intention varies at the intersection of these two identities. Method Data come from the pregnancy roster data in Waves 4 and Wave 5 subsample in the National Longitudinal Study of Adolescent to Adult Health. We used live births as the unit of analysis (n = 8,527) and multilevel logistic regression models to account for clustering of births within women. Women were asked if they “wanted” to be pregnant at the time of pregnancy. The authors conducted models stratified by race/ethnicity as well as models stratified by sexual identity. Results Among White women, SMW were more likely to describe their births as unwanted than were their heterosexual counterparts. Conversely, among Black and Latina women, SMW were less likely to describe their births as unwanted than were their heterosexual counterparts. Results stratified by sexual identity underscore these contrasting patterns: Among heterosexual women, White women were less likely to describe their births as unwanted when compared with Black and Latina women; among SMW, White women were more likely to describe their births as unwanted than were Black and Latina women. Conclusion Traditional race/ethnicity trends in pregnancy intention (i.e., greater unwanted pregnancy among Black/Latina than White women) are reversed among SMW.

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“…24 Moreover, 24% of these instances had occurred prior to 2000, and only 28% were reported to have been successful. Abortion is underreported on surveys of this type, and the actual incidence may be higher, 29,30 but it is nonetheless unlikely that even a substantial increase in self-managed abortion can account for the majority of the decline in abortion incidence nationally during the study period.…”

Section: Changes In Clinic Numbers Abortion Rates and Policy Contextmentioning

confidence: 96%

Abortion Incidence and Service Availability in the United States, 2017

Jones¹,

Witwer²,

Jerman³

2019

145

143

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This study used new data from the Guttmacher Institute to examine trends in abortion incidence and rates between 2014 and 2017. In addition, we examined changes in the number of health care facilities that provide abortions. ■ ■ In 2017, an estimated 862,320 abortions were provided in clinical settings in the United States, representing a 7% decline since 2014 and the continuation of a long-term trend. ■ ■ The U.S. abortion rate dropped to 13.5 abortions per 1,000 women aged 15-44 in 2017, the lowest rate recorded since abortion was legalized in 1973. Abortion rates fell in most states and in all four regions of the country. ■ ■ A total of 339,640 medication abortions occurred in 2017-about 39% of all abortions. ■ ■ As in previous years, clinics provided the overwhelming majority of U.S. abortions (95%), while private physicians' offices and hospitals accounted for 5%. ■ ■ In 2017, 808 clinic facilities provided abortions, a 2% increase from 2014. However, regional and state disparities in clinic availability grew more pronounced; the number of clinics increased in the Northeast and the West, by 16% and 4% respectively, and decreased in the Midwest and the South, by 6% and 9%, respectively. ■ ■ Although the number of state abortion restrictions continued to increase in the Midwest and South between 2014 and 2017, these restrictive policies do not appear to have been the primary driver of declining abortion rates. There was also no consistent relationship between increases or decreases in clinic numbers and changes in state abortion rates. ■ ■ Fertility rates declined in almost all states between 2014 and 2017, and it is unlikely that the decline in abortion was due to an increase in unintended births. ■ ■ Factors that may have contributed to the decline in abortion were improvements in contraceptive use and increases in the number of individuals relying on self-managed abortions outside of a clinical setting.

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Abortion Underreporting in Add Health: Findings and Implications

Cited by 29 publications

References 26 publications

Texas women’s decisions and experiences regarding self-managed abortion

Texas women’s decisions and experiences regarding self-managed abortion

Racial/Ethnic Differences in Unwanted Births: Moderation by Sexual Orientation

Abortion Incidence and Service Availability in the United States, 2017

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