Perceived stress and emotional social support among women who are denied or receive abortions in the United States: a prospective cohort study

Abstract

BackgroundExamining women’s stress and social support following denial and receipt of abortion furthers understanding of the effects of unwanted childbearing and abortion on women’s well-being. This study investigated perceived stress and emotional social support over time among women who were denied wanted abortions and who received abortions, and compared outcomes between the groups.MethodsThe Turnaway Study is a prospective cohort study of women who sought abortions at 30 abortion facilities across the United States, and follows women via semiannual phone interviews for five years. Participants include 956 English or Spanish speaking women aged 15 and over who sought abortions between 2008 and 2010 and whose gestation in pregnancy fit one of three groups: women who presented up to three weeks beyond a facility’s gestational age limit and were denied an abortion; women presenting within two weeks below the limit who received an abortion; and women who received a first trimester abortion. The outcomes were modified versions of the Perceived Stress Scale and the Multidimensional Scale of Perceived Social Support. Longitudinal mixed effects models were used to assess differences in outcomes between study groups over 30 months.ResultsWomen denied abortions initially had higher perceived stress than women receiving abortions near gestational age limits (1.0 unit difference on 0-16 scale, P = 0.003). Women receiving first-trimester abortions initially had lower perceived stress than women receiving abortions near gestational age limits (0.6 difference, P = 0.045). By six months, all groups’ levels of perceived stress were similar, and levels remained similar through 30 months. Emotional social support scores did not differ among women receiving abortions near gestational limits versus women denied abortions or women having first trimester abortions initially or over time.ConclusionsSoon after being denied abortions, women experienced higher perceived stress than women who received abortions. The study found no longer-term differences in perceived stress or emotional social support between women who received versus were denied abortions.

Assessment of depression, anxiety, and social support in the context of therapeutic abortion

“…A negative correlation was determined between negative emotional problems and emotional social support after abortion . In a study by Harris, the stress experienced by women who underwent therapeutic abortion was higher than women who had a first‐trimester abortion, and this stress was higher in women who refused a therapeutic abortion.…”

Moderators and mediators of the relationship between receiving versus being denied a pregnancy termination and subsequent binge drinking

“…Also, most women in the Near Limit group received terminations later in gestation than most US women (Pazol et al, 2013). However, our previously published analyses of alcohol, tobacco, drug use, stress, mental health, and emotions found that Near Limits are substantially similar to First Trimesters in their experiences subsequent to the termination (Foster et al, 2015; Harris et al, 2014; Roberts et al, 2015; Roberts and Foster, 2015; Roberts et al, 2014c; Rocca et al, 2015). We also note that about 10% of Turnaway Births placed their babies for adoption.…”

“…The Turnaway Study seeks to understand how the outcome of an unwanted pregnancy affects women’s subsequent physical and mental health and socioeconomic status (Foster et al, 2015; Harris et al, 2014; Roberts et al, 2014a, 2015; Roberts and Foster, 2015; Roberts et al, 2014c; Rocca et al, 2013, 2015). Analyses presenting the main effects of termination vs. birth on subsequent alcohol use, binge drinking, and problem symptoms have been published previously (Roberts et al, 2015).…”

“…The change to past week was made so the baseline measure would reflect the time period after termination seeking and not the time period leading up to termination seeking. The modified scale had a Cronbach’s alpha of .74 (Harris et al, 2014). We also considered emotions about the pregnancy.…”

“…This stress could lead women denied terminations to consume alcohol to cope. Our previous analyses found that perceived stress was initially higher after being denied than after receiving terminations, but these differences were temporary (Harris et al, 2014). Further, those who had more difficulty coping – either with termination or continued pregnancy – may also drink more subsequent to the pregnancy.…”