The Effects of Abortion Decision Rightness and Decision Type on Women’s Satisfaction and Mental Health

Abstract

Background A case series report based on the Turnaway Study has previously concluded that 99% of women with a history of abortion will continue to affirm satisfaction with their decisions to abort. Those findings have been called into question due to a low participation rate (31%) and reliance on a single yes/no assessment of decision satisfaction. Aim To utilize more sensitive scales in assessing decision satisfaction and the associated mental health outcomes women attribute to their abortions. Method A retrospective survey was completed by 1,000 females, aged 41-45, living in the United States. The survey instrument included 11 visual analog scales for respondents to rate their personal preferences and outcomes they attributed to their abortion decisions. A categorical question allowed women to identify if their abortions were wanted and consistent with their own values and preferences, inconsistent with their values and preferences, unwanted, or coerced. Linear regression models were tested to identify which of three decision scales best predicted positive or negative emotions, effects on mental health, emotional attachment, personal preferences, moral conflict, and other factors relevant to an assessment of satisfaction with a decision to abort. Results Of 226 women reporting a history of abortion, 33% identified it as wanted, 43% as accepted but inconsistent with their values and preferences, and 24% as unwanted or coerced. Only wanted abortions were associated with positive emotions or mental health gains. All other groups attributed more negative emotions and mental health outcomes to their abortions. Sixty percent reported they would have preferred to give birth if they had received more support from others or had more financial security. Conclusions Perceived pressure to abort is strongly associated with women attributing more negative mental health outcomes to their abortions. The one-third of women for whom abortion is wanted and consistent with their values and preferences are most likely over-represented in studies initiated at abortion clinics. More research is needed to understand better the experience of the two-thirds of women for whom abortion is unwanted, coerced, or otherwise inconsistent with their own values and preferences.

Welcomed Pregnancies: Characteristics and Patterns of Adjusting to Unwanted, Unplanned, Untimely or Otherwise Difficult Pregnancies

“…A strength of our study is that it had a high participation rate in a sample that is reasonably representative of the national population of women 41-45 years of age, as confirmed by the findings that the number of women reporting abortions was very similar to the national estimates for women in this age group [17], and the proportion of women reporting contact with a pregnancy help center was very similar to that reported in the Google Ads study [11]. Another strength is that it explores a number of variables and metrics that have not previously been studied.…”

“…Of the remaining 1,039 eligible respondents, 39 (4%) failed to complete the survey, resulting in a 96% completion rate. Of the 1,000 women who completed the survey, 226 (22.6%) reported a history of abortion [16,17] and 275 (35.5%) of those who did not have a history of abortion reported experiencing a problematic pregnancy. Based on our abortion risk assessment (a score above 50 on at least one of the abortion risk scales), 112 (40.7%) of the women who reported a history of a problematic pregnancy had been at higher risk of abortion.…”

“…Following a short series of demographic questions, women were asked about their reproductive history. Women who reported an induced abortion were taken down a questionnaire path investigating their abortion experiences, reported elsewhere [16,17]. Women who reported no history of abortion but did report a history of at least one "unplanned, mistimed, unwanted, or otherwise difficult pregnancy" were presented with the questions reported herein.…”

A Reanalysis of Mental Disorders Risk Following First-Trimester Abortions in Denmark

“…[1,[8][9][10] This reanalysis confirms that the Danish data, when examined over periods of at least nine months, is consistent with the findings of both records-based [3,4,12,13] and survey-based studies. [1,11,[14][15][16][17][18] Therefore, the authors of the original study erred in their conclusion that first-time contact rates before and after an abortion are not significantly different in Danish medical records. [2] The differences are significant.…”