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Decision Rightness and Emotional Responses to Abortion in the United States: A Longitudinal Study.

Rocca CH, Kimport K, Roberts SC, Gould H, Neuhaus J, Foster DG - PLoS ONE (2015)

Bottom Line: However, existing research is inconclusive.Multivariable mixed-effects models were used to examine changes in each outcome over time, to compare the two groups, and to identify associated factors.Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years.

View Article: PubMed Central - PubMed

Affiliation: Advancing Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Francisco, San Francisco, California, United States of America.

ABSTRACT

Background: Arguments that abortion causes women emotional harm are used to regulate abortion, particularly later procedures, in the United States. However, existing research is inconclusive. We examined women's emotions and reports of whether the abortion decision was the right one for them over the three years after having an induced abortion.

Methods: We recruited a cohort of women seeking abortions between 2008-2010 at 30 facilities across the United States, selected based on having the latest gestational age limit within 150 miles. Two groups of women (n=667) were followed prospectively for three years: women having first-trimester procedures and women terminating pregnancies within two weeks under facilities' gestational age limits at the same facilities. Participants completed semiannual phone surveys to assess whether they felt that having the abortion was the right decision for them; negative emotions (regret, anger, guilt, sadness) about the abortion; and positive emotions (relief, happiness). Multivariable mixed-effects models were used to examine changes in each outcome over time, to compare the two groups, and to identify associated factors.

Results: The predicted probability of reporting that abortion was the right decision was over 99% at all time points over three years. Women with more planned pregnancies and who had more difficulty deciding to terminate the pregnancy had lower odds of reporting the abortion was the right decision (aOR=0.71 [0.60, 0.85] and 0.46 [0.36, 0.64], respectively). Both negative and positive emotions declined over time, with no differences between women having procedures near gestational age limits versus first-trimester abortions. Higher perceived community abortion stigma and lower social support were associated with more negative emotions (b=0.45 [0.31, 0.58] and b=-0.61 [-0.93, -0.29], respectively).

Conclusions: Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding.

No MeSH data available.


Related in: MedlinePlus

Mean predicted probability of reporting that abortion was the right decision over three years after an abortion.The line represents the trajectory of the average participant (average intercept and slope), based on a multivariable mixed-effects model of reporting that abortion was the right decision, with mean-centered covariables equal to zero.
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pone.0128832.g001: Mean predicted probability of reporting that abortion was the right decision over three years after an abortion.The line represents the trajectory of the average participant (average intercept and slope), based on a multivariable mixed-effects model of reporting that abortion was the right decision, with mean-centered covariables equal to zero.

Mentions: In crude data, approximately 95% of women completing each follow-up interview reported that having the abortion was the right decision for them. Based on the mixed-effects model, which accounts for attrition and baseline characteristics and allows for individual variation in trajectories over time, the predicted probability of the average participant reporting that the abortion was the right decision was >99% across all times, with an increase over three years (adjusted odds ratio [aOR] = 1.05 per month, 95% confidence interval [CI] [1.00, 1.08]) (Fig 1 and Table 2). Women whose pregnancies had been more planned and who had greater difficulty deciding to seek abortion reported lower levels of decision rightness (aOR = 0.72 [0.60, 0.85] and aOR = 0.48 [0.36, 0.64], respectively), as did Latinas (aOR = 0.31 [0.13, 0.74], versus white). Women both in school and employed at baseline were more likely to report that abortion was right than those neither in school nor employed (aOR = 3.23 [1.06, 9.81]). Women reporting that the man involved in the pregnancy was not a part of the decision-making process had greater feelings of decision rightness than women whose partners did not want or were not sure if they wanted to terminate the pregnancy.


Decision Rightness and Emotional Responses to Abortion in the United States: A Longitudinal Study.

Rocca CH, Kimport K, Roberts SC, Gould H, Neuhaus J, Foster DG - PLoS ONE (2015)

Mean predicted probability of reporting that abortion was the right decision over three years after an abortion.The line represents the trajectory of the average participant (average intercept and slope), based on a multivariable mixed-effects model of reporting that abortion was the right decision, with mean-centered covariables equal to zero.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496083&req=5

pone.0128832.g001: Mean predicted probability of reporting that abortion was the right decision over three years after an abortion.The line represents the trajectory of the average participant (average intercept and slope), based on a multivariable mixed-effects model of reporting that abortion was the right decision, with mean-centered covariables equal to zero.
Mentions: In crude data, approximately 95% of women completing each follow-up interview reported that having the abortion was the right decision for them. Based on the mixed-effects model, which accounts for attrition and baseline characteristics and allows for individual variation in trajectories over time, the predicted probability of the average participant reporting that the abortion was the right decision was >99% across all times, with an increase over three years (adjusted odds ratio [aOR] = 1.05 per month, 95% confidence interval [CI] [1.00, 1.08]) (Fig 1 and Table 2). Women whose pregnancies had been more planned and who had greater difficulty deciding to seek abortion reported lower levels of decision rightness (aOR = 0.72 [0.60, 0.85] and aOR = 0.48 [0.36, 0.64], respectively), as did Latinas (aOR = 0.31 [0.13, 0.74], versus white). Women both in school and employed at baseline were more likely to report that abortion was right than those neither in school nor employed (aOR = 3.23 [1.06, 9.81]). Women reporting that the man involved in the pregnancy was not a part of the decision-making process had greater feelings of decision rightness than women whose partners did not want or were not sure if they wanted to terminate the pregnancy.

Bottom Line: However, existing research is inconclusive.Multivariable mixed-effects models were used to examine changes in each outcome over time, to compare the two groups, and to identify associated factors.Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years.

View Article: PubMed Central - PubMed

Affiliation: Advancing Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Francisco, San Francisco, California, United States of America.

ABSTRACT

Background: Arguments that abortion causes women emotional harm are used to regulate abortion, particularly later procedures, in the United States. However, existing research is inconclusive. We examined women's emotions and reports of whether the abortion decision was the right one for them over the three years after having an induced abortion.

Methods: We recruited a cohort of women seeking abortions between 2008-2010 at 30 facilities across the United States, selected based on having the latest gestational age limit within 150 miles. Two groups of women (n=667) were followed prospectively for three years: women having first-trimester procedures and women terminating pregnancies within two weeks under facilities' gestational age limits at the same facilities. Participants completed semiannual phone surveys to assess whether they felt that having the abortion was the right decision for them; negative emotions (regret, anger, guilt, sadness) about the abortion; and positive emotions (relief, happiness). Multivariable mixed-effects models were used to examine changes in each outcome over time, to compare the two groups, and to identify associated factors.

Results: The predicted probability of reporting that abortion was the right decision was over 99% at all time points over three years. Women with more planned pregnancies and who had more difficulty deciding to terminate the pregnancy had lower odds of reporting the abortion was the right decision (aOR=0.71 [0.60, 0.85] and 0.46 [0.36, 0.64], respectively). Both negative and positive emotions declined over time, with no differences between women having procedures near gestational age limits versus first-trimester abortions. Higher perceived community abortion stigma and lower social support were associated with more negative emotions (b=0.45 [0.31, 0.58] and b=-0.61 [-0.93, -0.29], respectively).

Conclusions: Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding.

No MeSH data available.


Related in: MedlinePlus