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Objectives: To compare attitudes toward abortion among youth before and after the Polish Constitutional Tribunal introduced abortion ban in October 2020., Study Design: The study uses two nationally representative samples of final-year secondary school students conducted in Poland before (year 2018, N = 1609) and after the abortion ban (year 2021, N = 1513)., Results: The support for abortion increased between 2018 and 2021 (OR=2.77 in foetus impairment case; OR=2.58 in mother's health at risk case). The increase was stronger among females than males., Conclusions: Youth accept abortion more in 2021. The increase may be linked to the Tribunal Court decision and youth involvement in massive demonstrations., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To describe medical student attitudes and exposure to abortion and pregnancy options counseling and influences of that experience on the provision of these services in their future practice., Study Design: A survey was conducted of 3rd and 4th year medical students in 2019 at an US medical school in the Northeast., Results: One hundred and sixty-two students participated in the survey (response rate = 46 %, 162/353). Only 27 % reported receiving at least one educational lecture on abortion during medical school. Fifty-eight percent reported clinical exposure to surgical abortion. About 2/3 reported being somewhat likely to provide abortions in the future, despite most identifying as "pro-choice." There was significant association between clinical exposure to surgical abortion and desire to include abortion in future practice (P = 0.03). The most common objections to performing future abortions were personal values, religious objection, and lack of training/experience. Most respondents did not feel comfortable providing counseling for abortion or adoption. Combined, only 14.4 % reported that they would be at least somewhat likely to apply to obstetrics-gynecology or family medicine residency programs, including programs with opportunities for such training., Conclusions: Earlier work has shown that medical student intentions to provide abortions prior to residency are better predictors of future abortion provision than during residency. Thus, medical school is a critical time for exposure to abortion and pregnancy options counseling. Such exposure and medical student attitudes are areas of research that should be further studied to contribute to the expansion and normalization of these services., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: In recent years, U.S. states have passed many restrictive abortion policies with a rationale of protecting health and safety, in apparent contravention of abundant scientific evidence on abortion safety. This study explored whether and how state legislators use scientific evidence when deciding abortion policy., Study Design: We conducted 29 semi-structured interviews with state legislators and their aides in Maryland, North Carolina, and Virginia in March through July 2017. We recruited via e-mail to members of all health-related committees of the General Assembly in each state, plus sponsors and co-sponsors of 2017 abortion bills, with follow-up via phone and in person. We conducted iterative thematic analysis of all interview transcripts., Results: We found no cases of lawmakers' decisions on abortion being shifted by evidence. However, some lawmakers used evidence in simplified form to support their claims on abortion. Lawmakers gave credence to evidence they received from trusted sources, and that which supported their pre-existing policy preferences. Personal stories appeared more convincing than evidence, with participants drawing broad conclusions from anecdotes. Democrats and Republicans had different views on bias in evidence., Conclusions: In this sample, evidence did not drive state legislators' policymaking on abortion. However, evidence did help inform high-level understanding of abortion, if such evidence supported legislators' pre-existing policy preferences. This work may help public health practitioners and researchers develop more realistic expectations for how research interacts with policymaking., Implications of This Work: To increase the utility of research, reproductive health researchers and practitioners should 1) work with established intermediaries to convey findings to lawmakers; 2) present stories that illustrate research findings; and 3) consider the evidence needs of the judicial branch, in addition to those of legislators., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Suicidal ideation due to abortion has been used to justify restrictive US abortion policies. Much research examining abortion and mental health has relied on self-report, has had low participation rates, and did not consider confounding factors. In the present study, we used data that do not rely on self-report and are not affected by low participation rates to examine the association between abortion and non-fatal suicide attempts, adjusting for confounding factors., Methods: In this longitudinal cohort study of Danish population registries, we linked data on a cohort of women born in Denmark between Jan 1, 1980, and Dec 30, 1998, who did not die or emigrate from Denmark before their 18th birthday or before study entry. Follow-up started on the woman's 18th birthday or Jan 1, 2000, whichever came last. Follow-up ended at the date of first suicide attempt, date of emigration from Denmark, date of death, or Dec 31, 2016, whichever came first. Women were between the ages of 18 and 36 years during the study period. We used a survival analysis to examine the risk of first suicide attempts or self-harm associated with a first abortion compared with no abortion, in the complete study cohort. To examine incidence rate ratios (IRRs) associated with abortion, we used Poisson regression with the logarithm of woman-years at risk as an offset. We also examined whether the risk of suicide attempts changed before and after the abortion, adjusting for age, calendar year, socioeconomic status, and history of childbirth, mental health, parental mental health, and physical health., Findings: Data on 523 280 women were included in this study. Of these, 48 990 (9·4%) women had a record of at least one first-trimester abortion, and 10 216 (2·0%) had a suicide attempt during the study period. Among 48 990 women who had an abortion, 1402 (2·9%) had a first suicide attempt after the first abortion. In our fully-adjusted model which adjusted for all covariates, the risk of first-time non-fatal suicide attempts was similar in the year before an abortion (IRR 2·46 [95% CI 2·22-2·72]) and the year after an abortion (IRR 2·54 [2·29-2·81], p=0·509) compared with women who had not had an abortion, and decreased with increasing time since the abortion (1-5 years IRR 1·90 [1·75-2·06]; ≥5 years IRR 1·73 [1·53-1·96])., Interpretation: We found that women who had abortions had a higher risk of non-fatal suicide attempts compared with women who did not have an abortion. However, because the increased risk was the same both the year before and after the abortion, it is not attributable to the abortion. Thus, policies based on the notion that abortion increases women's risk of suicide attempts are misinformed., Funding: Society of Family Planning, American Foundation for Suicide Prevention, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objectives: To investigate: (1) whether women self-report an ability to choose their preferred termination of pregnancy (TOP) procedure, (2) what factors influence this choice, and (3) what effect this choice has on emotional responses and satisfaction with care., Study Design: A mixed-method prospective comparative study in which women requesting a TOP between five and eighteen weeks gestation for social reasons (as opposed to medical indications), were invited to complete a semi-structured pre-TOP interview and questionnaire, and a post-TOP questionnaire four weeks after the procedure., Main Outcome Measures: Quantitative data was collected using the Patient Health Questionnaire, Generalised Anxiety Disorder Scale, Positive and Negative Affect Scale, Impact of Event Scale - Revised, and Client Satisfaction Questionnaire., Results: Pre-TOP emotion-based factors did not differ between groups. Most women felt that they were able to choose their preferred method of TOP. Their decisions were based on factors categorised as procedure-related, lifestyle or social circumstance-related, emotional, or other factors. When no choice was perceived, common reasons reported were that: (1) gestation was too far along for there to be another option, or (2) an appointment was not available within the required timeframe. When women felt that the method of TOP performed was not their choice they found the procedure more stressful. All women reported high satisfaction with care., Conclusion: A better understanding of the patient experience can inform service development, enabling staff to ensure that the services provided meet women's needs. The perception that one is able to choose their preferred TOP procedure is important for reducing procedure-related stress and ensuring high satisfaction with care., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: To report results of a community survey of NSW residents' knowledge of current abortion law and views on abortion law reform., Methods: A total of 1,015 men and women participated. Recruitment and questionnaires were completed anonymously online using survey panel sampling., Results: Seventy-six per cent of respondents were unaware that abortion remains a criminal offence in the Crimes Act 1900 (NSW) and 73% thought it should be decriminalised and regulated as a healthcare service. Support for decriminalisation was consistent across genders, age groups, residents of metropolitan/regional and rural areas and levels of education. Support was strong for women seeking abortion to be protected from harassment (89%) and for protester exclusion zones around clinics (81%), with support for these measures significantly stronger among regional/rural residents than Sydney-based respondents., Conclusions: Abortion law in NSW is out of step with contemporary community views. Residents are largely unaware that it remains a criminal offence and, when informed, support decriminalisation. There is strong support for legal changes to protect women from harassment and to provide protester exclusion zones around abortion clinics. Implications for public health: Abortion law reform would reduce current inequities of access, be democratic and support women's autonomy and reproductive rights., (© 2018 The Authors.)

Purpose: Like many states, Texas requires parental consent for adolescents under 18 to access abortion care. Adolescents who cannot obtain parental consent can try to obtain a judicial bypass of parental consent through the court system. Little is known about adolescents' experiences with the judicial bypass process. Working with Jane's Due Process, an organization providing legal representation for adolescents, we explored adolescents' experiences with the judicial bypass process., Methods: We conducted phone interviews with 20 adolescents, 16-19 years old in Texas between September and December 2016 about their experiences trying to obtain a judicial bypass. Data analysis included inductive and deductive coding based on theories about engaging with the court system and stigma regarding abortion and adolescent sexuality., Results: In addition to unpredictability and logistic burdens such as finding time away from school and arranging transportation, participants described the bypass process as "intimidating" and "scary" and described judges and guardians-ad-litem who shamed them, "preached" at them, and discredited evidence of their maturity. Data suggest adolescents internalize stigma and trauma they experienced through rationalizing both the need for the bypass process and disrespectful treatment by authority figures., Conclusions: We found the bypass process functions as a form of punishment and allows state actors to humiliate adolescents for their personal decisions. The bypass process was implemented to protect adolescents from alleged negative emotional consequences of abortion, yet our results suggest the bypass process itself causes emotional harm through unpredictability and humiliation. Despite participants' resilience, the process may have negative consequences for adolescent health., (Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: Following the 2016US presidential election, social media posts and news stories amplified concerns about the potential for reduced access to contraception under the incoming administration and urged women to seek long-acting reversible contraception. We aimed to describe women's concerns about future access to contraception, in their own words., Study Design: A social-media-based, anonymous online survey assessing thoughts and concerns about future access to contraception was distributed to reproductive-aged US women for 1 week in mid-January 2017. Participants who were concerned about future access to contraception could share their thoughts and feelings in an open-ended comments box. We qualitatively analyzed 449 written responses for content and themes, with the goal of characterizing key concerns., Results: Women who provided written comments had a mean age of 28years; 85% were white, 88% had at least a college degree, and 93% identified as Democratic or Democratic-leaning. Women were highly concerned about future affordability of contraceptive methods due to potential loss of insurance, reduced insurance coverage for contraceptive methods and reduced access to low-cost care at Planned Parenthood. Many also worried about increased restrictions on abortion. Participants' concerns regarding access to contraception and abortion centered around themes of reproductive and bodily autonomy, which women described as fundamental rights., Conclusions: Women in this study expressed considerable fear and uncertainty regarding their future access to contraception and abortion following the 2016US presidential election. The potential for restricted access to affordable contraception and abortion was viewed as an unacceptable limitation on bodily autonomy., Implications: As the future of US health care policy is debated, many women are concerned about the impact of policy changes on their ability to access affordable contraception and abortion, which many view as essential to the preservation of bodily and reproductive autonomy., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To measure the prevalence of believing that abortion should be illegal in all or most cases among women obtaining an abortion in the United States and to identify correlates of holding this belief., Methods: Study population was drawn from the nationally-representative 2008 Abortion Patient Survey. The primary outcome was having an anti-legal abortion attitude, defined as agreeing that abortion should be illegal in all or most cases. We assessed potential correlates in bivariable and multivariable analyses using weights to account for the complex sampling., Results: A total of 4769 abortion patients completed the survey module containing the question on abortion legality, of which 4492 (94.2%) had non-missing data for the outcome. Overall, 4.1% of patients (N=183) reported an anti-legal abortion attitude. Correlates of having anti-legal attitude included being married, at <200% federal poverty level, fundamentalist, contraception non-use, no abortion history, perceiving the pregnancy with ambivalence or as unintended, and using misoprostol or another product on their own to bring back their period or end the pregnancy., Conclusions: Abortion patients who do not believe abortion should be legal appear to differ substantially from women who are more supportive of legality. Findings raise important questions about this subset of patients, including whether possible discordance between patient beliefs and behavior could influence their use of medical abortion or other products., Implications: Some abortion patients do not agree with abortion legality, and this subset could experience a degree of cognitive dissonance, which could influence the method by which they seek to abort., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To propose recommendations for women's counseling in abortion request and the psychological experience of orthogenic teams., Materials and Methods: Bibliographic search in the Medline database, PubMed, Cochrane Database Library, EM Premium bases, ENT Unistra and Cairn from 1990 to 2016., Results: During the pre-abortion consultations, it is recommended to respect the choice of the woman on to see or not the ultrasound images (gradeC) and determine with her the time it needs to perform abortion (professional agreement). Women's satisfaction seems greater when they have the possibility to choose the abortion method (grade B). It is therefore important that both methods are available to all gestational ages (professional agreement). There is no relationship between an increase in psychiatric disorders and induced abortion (NP2). Meetings for professionals are useful and should, to the extent possible, be established (professional agreement)., Conclusion: Improving psychological support for women involve listening them and respect their choice. This also involves thinking as a team., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Background: Women who terminate pregnancies drink more subsequent to the pregnancy than women who give birth, including women who give birth after seeking to terminate a pregnancy., Methods: Data are from the Turnaway Study, a prospective, longitudinal study of 956 women who sought to terminate pregnancies at 30 U.S. facilities. This paper focuses on the 452 women who received terminations just below facility gestational limits and 231 who were denied terminations because they presented just beyond facility gestational limits. This study examined whether baseline characteristics moderate the relationship between termination and subsequent binge drinking and whether stress, feelings about the pregnancy, and number of social roles mediate the relationship., Results: Only having had a previous live birth modified the termination-binge drinking relationship. Among women with previous live births, binge drinking was reduced among women carrying to term compared to terminating the pregnancy. Among women who had not had a previous live birth, however, the reduction in binge drinking among those denied termination was not sustained over time, and binge drinking of those who had and had not had terminations converged by 2.5 years. Neither stress, negative emotions, nor social roles mediated effects on binge drinking. Positive emotions at one week mediated effects on binge drinking at six months, although positive emotions at two years did not mediate effects on binge drinking at 2.5 years., Conclusions: Higher levels of binge drinking among those who terminate pregnancies do not appear due to stress or to negative emotions. Only parous women - and not nulliparous women - denied terminations experienced sustained reductions in binge drinking over time., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objectives: Lack of providers is a barrier to accessing abortion in Canada. The factors influencing the number of abortion providers are poorly understood. In this study, we assessed the attitudes and intentions of medical students towards abortion training and provision to gain insight into the future supply of abortion providers., Methods: We surveyed first, second, and third year medical students at an Ontario university to determine their intentions to train in and provide abortion services during different stages of training and in future practice. We assessed students' attitudes and intentions towards training in and providing abortions, their perceptions of social support, their perceived ability to receive training in and to provide abortion services, and their attitudes towards the legality of abortion., Results: Surveys were completed by 337 of 508 potential respondents (66.7%). The responses indicated that the students in the survey held relatively positive attitudes towards the legality and availability of abortion in Canada. Respondents had significantly more positive attitudes towards first trimester medical abortions (and a greater intention to provide them) than towards second trimester surgical abortions. Thirty-five percent of students planned to enter a specialty in which they could perform abortions, but fewer than 30% of these students planned to provide any type of abortion. Intentions to provide abortions were correlated with positive attitudes toward abortion in general and greater perceived social support for abortion provision., Conclusion: A small proportion of students sampled intended both to enter a specialty in which abortion would be within the scope of practice and to provide abortion services. Lack of perceived social support for providing abortions and the perceived inability to obtain abortion training or to logistically provide abortions were identified as two potentially modifiable barriers to abortion provision. We propose increasing education on abortion provision and creating policies to promote medical abortion as a method of improving access to abortion across Canada.

Introduction: Although abortion care has been an established routine since decades in India, 8% of maternal mortality is attributed to unsafe abortion. Increased knowledge and improved attitudes among health care providers have a potential to reduce barriers to safe abortion care by reducing stigma and reluctance to provide abortion. Previous research has shown that medical students' attitudes can predict whether they will perform abortions. The objective of our study was to explore attitudes toward abortion among medical interns in Maharastra, India., Study Design: A cross-sectional survey was carried out among 1996 medical interns in Maharastra, India. Descriptive and analytical statistics were used to interpret the study instrument., Results: Almost one quarter of the respondents considered abortion to be morally wrong, one fifth did not find abortions for unmarried women acceptable and one quarter falsely believed that a woman needs her partner or spouse's approval to have an abortion. Most participants agreed that unsafe abortion is a serious health problem in India. A majority of the respondents rated their knowledge of sexual and reproductive health as good, but only 13% had any clinical practice in abortion care services., Conclusion: Disallowing attitudes toward abortion and misconceptions about the legal regulations were common among the surveyed medical students. Knowledge and attitudes toward abortion among future physicians could be improved by amendments to the medical education, potentially increasing the number of future providers delivering safe and legal abortion services., Implication Paragraph: Abortion is legal in India since decades, but maternal mortality due to unsafe abortions remains high. This survey of attitudes toward abortion among medical interns in Maharastra indicates that disallowing views prevail. Improved knowledge and clinical training can increase numbers of potential abortion providers, thus limit unsafe abortion., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Little is known about women's experiences with and reactions to protesters and how protesters affect women's emotional responses to abortion., Study Design: We interviewed 956 women seeking abortion between 2008 and 2010 at 30 U.S. abortion care facilities and informants from 27 of these facilities., Results: Most facilities reported a regular protester presence; one third identified protesters as aggressive towards patients. Nearly half (46%) of women interviewed saw protesters; of those, 25% reported being "a little" upset, and 16% reported being "quite a lot" or "extremely" upset. Women who had difficulty deciding to abort had higher odds of reporting being upset by protesters. In multivariable models, exposure to protesters was not associated with differences in emotions 1 week after the abortion., Conclusion: Protesters do upset some women seeking abortion services. However, exposure to protesters does not seem to have an effect on women's emotions about the abortion 1 week later., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Although legal, access to safe abortion remains limited in India. Given positive experiences of task-shifting from other developing countries, there is a need to explore the feasibility of expanding the manual vacuum aspiration (MVA) provider base to include nurses in India., Study Design: A prospective, two-sided equivalence study was undertaken in five facilities of a non-government organisation in Bihar and Jharkhand to explore whether efficacy and safety rates associated with MVA provided by newly trained nurses were equivalent to those provided by physicians. Eight hundred and ninety-seven consenting women with gestation ages of ≤ 10 weeks were recruited., Results: Nurses were as skilled as physicians in assessing gestation age and completed abortion status, performing MVA and obtaining patient compliance. Overall failure and complication rates were low and equivalent between the two provider types, and both provider types were equally acceptable to women who underwent the procedure (98%)., Conclusion: Findings of the study make a compelling case for amending existing laws to expand the MVA provider base in order to increase access to safe abortion in India., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Unintended pregnancy is a common reproductive health event. Professional responsibilities for nurses providing care to women with unintended pregnancies include appropriate assessment, options counseling, provision of or referral for desired services, care coordination, and prevention efforts aimed at decreasing future unintended pregnancies. Nurses' awareness of available services and their involvement in referring or providing services is an essential component to reproductive health care., (© 2011 AWHONN, the Association of Women's Health, Obsteric and Neonatal Nurses.)

Background: In Mexico, abortion is not penalized when a woman gets pregnant as a result of rape, yet access to abortion services is limited. Understanding physicians' opinions about abortion is critical to creating strategies that will broaden women's access to services., Study Design: Multivariate logistic regression was performed using data collected from a sample of 1206 physicians in Mexico. The influence of independent variables on two outcomes was analyzed: physicians' agreement with abortion being legal in the case of pregnancy caused by rape and willingness to provide abortion services in such cases., Results: Physicians who had performed legal abortions, knew about existing abortion legislation and practiced general or family medicine were significantly more likely to agree that abortion should be legal when pregnancy is caused by rape and were more likely to be willing to provide abortion in the case of rape. Physicians who held a negative attitude towards women who seek abortion and those with greater church attendance were less likely to agree with the legality of abortion., Conclusions: Physicians are among the most important gatekeepers to women's access to safe abortion services. A majority of Mexican physicians agree that abortion should not be legally penalized under certain circumstances. Yet, many also hold negative attitudes towards women who seek abortion. Physicians' support for women's access to safe abortion services is key to ensuring that such services will exist in Mexico.

Objective: The aim of the study was to evaluate, by means of a randomized controlled trial, whether a patient-centered contraceptive counseling intervention increased the use of contraception, and the knowledge and positive attitudes towards contraception, in women who undergo a termination of pregnancy (TOP)., Methods: The study was carried out at the San Paolo Hospital of Milan between the 1st of February and the 31st of May 2004. Participants (41 women; ages 20-44 years) were randomly divided into two groups: an experimental group (n = 20), who received patient-centered contraceptive counseling, and a control group (n = 21), who received the routine treatment in use at the San Paolo Hospital and were referred to the community health centers after the TOP. Both groups were administered a questionnaire at two points in time (before the counseling and 1 month later) which evaluated participants' knowledge, attitudes and use of contraception (the latter was also followed up 3 months later). The counseling intervention lasted 30 min and was carried out by a psychologist and a gynaecologist., Results: It was found that knowledge, favorable attitudes and use of effective contraception increased significantly for the experimental group, whereas there was no significant change for the control group., Conclusion: The counseling intervention was therefore found to be efficacious in improving understanding and use of contraception in women who have undergone a TOP. The hope is that this will contribute to increased use of effective contraception in the future., Practice Implications: Following the principles of patient-centered medicine, this study provides evidence for the importance of exploring woman's feelings, beliefs, wishes and expectations regarding contraception within a contraceptive counseling intervention.

Our study explored a largely unacknowledged obstacle to abortion access in Massachusetts: the unwillingness of nurses to staff abortion procedures. Evidence suggests that nurses tend to be more likely to oppose abortion than other medical professionals. However, the attitudes and practices of hospital-based nurses regarding abortion have not been thoroughly investigated. We collected qualitative information from physicians and nurse managers to understand how nurses' attitudes affect hospital-based abortion services in Massachusetts. We surveyed key respondents at all hospitals in Massachusetts where abortion services are available to any woman who requests them. Of the 20 individuals who responded (87%), 17 were physicians and 3 were nurse managers. We found that over half of physician respondents believed that the unavailability or unwillingness of nurses to staff abortions is a slight or moderate problem, and nearly a quarter of physician respondents characterized it as a large or very large problem. Thus, nurses' attitudes towards abortion and their unwillingness to assist with procedures may hinder patient access to abortion services.

Purpose: To assess whether younger adolescents experience greater adverse psychological outcomes after abortion than those aged 18-21 years, whether abortion places all adolescents at risk for negative sequelae, and what factors predict negative outcomes., Methods: A total of 96 young women aged 14-21 years seeking counseling for unwanted pregnancies at four clinics completed questionnaires after counseling. These included the Beck Depression Inventory (BDI), an emotion scale, questions regarding sociodemographic and reproductive background, feelings about pregnancy, and decision-making. Sixty-three respondents were reinterviewed 4 weeks postabortion and completed the BDI, emotion scale, Spielberger State Anxiety Inventory, Rosenberg Self-esteem Scale, Impact of Events Scale, and Positive States of Mind Scale. Chi-squares and Student's t-tests were used to compare: (a) responses of adolescents under 18 years of age with those 18-21 years, (b) preabortion and postabortion responses, and (c) the current sample with other samples of adolescents., Results: Adolescents under age 18 years were less comfortable with their decision, but showed no other differences compared with those aged 18-21 years. Both groups showed significant improvement in psychological responses postabortion. Postabortion scores did not differ significantly from those of other adolescent samples reported in the literature. Preabortion emotional state and perception of partner pressure predicted postabortion response., Conclusions: Despite its legal significance, age 18 years was not a meaningful cutoff point for psychological response to abortion in this sample. There was no evidence that abortion poses a threat to adolescents' psychological well-being.

Objective: To identify the short-term grief response after elective abortion., Design: Descriptive, comparative study., Setting: Instruments were administered in a women's health clinic., Participants: Ninety-three women, 45 who had a history of elective abortion within the past 1 to 14 months and 48 who had never had an abortion. Inclusion criteria included no perinatal losses within the past 5 years; no documented psychiatric history; and ability to read, write, and comprehend English., Main Outcome Measures: Nature and intensity of short-term grief., Results: Women with a history of elective abortion experienced grief in terms of loss of control, death anxiety, and dependency. Although there were no statistically significant differences in the intensity of grief in women who had a history of elective abortion and the comparison group, there was an overall trend toward higher grief intensities in the abortion group. Presence of living children, perceived pressure to have the abortion, and the number of abortions appear to affect the intensity of the short-term grief response., Conclusion: Elective abortion has the potential for eliciting a short-term grief response. Research is needed to identify which women are at greatest risk. This grief response should be acknowledged and appropriate interventions undertaken.

Purpose: To gain knowledge of the attitudes, questions, and problems in decision making on abortion by young men recently informed about the positive pregnancy tests of their girlfriends. This knowledge will be used as a basis for developing a service for such young men., Methods: A grounded theory approach was used for interviews at an outpatient clinic for adolescents in Sweden with 18 individuals faced with sharing the decision about abortion., Results: In a suggested model, the decision-making process can be understood by three concepts: reactions (including feelings, apprehensions, and moral conflicts), impact factors (including quality of relationship, consideration for girlfriend, and psychosocial factors), and tools for process (including communication, secrecy/confidentiality, and organized support)., Conclusions: This study suggests the importance of helping the male adolescent with his reactions as a condition for using the equipment constituting impact factors and tools for process on the way to decision about abortion.

Repetitive abortions reveal an ambivalence towards contraception. The desire for pregnancy does not always go along with a desire for motherhood. It is a neurotic expression full of guilt that shows that these women did not overcome a childish rivality with their mothers, and remain within a symbiotic relationship with them.

Studies of women undergoing termination of a pregnancy are often used to make recommendations about family planning and health education policy. However, it is not clear how similar the women in these studies are to the general population of women of childbearing age. Our secondary analysis of the National Sexual Attitudes and Lifestyles Survey allowed us to test the hypothesis that women who have undergone an abortion are the same as those who have not (in terms of socio-demographic characteristics, lifestyles, and attitudes). Our findings show significant differences between these two groups of women, particularly regarding ethnicity, marital status, number of natural children, lifetime number of sexual partners, and attitudes to abortion. We conclude that family planning/reproductive health services and health education policies need to take these differences into account and that further research is required to explain why these differences arise.

Purpose: Our study investigates the factors associated with length of time to referral appointments for pregnant teens diagnosed in a hospital-based adolescent clinic., Methods: Ninety-six pregnancies diagnosed during a six-month period at a hospital-based adolescent clinic were followed prospectively. Demographic data, plans for pregnancy, last menstrual period (LMP), and who accompanied patient to the appointment were recorded by providers. Appointment at referral site was confirmed by the patients' primary provider, contact with the patient, and/or referral site. The time from first positive pregnancy test to kept referral appointment was determined., Results: Of the 96 diagnosed pregnancies, data were available for 94 patients. The mean age was 17.6 +/- 2.0 years. The average gestation was 7.4 +/- 4.2 weeks (range 4-27 weeks) at initial visit and 11.7 +/- 4.9 weeks (5-30 weeks) at referral site. The time to referral appointment was significantly shorter for patients who planned to terminate compared with those who planned to continue with the pregnancy (22.4 +/- 16.6 vs. 35.7 +/- 24.5 days, P = 0.0042). However, the final decision to continue vs. terminate the pregnancy was a stronger predictor of the interval to kept referral appointment (R2 = 0.177) than the initial plan. Those who planned to tell more people about their pregnancy had a significantly higher rate of continuing the pregnancy than those terminating., Conclusion: Pregnant teens may need multiple follow-up appointments to facilitate connection to referral care. Close follow-up and communication with referral sites needed to optimize care of pregnant teens because of the delay until teens access pregnancy services.

This cross-sectional study characterizes first-trimester abortion patients who perceived inadequate knowledge of pregnancy symptoms and identifies net predictors of inadequate symptom knowledge. Data were collected at an abortion facility in Hampton Roads, Virginia. Study subjects were women surveyed on the day of their abortions, prior to termination procedures. Self-reported knowledge of pregnancy symptoms was the study's dependent variable. Of 342 women, 120 (35%) perceived inadequate symptom knowledge. These women more often were young, black, single, and poorly educated. Only black race was a net predictor of inadequate symptom knowledge when study variables were entered into a multiple logistic regression. Black race was the only net predictor of inadequate symptom knowledge among first-trimester abortion patients. This racial difference was not explained by socioeconomic or access factors. Future research should consider an alternative hypothesis, the possibility that more effective communications with black abortion patients are needed. Additionally, health-care providers should not presume that first-trimester abortion patients are familiar with pregnancy symptoms and should not stereotype patients who perceive knowledge limitations with regard to socioeconomic status.

The issue of parental involvement in an adolescent's decision to abort a pregnancy is complex and controversial. Consequently, the impact of legislation to mandate parental involvement is reviewed. Although the costs of such legislation are high, there are at least three important clinical benefits. First, a legal mandate will require many adolescents who would not otherwise involve their parents in this decision process to seek their counsel and emotional support. Second, parent's responsibility for the actions of their adolescent children is acknowledged within the legal system. Third, family unity may be promoted by allowing parents and adolescents an opportunity to deal more openly with the causes and implications of the pregnancy.

Women having recourse to repeated voluntary abortion are more and more numerous. Contraception is not a prophylactic mean for that, and it explains the interest to study the personality of women who abort repeatedly. We tested 41 of these women with the Minnesota Multiphasic. The answers showed psychotic and psychopathic tendencies, all the more as they were younger.

This study was based on a representative sample of 233 women. This first communication explains the methodology used in the study. It discusses social characteristics of the sample population and analyzes the subjects' motivations for requesting an abortion. Two important aspects of this study are: 1. the sample population is not a specific population; 2. many reasons are involved in the decision to terminate pregnancy. Most frequently cited are sociological reasons, often reinforced by economic reasons.

Legal termination of pregnancy only rarely has psychological sequelae, which furthermore are usually moderate and transitory. They are usually found in women who have been pressed to have a termination by third parties, in those women who are ambivalent as far as the termination is concerned, in those who submit to the operation because of a medical indication and in those women where there is a brittle psychological state before pregnancy. The author makes certain suggestions which should help to prevent psychological troubles developing in a certain number of cases.

Using matched samples (n = 249) of single, generally young black women, two thirds on welfare and previously pregnant, the study examined why some women decide to deliver while others, with almost identical sociodemographic and prior pregnancy experiences, decide to abort. Women delivering were in significantly longer relationships with partners who had also been less cooperative about contraception. Discussion with significant others occurred more often in decisions to deliver and greater support was received for that option. For many women the abortion decision and, to a lesser extent the decision to deliver, was conflictful, options evenly balanced, and considerable indecision reported. Attitudes about ethical aspects of abortion and knowledge of role models for single parenthood and seeking abortion among friends and relatives also discriminated the two samples. Women who delivered all previous pregnancies found the decision to abort particularly difficult. In this young population 29.2 per cent of women currently delivering had previously aborted; 55.8 per cent of women currently aborting had delivered. During their reproductive life, therefore, almost all women in this population will face the decision whether to abort and many will choose that option. Whether abortion or delivery is chosen will depend upon circumstances surrounding specific pregnancies rather than characteristics of the mother. Adoption is not an option in the pregnancy decision of women in this population.