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Background: Pregnancy termination is an essential component of reproductive healthcare. In Southern Africa, an estimated 23% of all pregnancies end in termination of pregnancy, against a backdrop of high rates of unintended pregnancies and unsafe pregnancy terminations, which contributes to maternal morbidity and mortality. Understanding the reasons for pregnancy termination may remain incomplete if seen in isolation of interpersonal (including family, peer, and partner), community, institutional, and public policy factors. This study therefore aimed to use a socio-ecological framework to qualitatively explore, in Soweto, South Africa, i) reasons for pregnancy termination amongst women aged 18–28 years, and ii) factors characterising the decision to terminate. Methods: In-depth interviews were conducted between February to March 2022 with ten participants of varying parity, who underwent a termination of pregnancy since being enrolled in the Bukhali trial, set in Soweto, South Africa. A semi-structured, in-depth interview guide, based on the socioecological domains, was used. The data was analysed using reflexive thematic analysis, and a deductive approach. Results: An application of the socio-ecological framework indicated that the direct reasons to terminate a pregnancy fell into the individual and interpersonal domains of the socioecological framework. Key reasons included financial dependence and insecurity, feeling unready to have a child (again), and a lack of support from family and partners for the participant and their pregnancy. In addition to these reasons, Factors that characterised the participants' decision experience were identified across all socio-ecological domains and included the availability of social support and (lack of) accessibility to termination services. The COVID-19 pandemic and resultant lockdown policies also indirectly impacted participants' decisions through detrimental changes in interpersonal support and financial situation. Conclusions: Amongst the South African women included in this study, the decision to terminate a pregnancy was made within a complex structural and social context. Insight into the reasons why women choose to terminate helps to better align legal termination services with women's needs across multiple sectors, for example by reducing judgement within healthcare settings and improving access to social and mental health support. Plain English summary: In South Africa, where the number of unintended pregnancies is high, we need an improved understanding of the main reasons why women terminate their pregnancies and what factors characterise this decision. Aside from individual factors, this should also be seen within the context of their environment, including relationships, community, and institutions. We therefore aimed to explore women's reasons for choosing to terminate their pregnancy through semi-structured in-depth interviews with participants. We included ten participants from Soweto, South Africa, who had undergone a pregnancy termination. The main reasons for terminating a pregnancy had to do with personal factors and reasons related to their social relationships and support. These included financial insecurity, not feeling ready to have a child (again), and lack of support from family or partners. We also found factors that characterised how the participant experienced the decision, such as barriers to getting a safe (legal) pregnancy termination. We found that amongst South African women, the decision to terminate is made in the context of their complex (social) environment. Insight into the reasons why women choose to terminate helps to better align legal termination services with women's needs, for example by reducing judgement within healthcare settings and improving access to social and mental health support. [ABSTRACT FROM AUTHOR]

After experiencing my own miscarriage, I was told by a pro-life advocate that the miscarriage should be easy for me to "get over" because, as a pro-choice advocate, I didn't regard embryos or fetuses as persons. While such a comment can be attributed to ignorance, it is true that the pro-choice community in general has been reluctant to acknowledge grief after pregnancy loss, whether through miscarriage, stillbirth, or abortion. In this paper, I argue that it is imperative that abortion rights advocates acknowledge the ambivalence and grief that can follow abortions and that they help create feminist, women-centered ways of addressing and alleviating any negative post-abortion feelings. [ABSTRACT FROM AUTHOR]

Amid growing restrictions on reproductive health care nationwide, understanding real-time contextualization of patient experience is critical. This qualitative approach uses inductive content analysis to examine 74 anonymous journal entries from 2020 to 2023 from patients accessing abortions in New Mexico. Prompted by a journal titled, "Tell your story, it may help someone else," entries described decision-making, highlighted autonomy, and built solidarity. This analysis explains how patients contextualized their abortion and offers insight to improving experiences for patients traveling for abortion care. (Am J Public Health. 2024;114(10):1008–1012. https://doi.org/10.2105/AJPH.2024.307772) [ABSTRACT FROM AUTHOR]

"Pro‐life" and "pro‐choice" are closely associated with discussions about abortion; we refer to the extent that people identify with these terms as "abortion identity." Most polling measures present pro‐life and pro‐choice as mutually exclusive options, but there is a dearth of information about people who might simultaneously endorse both (or neither) labels. Method: We administered a survey to adults in the United States (n = 580) that included two different formats for participants to select their abortion identity: a categorical item with response options ranging from strongly pro‐choice to strongly pro‐life (and "both" and "neither") and two separate items (sliders) that asked people the extent to which they identify with each term. We asked participants endorsing both pro‐life and pro‐choice to some extent on the slider items to explain their responses in an open‐ended item. We used logistic regression to examine the relationship between participants' socio‐demographic characteristics and the likelihood of dual identification slider scores; we analyzed open‐ended data for content and themes. Results: On the sliders, more than 64% of participants identified as both pro‐life and pro‐choice to some extent. Variability existed between people's abortion identity on the close‐ended items and their response to the open‐ended questions. Among those with mixed abortion identities, participants described abortion as a serious and undesirable option but reflected positively on notions of personal choice and bodily autonomy. Conclusions: Our findings demonstrate complexity in measuring people's endorsement of abortion identity labels. We recommend developing more nuanced and consistent measures to assess abortion attitudes. [ABSTRACT FROM AUTHOR]

Background: Unintended (unwanted) pregnancy is a sexual and reproductive health issue with psychosocial consequences for the individual, their family, and society. However, the relationship between social support and related mental health issues, like depression and the effects of childhood adversity, is poorly studied. This study aims to explore the connections between childhood adversity, perceived social support, and depressive symptoms in pre-abortion women (women who have decided to have an abortion) in a clinical setting, based on the common risk factor approach and social support theory. Methods: A total of 299 pre-abortion Chinese women 18–45 years were recruited in a hospital in Shantou, China. Hierarchical linear regression analyses were employed to examine the relative effects of childhood adversity and sources of social support on depressive symptoms, controlling for sociodemographic influences. Results: The results show that 37.2 percent of participants reported at least one adverse experience in childhood. More than half of the respondents were at risk for depression. Results of regression analysis showed that childhood adversities were negatively associated with depressive symptoms before sources of social support were entered into the model. However, when the sources of perceived social support were added, the effect of childhood adversity was not significant. Perceived social support explained the additional 15 percent variance in depressive symptoms. Additionally, being married (β = -.12, p <.05) and number of siblings (β =.13, p <.05) were significantly related to depressive symptoms. Discussion: Pre-abortion women are at risk of mental health problems. Peer and familial social supports can alleviate the influence of childhood adversity on depression among pre-abortion Chinese women. Strengthening the role of various sources of social support can help to improve the mental health conditions of pre-abortion women. [ABSTRACT FROM AUTHOR]

Putting an end to the silent pandemic of unsafe abortion is a major public health concern globally. Adoption of post-abortion contraception is documented as a significant contributor to reduce the number of unintended pregnancies and number of induced abortions. This study aimed at investigating the post abortion contraceptive behavior of Indian women exploring the determinants of post-abortion contraceptive uptake. Retrospective calendar data for 6,862 women aged 15–49 years from fifth round of National Family Health Survey (2019–2021) was used for the study. Multinomial logistic regression method was used to model the determinant factors to post-abortion contraceptive uptake. 72.6% women reported adopting no method of contraception after the abortion procedure. A total of 27.4% women adopted some method of contraception after abortion. 14% women preferred adopting short term modern methods. Women in early reproductive age group which is the most vulnerable group in experiencing unintended pregnancies are less likely to adopt any contraceptive method after abortion. Uptake of post abortion contraception is quite low in India. Effort should be taken in the direction of bringing awareness through provision of targeted contraceptive counselling after abortion. [ABSTRACT FROM AUTHOR]

Introduction: Although abortion can be implemented within the framework of legal rules and practices, the issue of abortion in socio-cultural, philosophical, and religious terms is one of the crucial issues that has been discussed since the existence of humanity. This study aims to examine the relationship between women's thoughts on voluntary abortion, their stigmatizing attitudes, beliefs, behaviors, and their spiritual well-being in Turkiye. Method: The sample of this analytical-cross-sectional study consisted of 300 women between the ages of 18 to 49 who had a telephone. Data were collected with the "Questionnaire Form, Functional Assessment of Chronic Illness Therapy Spirituality Well-Being (FACIT-Sp), and the Stigmatizing Attitudes, Beliefs and Actions Scale Toward Abortion (SABAS)." Results: The findings showed that 30.3% of the women participating in this study had voluntary abortions. The FACIT-Sp total score of women who had voluntary abortion (12.58 ± 7.99) was significantly lower than those who did not have an abortion (29.02 ± 6.36), and the SABAS total score was not associated with having a voluntary abortion. A weak, positive linear relationship was found between FACIT-Sp and SABAS total scores (r =.115, p <.05). Discussion: Study findings showed that there was a significant relationship between having had a voluntary abortion and a lower spiritual well-being score and there was a positive relationship between spiritual well-being and stigmatizing attitudes, beliefs, and behaviors toward abortion. [ABSTRACT FROM AUTHOR]

In polarized societal debates, it is often assumed that perceiving polarization leads individuals to take sides (e.g., "pro‐life" or "pro‐choice"). However, perceiving polarization can also make individuals ambivalent because they feel "caught in the social crossfire" of the debate. We conducted a survey study (Ntotal = 863 women) on ambivalents' perspectives of the U.S. abortion debate. Findings supported the hypothesis that ambivalents' perceived polarization related positively to their felt ambivalence. This relationship can be explained by their feeling of being "caught in the social crossfire": they feel torn while also understanding both sides of the debate. Moreover, felt ambivalence was positively related to tendencies toward avoidance of the debate but also toward conciliatory efforts (e.g., to create mutual understanding between the groups). We discuss the implications of these findings for the relationship between perceived polarization and felt ambivalence among ambivalents. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abortion attitudes are typically contextualized as pro-life or pro-choice, yet these characterizations ignore the complex ideas that individuals hold about abortion. To address this gap, we conducted a thematic analysis of 28 semi-structured interviews with women in the UK, both with (n = 12) and without (n = 16) personal abortion experience. The theme "blind spots" captures patterns in our participants' accounts, wherein complexity and even conflict would emerge within expressed abortion judgments. Our subthemes highlight those conflicts between more and less restrictive abortion attitudes that occurred when considering either the same (self or other) or different (self vs. other) attitudinal objects. Many participants were unaware of the conflicting and nuanced attitudes they held about abortion, evidenced by an inability to integrate these positions into a clear and consistent judgment, indicating that a dichotomy of abortion attitudes may be too simplistic. [ABSTRACT FROM AUTHOR]

The general public and abortion patients in the United States have misinformation about the risks of infertility associated with abortion, which may influence abortion care-seeking. The Google Ads Abortion Access Study was a national study of people considering abortion and searching online for information. Participants completed baseline and follow-up surveys, providing free text responses to questions about barriers and facilitators to abortion. We conducted an exploratory analysis of the free text responses related to fertility and used thematic analysis to identify concerns raised about links between abortion and future fertility. Of 864 participants who provided free text responses in the follow-up survey, 32 specifically mentioned fertility. Few expressed fear that complications from the abortion procedure would somehow lead to infertility; rather, most discussed complex and overlapping thoughts about how abortion factored into their reproductive life plans. These included age-related concerns, missing out on their "chance" to have a child, fear of being punished by God with infertility for having an abortion, and conflicting emotions if they had previously been told they were subfecund or infertile. Although previous research has focused on misinformation about the link between abortion and infertility, participants in this study rarely mentioned it as a concern. Researchers and practitioners should be attuned to the distinctions people make between infertility occurring as a result of abortion and other fears they might have about not achieving their future reproductive aspirations, ask questions, and provide counseling accordingly. [ABSTRACT FROM AUTHOR]

Nepal, a country with deeply ingrained patriarchal values and culture, has limited evidence regarding the practices of sex selection and sex-selective abortion. This study aimed to investigate the attitudes and practices surrounding sex-selective abortion (SSA) and the factors associated with it. A cross-sectional study design was used to collect data from 320 women between the ages of 15 and 49, who had at least one child under the age of 5 and lived in the Bhaktapur district, Nepal. A total of 19.7% of the participants had undergone an abortion, with 39.6% of those being SSAs. Factors like women empowerment and preference for smaller family size are associated with women's favorable attitude toward SSA. In multivariate analysis, women who faced pressure from their families to have a son and those who were aware of Nepal's abortion laws were more likely to abort a female fetus. [ABSTRACT FROM AUTHOR]

We examined public opinion regarding unique aspects of abortion legality to better understand potential contexts in which stigma may occur and the extent that people (a) believe actors involved in abortion (i.e., pregnant woman, healthcare provider, man involved in the pregnancy, someone providing information about where to get an abortion, parents of a minor) should be held responsible for illegal abortion, (b) believe abortion should be illegal across different circumstances, and (c) endorse different punishments for pregnant women and healthcare providers, including variation by responsibility. An online survey was administered to 2,489 English and Spanish-speaking U.S. adults, using quota-based sampling, with post-stratification weights applied to match U.S. benchmarks. People scored healthcare providers and women more responsible than other actors. Although the majority did not support abortion being illegal for most circumstances, a substantial proportion were unsure. Additionally, "no punishment" was most frequently selected for the woman and healthcare provider. However, those who endorsed any punishment, compared with no punishment, typically indicated the pregnant woman and healthcare provider were more responsible. Our findings suggest that current laws criminalizing abortion are misaligned with public opinion and that pregnant women and healthcare providers are likely most susceptible to abortion-related stigma. [ABSTRACT FROM AUTHOR]

Abortion is a frequent topic of policy debate in America and a central issue in politics since the Dobbs v Jackson Women's Health Supreme Court decision. A number of states have completely or nearly completely banned abortion and criminalized health care providers. People seeking abortion care are turning to alternatives outside the formal health care system or traveling to states that have preserved access. Approximately half of US Obstetrics/Gynecology residents will train in a state where abortion is illegal, lending to a frightening future where Obstetrics/Gynecologists are not trained to provide this common, sometimes life-saving, health care. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate whether a Muslim woman with a child afflicted with a genetic disease who is living at home would perform more prenatal tests and pregnancy terminations as opposed to a woman with a normal child living at home, and what demographic characteristics, if any, influenced this decision. The study included 771 Muslim women; 37.1% lived with a child afflicted with a genetic disease; and 62.9% did not. Muslim women with a child affected with a genetic disease living at home will undergo more prenatal testing and more pregnancy terminations. Village dwellers were more religious and consulted further with a religious authority. More city dwellers underwent prenatal tests and pregnancy terminations and received more health care and genetic counseling. In the villages populated by Muslims, more genetic counselling must be given, accompanied by guidance from religious Muslim authorities. [ABSTRACT FROM AUTHOR]

Copyright of Matronas Hoy is the property of Asociacion Espanola de Matronas (AEM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the significant delays in accessing abortion-related care across Australia during 2022. It highlights how these delays have led to barriers, unnecessary second-trimester procedures, increased financial and emotional burdens, and reduced options for abortion methods and facilities.

The relationship between people's attitudes about abortion acceptability and the Supreme Court decision in Roe v. Wade—two distinct but related issues—has not been rigorously explored. The authors used a mixed-methods approach for analyzing in-depth interviews to better understand how participants' feelings toward abortion acceptability are related to perceptions of whether abortion should be legal. The authors then assessed (1) correlations between abortion acceptability and different measures of support for Roe v. Wade, and (2) how the phrasing of survey items related to Roe v. Wade may evoke different responses via an online survey fielded in 2018. The study's qualitative results highlight that there is a disjuncture between people's moral feelings toward abortion and their attitudes toward abortion legality. The study's quantitative results further demonstrate that correlations between abortion acceptability and support for Roe v. Wade are moderate, and the differences in responses to the phrasing of survey items related to Roe v. Wade are moderated by knowledge. The authors recommend that when researchers develop survey items, they avoid ambiguities of abortion as a general construct, especially when public opinion measures on abortion are employed for research and the design of social and health policy and practice. [ABSTRACT FROM AUTHOR]

The objective of this article is to assess the effect of domestic violence on abortion and investigate the mediating role of unwanted pregnancy. A secondary analysis was conducted on the National Family Survey data. This survey was a cross-sectional study conducted across Iran in 2018. The association between domestic violence and abortion was analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM) with WarpPLS version 8.0. From among 1,544 married women (mean age 42.8 years) who participated in this survey, 27% (418 women) reported experiencing at-least one-lifetime of abortion. Overall, two in three women (67.3%) experienced at least one form of domestic violence. Almost half of the women with experience of abortion (49.3%) reported at least one unwanted pregnancy in their life course. The bivariate analysis showed a significant positive relationship between domestic violence and abortion, and there was a positive direct effect of domestic violence on unwanted pregnancy. Moreover, age had a negative direct and indirect effect on unwanted pregnancy and abortion. Although, the direct effect of domestic violence on abortion was not significant in the Structure Equation Model, a positive indirect effect of domestic violence on abortion through unwanted pregnancy was confirmed. The effect of unwanted pregnancy on abortion was particularly strong (β =.395, p <.01). These results have some implications for prevention of abortion through interventions against unwanted and unplanned pregnancy and domestic violence. This study makes a unique theoretical contribution to the literature through assessing the mediating role of unwanted pregnancy between domestic violence and abortion by using the SEM model. [ABSTRACT FROM AUTHOR]

Purpose Nurses must stay close to couples if a baby is stillborn, share their thoughts, provide nursing care for stillbirths, and provide continuous nursing care to grieving parents. The purpose of this study was to develop a prototype grief care tool through which nurses can record their experiences related to the events. It will help them clarify their feelings when dealing with couples experiencing a stillbirth and providing nursing care from pregnancy to the post-partum period. Methods This is a qualitative descriptive study. The participants were 13 nurses (midwives/nurses) who dealt with natural or induced stillbirths after 12 weeks of pregnancy. A prototype grief care tool provided the most unusual cases of stillbirth nursing, and data were obtained through semi-structured interviews about nurses' feelings when dealing with stillbirths. The obtained data were analyzed qualitatively and inductively. Results Nurses' feelings about stillbirth were collated into four categories. "Sense of mission toward stillbirth nursing" was about sincerity and the sense of responsibility as a caregiver toward couples who had experienced stillbirth. In contrast, "difficulties caring for a couple with a stillborn child" dealt with difficulties in understanding and talking about the couple's feelings and anxieties about the stillbirth. Further, "inquiring minds about stillbirth nursing" was about looking back at the nursing provided, searching for better stillbirth nursing for couples, and wanting to learn more about stillbirth nursing. "Expectations for team medical care" was about being involved with couples as a team and supporting each other. Conclusion Midwives and nurses involved in stillbirths felt both a sense of mission in stillbirth nursing and a sense of difficulty in dealing with the parents. In addition, they looked back on their experiences in stillbirth nursing and searched for better stillbirth nursing methods. The findings suggested that using the grief care tool prototyped in this study to record the nursing experience of stillbirth will help nurses to recollect their thoughts on the couple and the stillborn at each stage of nursing. It would provide an opportunity to reflect on the nursing provided and feelings experienced, leading to an inquiry into stillbirth nursing. [ABSTRACT FROM AUTHOR]

Stigma toward women who have had an induced abortion was measured in 458 adult Mexicans and was related to the respondents' place of residence, religiosity, beliefs about motherhood, ambivalent sexism, age, and personal acquaintance with a woman who had aborted. All participants completed a set of questionnaires that were validated in Mexico. The variables that predicted stigma were religiosity, hostile sexism, age, and beliefs about motherhood as giving meaning to life. The results of this study could facilitate designing strategies to reduce such stigma and its negative consequences on the psychological and physical health of women who have aborted. [ABSTRACT FROM AUTHOR]

This article draws on the research project Post-abortion narratives shared by Perth women via face-to-face interviews. The project was subsequently disrupted by the arrival of COVID-19 in Perth, Australia, making it necessary to conduct interviews via video call. The experience of using an online platform to conduct interviews became an opportunity to consider more carefully the practice of 'deep listening'. This kind of listening involves creating an emotional connection with the participant so that the interviewer is able to hear multiple layers of meaning and context. It includes listening mixed with perception in which one can hear the emotions of the other. In a paradigm where the interview is seen as an interaction between two embodied individuals and the interviewer herself is the instrument of research, this article examines the communication that occurs in the space between two co-present, embodied individuals and explicates the practice of deep listening. While interviewing via video call is an excellent tool, I argue that a layer of meaning is removed by the technological medium, which impacts the researcher relationship and thus the ability to listen deeply. [ABSTRACT FROM AUTHOR]

The article reports on the psychological effects of the restrictive state laws on abortion access for women, particularly low-income and Black women.It mentions that these women face hurdles like waiting periods, gestational limits, and regulatory obstacles, making it more difficult for them to access abortion care, leading to financial, emotional and health costs.

Copyright of Journal of Nursing & Health is the property of Journal of Nursing & Health (JONAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Abortion is one of the most common gynaecological procedures. It is related to personal, social, and economic reasons under a legal term that is recognised as a common sexual and reproductive right in most of countries. However, making the decision to abort is complex, because it is politicised and is often framed in public discourse related to moral or ethical issues beyond women's experiences. Therefore, it is subject to medical criteria, religious evaluations, and sociological analysis. Purpouse: The aim of this synthesis of qualitative studies was to synthesise the decision-making experiences of women who legally aborted. Research design and method: The Noblit and Hare's interpretive meta‐ethnography was conducted, and it was written in accordance with the eMERGe meta‐ethnography reporting guidance. Ten studies met the research objective and inclusion criteria, after a comprehensive systematic search strategy in five databases. Findings: The metaphor "The wrestling between why and what will happen next" and three themes emerged from the data analysis: (1) Forces that incite the arm wrestling; (2) Facing social stigma; and (3) Defeated by a greater rival. The metaphor provided interpretive experiences of the moral conflict experienced by women who decided to have an abortion and emerged from the confrontation of the reasons why they decided to abort and the social repercussions that making the decision entails. The result of the struggle was loneliness and vulnerability. Conclusion: The lines of action impact policy makers, the media, and health professionals. Actions should focus on the de-stigmatisation and normalisation of abortion, the use of appropriate language, and the training and sensitisation of health professionals. [ABSTRACT FROM AUTHOR]

Objectives: Existing research has not thoroughly characterized the psychosocial costs associated with seeking abortion care in restrictive states. Our study seeks to fill this gap by analyzing the accounts of Ohio abortion patients from 2018 to 2019.Study Design: Using inductive and deductive approaches, we analyzed semi-structured in-depth qualitative interviews with 41 Ohio residents who obtained abortion care from one of three clinics in Ohio or Pennsylvania.Results: Ohioans seeking abortion care often experienced fear of judgment, interpersonal strain, and stress as a result of efforts to overcome pre-Dobbs financial, geographic, and timing challenges. Those who needed financial assistance or traveled more than an hour generally reported greater exposure to psychosocial costs.Conclusions: Participants in this study incurred a complex set of psychosocial costs. Psychosocial costs often resulted from, or were exacerbated by, the financial, geographic, and time-sensitive burdens that patients experienced seeking care.Implications: The psychosocial costs incurred by patients seeking abortion care may be exacerbated in restrictive contexts, especially those who do not have access to insurance coverage for care. Psychosocial costs associated with care seeking are likely to increase as states implement more severe restrictions post-Dobbs. To fully understand abortion costs, researchers must examine costs comprehensively, including both financial and psychosocial costs. [ABSTRACT FROM AUTHOR]

There is a great deal of misinformation and stigma surrounding abortion, even though it is a common reproductive health service. Teaching about abortion encompasses many things: managing the beliefs of students and teachers; state regulations around teaching or talking about abortion in schools; available resources; and the cultural miseducation and stigma around abortion. As social media becomes more accessible and widely used, educators can use it as a tool for teaching sensitive issues and navigating some of the restrictions and difficulties teaching about abortion comes with. This article explores current considerations and issues around abortion education and how TikTok can be used to teach this sensitive topic both inside and outside of the classroom, especially with adolescents and young adults. With its 1 billion monthly active users, TikTok is a potential educational space for teaching about abortion by spreading accurate information, engaging the audience, and working to open lines of communication to combat abortion stigma [ABSTRACT FROM AUTHOR]

This study examined the associations between childbirth decisions in women with unintended pregnancies and long-term psychological distress. An online survey of women selected from a representative research panel was conducted in July 2021. Among participants who experienced an unintended pregnancy, the childbirth decision was categorized: (i) wanted birth, (ii) abortion, (iii) adoption, and (iv) unwanted birth. Participants who made childbirth decisions more than 1 year ago were included. ANCOVA was conducted with psychological distress (Kessler 6) as the dependent variable and education, marital status, years from the decision, age of the first pregnancy, economic situation at the unintended pregnancy, and the number of persons consulted at the unintended pregnancy as covariates. Logistic regression analysis was conducted for high distress (K6 ≥ 13) by adjusting the same covariates. A total of 47,401 respondents participated in the study. Women with an experience of unintended pregnancy experienced more than 1 year before the study were analyzed (n = 7162). Psychological distress was the lowest for wanted birth and increased for abortion, adoption, and unwanted birth. In the adjusted model, abortion was associated with lower distress scores than both adoption and unwanted birth. Compared to the wanted birth, adoption and unwanted birth showed significantly higher levels of distress (adjusted odds ratio [aOR] = 2.03 [95% CI 1.36–3.04], aOR = 1.64 [95% CI 1.04–2.58], respectively). Long-term effects on psychological distress differed according to the childbirth decisions in unintended pregnancy. Healthcare professionals should be aware of this hidden effect of unintended pregnancy experience on women's mental health. [ABSTRACT FROM AUTHOR]

Context: When an individual seeking an abortion cannot obtain one, carrying that pregnancy to term may affect both her relationship with the man involved in the pregnancy and her prospects for new intimate relationships. We aimed to assess the impact of receiving versus being denied a wanted abortion on women's intimate relationships, up to 5 years after seeking an abortion in the United States. Methods: Using mixed‐effects regression models, we compared relationship outcomes among women who presented for abortion care just under facilities' gestational age limits ("Near‐limit abortion patients," n = 452) with those who presented just over, were denied an abortion ("Turnaways," n = 146) at 30 US facilities. Results: At 1 week post‐abortion seeking, the predicted probability of being in a relationship with the man involved in the pregnancy was 58%, gradually declining to 27% at 5 years with no significant differences between those who received and those who were denied an abortion. However, from 2 to 5 years post‐abortion seeking, participants who were denied an abortion had double the odds (aOR = 2.01, 95% CI: 1.09–3.69) of being in a poor intimate relationship, with a predicted probability of being in a poor relationship of 14% among those denied an abortion compared with 9% among those who received one (p < 0.05). Conclusions: Carrying an unwanted pregnancy to term does not increase the chance of being in an intimate relationship with the man involved in the pregnancy but may have negative implications for the quality of future relationships up to 5 years post‐abortion seeking. [ABSTRACT FROM AUTHOR]

Men's involvement in abortion is significant, intersecting across the individual, community and macro factors that shape abortion-related care pathways. This scoping review maps the evidence from low- and middle-income countries relating to male involvement in abortion trajectories. Five databases were searched, using search terms, to yield 7493 items published in English between 01.01.2010 and 20.12.2019. 37 items met the inclusion criteria for items relating to male involvement in women's abortion trajectories and were synthesised using an abortion-related care-seeking framework. The majority of studies were conducted in sub-Saharan Africa and were qualitative. Evidence indicated that male involvement was significant, shaping the ability for a woman or girl to disclose her pregnancy or abortion decision. Men as partners were particularly influential, controlling resources necessary for abortion access and providing or withdrawing support for abortions. Denial or rejection of paternity was a critical juncture in many women's abortion trajectories. Men's involvement in abortion trajectories can be both direct and indirect. Contextual realities can make involving men in abortions a necessity, rather than a choice. The impact of male (lack of) involvement undermines the autonomy of a woman or girl to seek an abortion and shapes the conditions under which abortion-seekers are able to access care. This scoping review demonstrates the need for better understanding of the mechanisms, causes and intensions behind male involvement, centring the abortion seeker within this. [ABSTRACT FROM AUTHOR]

Background: Abortion is a legally restricted, yet common reproductive life event among women in Burkina Faso; however, women's abortion experiences vary greatly depending on their social and economic capital, partner involvement, and level of knowledge. We sought to classify women's abortion care-seeking experiences across the life course and social conditions into typologies using qualitative data. Methods: An initial quantitative survey among a nationally representative sample of women ages 15–49 years collected information on women's induced abortion experiences. Women who reported an abortion in the last 10 years were asked if they would agree to participate in a subsequent in-depth interview (IDI) to learn more about their abortion experience. Twenty-five women, identified via purposive sampling, completed an IDI. Using a process of typology construction, we identified attributes of each woman's condition at the time of her abortion and aspects of her abortion experience, created a matrix of attributes and cases, and identified emerging relationships. Three types were identified through this process. Results: Twenty-three IDIs were analyzed, and women's abortion experiences were grouped into three types: abortion to delay childbearing in adolescence; abortion to space childbirth among women in union; abortion to avoid childbearing among single mothers. Two cases were identified as outliers. Cases were grouped based on the context of their pregnancy, the reason for the abortion and involved decision-makers, and their patterns of care-seeking, including methods and sources used. Conclusion: Structural inequities related to gender and wealth were prominent forces shaping women's abortion experiences. Comprehensive sexuality education coupled with community-based interventions to promote gender-equitable relationships and address social stigma related to women's sexuality could reduce reproductive coercion and unintended pregnancies. [ABSTRACT FROM AUTHOR]

Purpose: To estimate the prevalence of posttraumatic stress disorder (PTSD) among parents in cases of fetal abnormalities and associated factors. Design and Methods: A cross‐sectional study. The study sample comprised 169 couples who experienced fetal abnormalities. Findings: We observed a high prevalence of PTSD. Fathers had similar levels of PTSD to those of mothers. Social support was an important protective factor against parental PTSD. In addition, a negative psychological reaction to the loss of a child in either the father or the mother affects the other spouse. Practice Implications: This study emphasizes recognizing the importance of social support and of psychological interactions between mothers and fathers in PTSD intervention for parents. [ABSTRACT FROM AUTHOR]

The article focuses on complete ectogenesis and associated concerns related to artificial womb technology (AWT). Topics discussed include AWT as a substitute for abortion, benefits of AWT to facilitate continued gestation and childbirth and consequences of policy designed to avoid abortion by substituting AWT.

Introduction: Despite the advances in modern health care, maternal morbidity and mortality remain major problems in Ethiopia. Repeat-induced abortion is an indispensable contributor to this problem. Even though there are adverse effects on health, a significant proportion of Ethiopian women procure more than one abortion during their reproductive lifetime. This study aimed to determine the prevalence and associated factors of repeat-induced abortion in South Ethiopia, in 2020. Methods: An institution-based cross-sectional study design and a systematic random sampling technique were used to collect data from 410 samples of women. Data were collected using pre-tested and semi-structured interviewer-administered questionnaires. The data were coded and entered into EpiData version 4.6.2.0 before being exported to Statistical Package for Social Sciences (SPSS) version 26 for analysis. Variables with a p-value of less than 0.05 in binary logistic regressions were exported into multivariate logistic regression analysis. Finally, variables with a p-value of less than 0.05 in the multivariate logistic regression analysis were used to declare statistical significance. Result: The prevalence of repeat-induced abortion was found to be 35.4% (95% confidence interval = 30.7–40). Not facing a complication in prior abortion care, having more than two partners in the last 12 preceding months, perceiving abortion procedure as non-painful, having a sexual debut before the age of 18 years, and consuming alcohol have higher odds of repeat-induced abortion when compared with their counterparts. Conclusion: The prevalence of repeat-induced abortion in Hawassa city is high compared to studies conducted in other parts of Ethiopia. Not facing complications during previous abortion care, perceiving the abortion procedure as non-painful, alcohol consumption, having multiple sexual partners, and having a sexual debut before the age of 18 years are found to increase the chance of repeat-induced abortion. [ABSTRACT FROM AUTHOR]

Context: Many people wanted to avoid or delay childbearing during the COVID‐19 pandemic. This study sought to examine the extent COVID‐19 influenced abortion care‐seeking in a region that did not enact policy restricting abortion due to the pandemic, has high service availability, and few abortion‐restrictive policies. Methodology: We conducted telephone surveys with adults (n=72) requesting abortion appointments between September 2020 and March 2021 at five clinics in Washington, DC, Maryland, and Virginia. We used χ2 tests to compare sociodemographic, reproductive history, service delivery characteristics, and pandemic‐related life changes by whether COVID‐19 influenced abortion care‐seeking. Results: Most respondents (93%) had an abortion at the time of the survey, 4% were awaiting their scheduled appointment, and 3% did not have an appointment scheduled. Nearly 40% of people reported COVID‐19 influenced their decision to have an abortion. These individuals were significantly more likely to report "not financially prepared" (44% vs. 16%) as a reason for termination compared to people reporting no influence of COVID‐19. They were also more likely to have lost or changed their health insurance due to pandemic‐related employment changes (15% vs. 2%), report substantial money difficulties due to COVID‐19 (59% vs. 33%), and report that paying for their abortion was "very difficult" (25% vs. 2%). Conclusion: COVID‐19 influenced many people to have an abortion, particularly those financially disadvantaged by the pandemic. Expansion of Medicaid abortion coverage in Washington, DC and Virginia could reduce financial barriers to care and help people to better meet their reproductive needs amid future crises. [ABSTRACT FROM AUTHOR]

Background: Difficulty accessing medication and poor patient experience have been implicated as risk factors for termination of pregnancy and suicidal ideation in women with hyperemesis gravidarum. We aimed to gain further insight into these factors in order to further inform and improve patient care. Methods: We performed a sub-analysis on quantitative data generated through a UK-wide survey of 5071 participants. A qualitative analysis of free text comments was performed using an inductive thematic approach. Results: 41.2% % of women taking prescribed medications had to actively request them. 'Extremely poor' or 'poor' experiences were described in 39.4% and 30.0% of participants in primary and secondary care respectively. Protective factors for termination of pregnancy and suicidal ideation include holistic support from family, friends and healthcare providers. Conclusion: Optimal care in hyperemesis gravidarum should incorporate timely access to pharmacotherapy, assessment of mental health, consideration of referral to specialist services and care being delivered in a compassionate manner. [ABSTRACT FROM AUTHOR]

The article provides information on the study "Socioeconomic Outcomes of Women Who Receive and Women Who are Denied Wanted Abortions in the U.S." by Diana Greene Foster and colleagues which examined the socioeconomic consequences of receipt versus denial of abortion. Topics discussed include reason for the lack of evidence about the socio-economic consequences of barriers to abortion services, methodology of the study, and economic hardship facing many women seeking abortion.

The article provides information on the study "Denial of Abortion Because of Provider Gestational Age Limits in the U.S." by Ushma D. Upadhyay and colleagues, which examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. Topics discussed include methodology of the study, reasons for delay and access barriers, and factors associated with obtaining an abortion after being denied one.

Continued pregnancy after an abortion attempt is a likely outcome in countries where unsafe abortions prevail. Yet there is a paucity of literature on the consequences and implications of failed abortions. This study explored young women's abortion decision-making, their experiences of failed abortion and its consequences in South-Western Nigeria. It presents findings from semi-structured interviews conducted with 14 women who had become unintentionally pregnant as unmarried teenagers, desired abortions, yet became mothers. Whilst the fear of the stigma associated with young unmarried motherhood gave rise to participants' desire for abortion, restrictive abortion laws influenced their experiences and abortion decision-making. Participants who attempted an abortion failed and were forced to carry their unwanted pregnancies to term. They then experienced continued discrimination, forced motherhood, and a rejection of maternalism. Their experiences are analysed as responses to the complex interplay between social norms, abortion restrictions, stigma and forced motherhood. The paper makes a case for improving women's reproductive autonomy in decision-making, – highlighting the social and mental health consequences of restricted access to abortion, and reinforce the importance of taking a holistic approach to addressing the sexual health of young women, by focusing not only on physical health but also on ensuring wellbeing. [ABSTRACT FROM AUTHOR]

(1) Background: This paper aims to examine two relevant phenomena in the context of public health: spontaneous abortion (SA) and induced abortion (IA). SA is one of the most common complications of pregnancies; IA is a conscious choice that is made by the mother/couple. (2) Methods: Permutation tests were applied to SA and IA standardized rates detected by ISTAT (2016–2020). The NPC test, chosen for its optimal properties, was applied to compare different Italian territorial divisions (stratifying for year and age classes of women) and analyze the trend of years by stochastic ordering. (3) Results: Only for SA, there are significant differences among the three territorial divisions: the South records higher SA standardized rates than the North and the Center; the rates of IA are similar. Relating to distinct women age classes, the SA standardized rates do not show significant differences among the three analyzed geographical areas; different results are highlighted for IA. Stochastic ordering shows that only the IA standardized rates are characterized by a significant monotonous decreasing trend over the years. (4) Conclusion: The SA phenomenon has shown a decreasing trend that could be justified by the progress of science. For IA, we can certainly say that the general decrease in the phenomenon is due to the greater use of contraceptive methods that help to prevent unwanted pregnancies. [ABSTRACT FROM AUTHOR]

To investigate which objective (actions/interventions) and subjective (perceptions of care quality) outcomes of care following stillbirth or termination of pregnancy predict perceived care quality. A cross-sectional descriptive study using an anonymous online survey. The population was women who had experienced a stillbirth or termination of pregnancy from ≥16 weeks of gestation, in the Spanish health system. Multiple sequential regression analysis was used to identify predictors of perceived care quality (satisfaction, willingness to recommend, competence and ability to provide loss-focused care). Results from 610 women were analysed. A significant regression equation (p<0.001) was found in each of the objective only and objective-subjective models. In the case of overall care (satisfaction-recommend composite), 72.0% of variance (adj. R2) was explained. In general, subjective evaluations of care are more potent predictors of perceived care quality than objective care interventions (e.g. autopsy performed). Feeling free to 'express emotions', 'teamwork between doctors and nurses/midwives', and 'being well-informed of all steps and procedures' were the three strongest predictors, followed by perception of 'medical negligence'. Information provision and loss-focused interventions had the weakest influence, except in the specific 'loss-focused' model. The results indicate that the 'atmosphere' of care is a transversal dimension related to the context of loss and trauma and has the single greatest influence on perceptions of care quality. It is necessary to use a specific 'loss-focused' care variable to adequately capture perceptions of the quality of bereavement care and a custom scale to measure the influence of care interventions on perceived quality. [ABSTRACT FROM AUTHOR]

Abortion is a critical life event and death choice for every pregnant woman. Women who are faced with unwanted pregnancies may seek abortions, regardless of their religious or ethical beliefs, or legal sanctions and any considerable risk. Opinions about abortion describe a combination of personal beliefs about foetal rights, beliefs about abortion morality, beliefs about governmental authority in public policies, and beliefs about the rights and responsibilities of the women seeking to have abortions. The purpose of this position statement is to pinpoint proponents' and opponents' viewpoints regarding abortion and provide recommendations to reduce unwanted pregnancies and meet women's family planning needs. [ABSTRACT FROM AUTHOR]

Context: In the United States, third‐trimester abortions are substantially more expensive, difficult to obtain, and stigmatized than first‐trimester abortions. However, the circumstances that lead to someone needing a third‐trimester abortion may have overlaps with the pathways to abortion at other gestations. Methods: I interviewed 28 cisgender women who obtained an abortion after the 24th week of pregnancy using a modified timeline interview method. I coded the interviews thematically, focusing on characterizing the experience of deciding to obtain a third‐trimester abortion. Results: I find two pathways to needing a third‐trimester abortion: new information, wherein the respondent learned new information about the pregnancy—such as of an observed serious fetal health issue or that she was pregnant—that made the pregnancy not (or no longer) one she wanted to continue; and barriers to abortion, wherein the respondent was in the third trimester by the time she was able to surmount the obstacles to abortion she faced, including cost, finding a provider, and stigmatization. These two pathways were not wholly distinct and sometimes overlapped. Conclusions: The inherent limits of medical knowledge and the infeasibility of ensuring early pregnancy recognition in all cases illustrate the impossibility of eliminating the need for third‐trimester abortion. The similarities between respondents' experiences and that of people seeking abortion at other gestations, particularly regarding the impact of barriers to abortion, point to the value of a social conceptualization of need for abortion that eschews a trimester or gestation‐based framework and instead conceptualizes abortion as an option throughout pregnancy. [ABSTRACT FROM AUTHOR]

Objective: Despite overwhelming data supporting the safety of abortion care in the U.S., public perceptions of abortion safety vary widely. While evidence suggests that the public overestimates abortion risk, few studies have analyzed why people think abortion is safe or unsafe.Study Design: Using data from the Ohio Survey of Women, a representative survey of women aged 18 to 44 years with a residential address in Ohio, we examined responses to 2 questions about abortion safety perceptions: the first asked respondents to rate abortion safety in Ohio, and the second asked respondents why they chose this rating of abortion safety. We analyzed these responses with inductive and deductive approaches.Results: There were 2529 responses, of which 1368 (54%) provided a response to the open-ended question about abortion safety. From this subset, 529 gave open-ended responses indicating that they perceive abortion as safe, with 47% attributing this perception to the procedure being performed by a professional in a regulated environment. In contrast, 370 gave open-ended responses indicating that they perceive abortion as unsafe; the most common explanations referred to health risks (19%) and that safety depends on preexisting health conditions (19%).Conclusion: Many participants perceived abortion as safe because it is performed by professionals in a clinical environment or because of personal experiences with abortion. Those perceiving a lack of safety provided more varied responses, including that abortion was dangerous due to a detrimental effect on mental health or protesters at abortion clinics.Implications: We identified that women have a broad range of reasons for perceiving abortion as safe or unsafe. Providers should be aware of this diversity of abortion safety perceptions so that they can best engage with their patients.This updated characterization of pain experienced during an evidence-based medication abortion regimen may allow for better pain-related counseling, tailoring of opioid prescription practices, and improvement in patient satisfaction. [ABSTRACT FROM AUTHOR]

The deliberate killing of a foetus in the womb, or a child from the first 24 h of birth to one month of age, or within the first year of life, is called foeticide, neonaticide and infanticide, respectively. Socioeconomic stress, mental illness, gender selection, shame or fear of punishment of adultery or illegitimacy, grudge and jealousy with parents and negligent delivery by dai are major causative factors in such cases. This is a retrospective, descriptive, observational study, and the sample pool consisted of 35 cases. Foeticide cases were 42.9% of the total and the same percentage of cases were neonaticides, while 14.3% of cases were of infanticide. The male-to-female ratio was 1.26:1 and the major cause of death was head injury. The study shows a prevalence of foeticide and neonaticide as compared to infanticide. It also displays the prevalence of males in overall cases and a higher number of unknown cases in our setting. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic raised significant challenges for in-person healthcare provision, leading healthcare providers to embrace digital health like never before. Whilst changes were made as part of a public health response, many have now become permanent fixtures of the healthcare landscape, significantly altering the way care is provided not only for patients, but also for the healthcare professionals that provide care. In abortion care in England and Wales, previously stringent regulations on in-person care provision were relaxed to permit the use of telemedicine and self-administration of medications at home. These changes have since been made permanent. However, there remains opposition to remote abortion care pathways on the basis of safeguarding. Opponents argue that it is not feasible to effectively safeguard patients accessing abortion care remotely. We conducted a qualitative study using semi-structured interviews with abortion care providers in England and Wales. Participants were asked about their views and experiences of the transition to remote care provision, with a particular focus on how they adapted their safeguarding practice. In this article, we present three themes that highlight the changing roles of healthcare professionals in abortion care: (1) a challenging backdrop and resulting apprehension, (2) adaptive practices, and (3) the continued importance of professional curiosity. Across all three themes, participants reflected significantly on how changes were made and what they experienced in the period of transition to telemedicine. In particular, they discussed the changing nature of their professional roles amidst digitalisation. Our findings provide a basis for reflection on the increasing introduction of digital approaches to healthcare provision, highlighting points for caution and emphasising the need to involve professionals in the transition process to ensure vital buy-in. Through this, we articulate two novel understandings of digitalisation: (1) the impact of speed-associated pressures on professional adaptation during digitalisation, and (2) off-proforma safeguarding through telemedicine as a form of invisible non-routine work. • Telemedical abortion care pathways were introduced during the COVID-19 pandemic. • We interviewed providers about their experiences of safeguarding amidst the changes. • Most providers took to the changes well and favoured being involved in design. • Staff buy-in is essential in moving to more digital approaches to healthcare. • Co-production, involving staff, should be used when implementing telemedicine. [ABSTRACT FROM AUTHOR]

Objective: To describe changes in contraceptive method plans pre-appointment, after counseling, and post-procedure in patients having an abortion.Study Design: We reviewed electronic medical records of University of California, Davis Health patients who had an operating room abortion from January 2015 to December 2016. We excluded persons with procedures for fetal anomaly or demise. We extracted patient demographics and contraceptive plans reported at each encounter (telephone intake, pre-operative appointment, and day of abortion). We evaluated individual contraceptive plans across the encounters, identified patient characteristics that contributed to plan change, and created a multivariable logistic regression model for predictors of contraception method plan change from telephone intake to post-procedure.Results: The 747 patients had a mean gestational age of 16 4/7 ± 5 0/7 weeks with 244 (32.7%) <15 weeks and 235 (31.5%) ≥20 weeks. At telephone intake, 273 (36.4%) wanted a long-acting method (139 [50.9%] intrauterine device [IUD]; 99 [36.3%] implant; 35 [12.3%] unspecified), 11 (3.9%) permanent contraception, and 248 (33.2%) a less effective or no method; 215 (28.8%) stated they were undecided. Most (357/433 [82.4%]) patients who planned a reversible method based on the telephone intake obtained that or a similar method. Of the 273 patients planning a long-acting method, 258 (94.5%) received an IUD (158 [40.9%]) or implant (100 [36.6%]). Of the 215 undecided patients, 88 (40.9%) received an IUD and 55 (25.6%) an implant. No demographic factors predicted a change in method plan.Conclusions: Most patients will receive the method they initially identified at the telephone intake after an abortion, especially those planning an IUD or implant. Undecided patients are commonly open to discussing options. [ABSTRACT FROM AUTHOR]