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Paradoxes in legal abortion: a longitudinal study of motives, attitudes and experiences in women and men
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: About one in four pregnancies in Sweden are terminated by legal abortion. However, women seeking abortion constitute a relatively invisible group. This is even more accentuated when it comes to the men involved in induced abortion.

Aim: The general aim of the present thesis was to investigate psychosocial background, current living conditions, motives, attitudes and experiences of legal abortion in women and men.

Methods: The five papers included in the thesis are based on a questionnaire study and a longitudinal interview study. Women seeking abortion were asked consecutively as they come to the hospital for the first time if they were willing to participate in the questionnaire study, which ultimately included 211 women and 75 men. The interview study comprised 58 women and 26 men and was conducted just after abortion and four and twelve months later.

Results: Most women and men had stable partner relationships and adequate finances. More than half were married or cohabiting and already had children. About half the women gave motives for abortion related to family planning. They wanted either to postpone childbirth or limit the number of children so they would be able to combine good parenting with professional employment. Motives for abortion in men were strikingly in accordance with the women's motives. Most men were in favour of abortion, 20 stressed they supported the decision and two wanted the woman to continue the pregnancy. Contradictory feelings in relation to both pregnancy and the coming abortion were common in women as well as men, but were very seldom associated with doupts about the actual decision to have an abortion. Social perspectives, connected with responsibility for all concerned (the foetus included) were found to legitimise the decision to have an abortion, whilst positive feelings in relation to the pregnancy and ethical perspectives concerning the rights of the foetus made in more difficult. In addition, the complexity increased in cases when the abortion could be simultaneously experienced as both a relief and a loss. However, at the follow-ups, the majority of the women did not report any emotional distress, either directly after the abortion or four or 12 months later, and the predominant reactions were relief and mental growth. As concerns contraceptives, about half the respondents had not used any contraceptive method at the time of conception. Common explanations for not preventing pregnancy were: thought it was a safe-period or let sexual feelings take over or took a chance. Furthermore, in 12 % of cases, the woman had felt pressure or threat from the man in connection with the conception.

Conclusions: Women resort to legal abortion in all kinds of psychosocial contexts. The motives reveal that women and men want to have children with the right partner at the right time and to limit the number of children. Despite painful and contradictory feelings almost no one regretted the abortion, either directly after the abortion or one year later. It is essential that both clinical work and research are open to contradictory feelings and paradoxical thinking in relation to abortion. In addition, it is necessary also to focus on the involvement and role of the males in order to obtain a proper picture of the phenomenon of abortion.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2002. , 59 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 779
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:umu:diva-47362ISBN: 91-7305-212-4 (print)OAI: oai:DiVA.org:umu-47362DiVA: diva2:442116
Public defence
2002-04-19, Rosa salen, plan 9, tandläkarhögskolan, Norrlands universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Projects
digitalisering@umu
Note

Härtill 5 uppsatser

Available from: 2011-09-20 Created: 2011-09-20 Last updated: 2015-04-09Bibliographically approved
List of papers
1. Legal abortion: a painful necessity
Open this publication in new window or tab >>Legal abortion: a painful necessity
2001 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 53, no 11, 1481-1490 p.Article in journal (Refereed) Published
Abstract [en]

This study was conducted to increase knowledge about the psychosocial background and current living conditions of Swedish women seeking abortion, along with their motives for abortion and their feelings towards pregnancy and abortion. Two hundred and eleven women answered a questionnaire when they consulted the gynaecologist for the first time. The study indicates that legal abortion may be sought by women in many circumstances and is not confined to those in special risk groups. For example, most women in the sample were living in stable relationships with adequate finances. The motives behind a decision to postpone or limit the number of children revealed a wish to have children with the right partner and at the right time in order to combine good parenting with professional career. The study shows that prevailing expectations about lifestyle render abortion a necessity in family planning. One-third of the women had had a previous abortion(s) and 12% had become pregnant in a situation where they had felt pressured or threatened by the man. Two-thirds of the women characterised their initial feelings towards the pregnancy solely in painful words while nearly all the others reported contradictory feelings. Concerning feelings towards the coming abortion, more than half expressed both positive and painful feelings such as anxiety, relief, grief, guilt, anguish, emptiness and responsibility, while one-third expressed only painful feelings. However, almost 70% stated that nothing could change their decision to have an abortion. Thus, this study highlights that contradictory feelings in relation to both pregnancy and the coming abortion are common but are very seldom associated with doubts about the decision to have an abortion.

Keyword
Sweden; Legal abortion; Family planning; Psychosocial aspects; Emotions; Reasons for abortion
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-27625 (URN)10.1016/S0277-9536(00)00436-6 (DOI)
Available from: 2009-11-12 Created: 2009-11-12 Last updated: 2017-12-12Bibliographically approved
2. The male partner involved in legal abortion
Open this publication in new window or tab >>The male partner involved in legal abortion
1999 (English)In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 14, no 10, 2669-2675 p.Article in journal (Refereed) Published
Abstract [en]

This study comprises 75 men who have been involved in legal abortion. The men answered a questionnaire concerning living conditions and attitudes about pregnancy and abortion. Most men were found to be in stable relationships with good finances. More than half clearly stated that they wanted the woman to have an abortion while 20 stressed that they submitted themselves to their partner's decision. Only one man wanted the woman to complete the pregnancy. Apart from wanting children within functioning family units, the motivation for abortion revealed that the desire to have children depended on the ability to provide qualitatively good parenting. More than half the men had discussed with their partner what to do in event of pregnancy and half had decided to have an abortion if a pregnancy occurred. More than half expressed ambivalent feelings about the coming abortion, using words such as anxiety, responsibility, guilt, relief and grief. In spite of these contradictory feelings, prevailing expectations concerning lifestyle make abortion an acceptable form of birth control. A deeper understanding of the complexity of legal abortion makes it necessary to accept the role of paradox, which the ambivalence reflects. Obviously, men must constitute a target group in efforts to prevent abortions.

Keyword
ambivalence, attitudes, legal abortion, male, motives
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-27627 (URN)10.1093/humrep/14.10.2669 (DOI)
Available from: 2009-11-12 Created: 2009-11-12 Last updated: 2017-12-12Bibliographically approved
3. Ambivalence - a logical response to legal abortion: a prospective study among women and  men
Open this publication in new window or tab >>Ambivalence - a logical response to legal abortion: a prospective study among women and  men
2000 (English)In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 21, no 2, 81-91 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to elucidate ambivalence in relation to legal abortion by studying emotions, attitudes, motives for abortion and ethical reasoning in a-strategic sample of women and men who, 1 year after abortion, expressed both positive and painful feelings in relation to the abortion. The study shows that social perspectives legitimate the decision to have an abortion whilst ethical perspectives complicate the decision. Nearly all women and men described having the abortion as an expression of responsibility. Almost one-half also had parallel feelings of guilt, as they regarded the abortion as a violation of their ethical values. The majority of the sample expressed relief while simultaneously experiencing the termination of the pregnancy as a loss coupled with feelings of grief/emptiness, in spite of the ambivalence, only one woman regretted the abortion. For the vast majority, the impact of the abortion had led to increased maturity and deepened self-knowledge. Thus, ambivalence might be regarded not only as problematic but also as indicating openness to the complexity of the abortion issue. Since incompatible values clash in connection with abortion, experiences of ambivalence become both logical and understandable.

Read More: http://informahealthcare.com/doi/abs/10.3109/01674820009075613

Keyword
ambivalence, attitudes, legal abortion, long-term follow-up, motives, male partner
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-27626 (URN)10.3109/01674820009075613 (DOI)
Available from: 2009-11-12 Created: 2009-11-12 Last updated: 2017-12-12Bibliographically approved
4. Wellbeing and mental growth: long-term effects of legal abortion
Open this publication in new window or tab >>Wellbeing and mental growth: long-term effects of legal abortion
2004 (English)In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 58, no 12, 2559-2569 p.Article in journal (Refereed) Published
Abstract [en]

The present study aims to increase knowledge about coping with legal abortion by studying women's reasoning, reactions and emotions over a period of 1 year. The study comprises interviews focusing on the experiences and effects of abortion in 58 women, 4 and 12 months after the abortion. The women also answered a questionnaire before the abortion concerning their living conditions, decision-making process and feelings about the pregnancy and the abortion. Majority of the women did not experience any emotional distress post-abortion and almost all the woman reported that they had coped well at the 1-year follow-up, although 12 had had severe emotional distress directly post-abortion. Furthermore, almost all described the abortion as a relief or a form of taking responsibility and more than half reported only positive experiences such as mental growth and maturity of the abortion process. Those without any emotional distress post-abortion stated clearly before the abortion that they did not want to give birth since they prioritised work, studies and/or existing children. The study shows that women generally are able to make the complex decision to have an abortion without suffering any subsequent regret or negative effects, as ascertained at the 1-year follow-up.

Keyword
Legal abortion; Emotional distress; Sweden
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-13701 (URN)10.1016/j.socscimed.2003.09.004 (DOI)15081205 (PubMedID)
Available from: 2007-09-28 Created: 2007-09-28 Last updated: 2011-09-20Bibliographically approved
5. Contraceptive risk-taking in women and men facing legal abortion
Open this publication in new window or tab >>Contraceptive risk-taking in women and men facing legal abortion
2001 (English)In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 6, no 4, 205-218 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of the study was to gain knowledge about contraceptive use, reproductive risk-taking and sexuality in Swedish women seeking abortion and their partners.

Methods: Two hundred and eleven women and 75 men answered a questionnaire before the abortion. The data have been divided into six subgroups: women with and without previous experience of abortion, single women and women with a partner relationship, and women whose partner participated in the study and the male partners.

Results: The main findings showed that there are more similarities than differences between the subgroups. Overall, there were no differences regarding use of contraceptives, sexual life and psychosocial characteristics. However, women with previous abortion experience were found to be older, had longer partner relationships and more often had children. Some gender differences were also found, i.e. women favored coitus-dependent contraceptives to a larger extent and took more responsibility for preventing unwanted pregnancies. At the time of conception, half the participants had not used any contraceptive methods and one-fifth had relied on 'natural family planning'. The most common reasons for not using contraceptives were related to risk-taking and/or to strong sexual desire. Twelve per cent of the women had felt pressure/threat from their partner in connection with the conception.

Conclusion: In efforts to prevent undesired pregnancies, this study highlights the need to incorporate a gender perspective both in communication about risk-taking and in counselling about contraceptives.

Place, publisher, year, edition, pages
Informa Healthcare, 2001
Keyword
Induced abortion, contraception, risk-taking, male, reproduction, gender
National Category
Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology
Identifiers
urn:nbn:se:umu:diva-41793 (URN)10.1080/ejc.6.4.205.218 (DOI)11848650 (PubMedID)
Available from: 2011-04-01 Created: 2011-04-01 Last updated: 2017-12-11Bibliographically approved

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