The experiences of women who face abortions

Seventy‐two Israeli women who were about to have abortions were interviewed. These women experienced intense emotions of sadness, ambivalence, confusion, and fear. To help them deal with this crisis, the women expressed a need for a professional counselor who provides information such as where to go, how to get money for the abortion, and how the operation is performed. The women also wished that the professional counselor would support them emotionally throughout the pregnancy experience and the abortion procedure.     

Irish women who seek abortions in England.

In 1991, 4158 women from Ireland and 1766 from Northern Ireland traveled to England for abortions. This situation has been ignored by Irish authorities. The 1992 case of the 14-year old seeking an abortion in England finally caught legal attention. This study attempts to help define who these abortion seekers are. Questionnaires from 200 Irish abortion seeking women attending private Marie Stopes clinics in London and the British Pregnancy Advisory Services clinic in Liverpool between September 1988 and December 1990 were analyzed. Findings pertain to demographic characteristics, characteristics of first intercourse, family discussion of sexual activity, and contraceptive use. From this limited sample, it appears that Irish women are sexually reserved and without access to modern methods of birth control and abortion. Sex is associated with shame and guilt. 23% had intercourse before the age of 18 years and 42% after the age of 20. 76% were single and 16% were currently married. 95% were Catholic; 33% had been to church the preceding Sunday and 68% within the past month. Basic information about menstruation is also limited and procedures such as dilatation and curettage may be performed selectively. 28% of married women were uninformed about menstruation prior to its onset. Only 24% had been using birth control around the time of pregnancy. The reason for nonuse was frequently the unexpectedness of intercourse. 62% of adults and 66% of women believe in legalizing abortion in Ireland. British groups have tried to break through the abortion information ban by sending telephone numbers of abortion clinics to Irish firms for distribution to employees. On November 25, 1992, in the general election, there was approval of constitutional amendments guaranteeing the right to travel for abortions and to receive information on abortion access. The amendment to allow abortion to save the life of the mother was not accepted.     

Characteristics of pregnant women who report previous induced abortions

Associations between previous induced abortion and demographic and health factors in pregnancy were measured in 9 874 women who gave birth and who had been interviewed during pregnancy. Previous abortion was most rare among women having their first baby and increased with increasing birth order up to the fourth, thereafter decreasing. It was positively correlated with maternal age and negatively with age at marriage. There was no effect of years of schooling, when other variables were taken into account, but there were significant differences between ethnic groups, abortion being commonest among Jewish women from North African countries and more prevalent in those from western and Asian countries than in the second-generation Israel-born or in Arab women.     

Are women who have abortions different from those who do not? A secondary analysis of the 1990 national survey of sexual attitudes and lifestyles

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.     

Why do women have abortions?

Most respondents to a survey of abortion patients in 1987 said that more than one factor had contributed to their decision to have an abortion; the mean number of reasons was nearly four. Three-quarters said that having a baby would interfere with work, school or other responsibilities, about two-thirds said they could not afford to have a child and half said they did not want to be a single parent or had relationship problems. A multivariate analysis showed young teenagers to be 32 percent more likely than women 18 or over to say they were not mature enough to raise a child and 19 percent more likely to say their parents wanted them to have an abortion. Unmarried women were 17 percent more likely than currently married women to choose abortion to prevent others from knowing they had had sex or became pregnant. Of women who had an abortion at 16 or more weeks' gestation, 71 percent attributed their delay to not having realized they were pregnant or not having known soon enough the actual gestation of their pregnancy. Almost half were delayed because of trouble in arranging the abortion, usually because they needed time to raise money. One-third did not have an abortion earlier because they were afraid to tell their partner or parents that they were pregnant. A multivariate analysis revealed that respondents under age 18 were 39 percent more likely than older women to have delayed because they were afraid to tell their parents or partner.     

HIV risk reduction in rural African American women who use cocaine

Research has demonstrated associations between cocaine use and sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV). More research has been conducted among the sub-population of women, with less focus on rural African American women. Investigation of the social context that influences rural African American women's behavior that places them at risk for STI/HIV has received limited attention. The results of one component of the comprehensive study presented here focused on perceived STI/HIV risk reduction strategies of U.S. southern rural African American women who used cocaine. This ethnographic study of 30 rural African American women using cocaine was conducted over four years. Respondents described HIV risk reduction strategies and their motives for using them. Condoms were used more with casual partners (80%) than primary partners (16%) and with partners who were less known, less trusted, young, or physically or sexually "dirty." Condoms were also used to prevent pregnancy (60%) more than to prevent STI/HIV (40%). HIV testing patterns varied, as did the motives for seeking testing. The sexual behavior of the women in this study exposed them to increased risk of STI/HIV. Although many perceived that they were using sexual risk reduction strategies, these strategies were not scientifically sound risk reduction strategies. Consequently, their exposure to STI/HIV continued as they used ineffective strategies both in assessing partner risk and in implementing risk reduction behaviors.     

Factors associated with the use of court bypass by minors to obtain abortions

Interviews with minors at four Minnesota abortion clinics revealed that 43 percent used the court bypass option that is part of that state's parental notification statute. The proportion who did so increased with age and was most common among lower socioeconomic groups. A discriminant function analysis showed that perceived maternal supportiveness was a key difference between those who went to court and those who notified their parents. Young women who attended religious services frequently were less likely than those who did not tell their parents of their abortion plans. Minors who notified only one parent--and still had to go to court under Minnesota law, which requires notification of both parents--were more likely than those who told neither to come from a single-parent household and to have good communication with their mother.     

Family dysfunction and Native American women who do not seek prenatal care

OBJECTIVE: To test the hypotheses that, in a health system with few external barriers to care, women with no prenatal care (NPC) have higher rates of nuclear family dysfunction and disproportionate amounts of adverse neonatal outcomes compared with women with prenatal care. DESIGN: Case-control study. SETTING: Indian Health Service system. PATIENTS: Nuclear families of women not seeking prenatal care compared with those who did seek prenatal care. MAIN OUTCOME MEASURES: Dysfunctional outcome measures in nuclear families were children adopted, placed, or under protective surveillance; mothers denying pregnancy, being abused, or attempting suicide; and parents with alcoholism. Neonatal outcome measures were low birth weight and neonatal intensive care days. RESULTS: Dysfunctional markers occurred significantly more frequently in families of women with NPC than in families of women with prenatal care (57% of NPC and 12% of control families; McNemar odds ratio, 14; 95% confidence interval, 4.7-41.6). Neonatal outcome in this Native American population showed that women with NPC had only 2.6% (58/2222) of the total births but accounted for 11% of the low-birth-weight infants (< 2500 g), 18% of the very-low-birth-weight infants (< 1500 g), and 24% of the level II and 41% of the level III newborn intensive care days. CONCLUSIONS: Women not seeking prenatal care in a system with few external barriers to care have significantly more family dysfunction (P < .001) than women seeking prenatal care. Infants of women with NPC generated a disproportionate amount of adverse neonatal outcome. The combination of NPC and family dysfunction was more predictive of adverse neonatal outcome than was NPC alone.     

Spontaneous abortions among women working in the pharmaceutical industry

A register based study was conducted on the pregnancy outcome of female workers in eight Finnish pharmaceutical factories to determine whether they had a higher risk of spontaneous abortion than the general population or matched controls. Information about all female workers who had been employed in the factories during the years 1973 or 1975 (four factories) to 1980 was obtained from the employers. The workers' pregnancy data were collected from the nation wide hospital discharge register and polyclinic data of hospitals from 1973 to 1981. The total number of 1795 pregnancies included 1179 deliveries, 142 spontaneous abortions, and 474 induced abortions. The spontaneous abortion rate (the number of spontaneous abortions X 100, divided by the number of spontaneous abortions plus the number of births) during employment was 10.9% and before/after employment 10.6%. The rate for all the women in the corresponding central hospital districts was 11.3% [corrected] during the study period. A case-control study was also carried out in which the cases were 44 women who had a spontaneous abortion during employment in the pharmaceutical factory. Three age matched female pharmaceutical factory workers who had given birth to a child were chosen as controls for every case. The information about occupational exposures was collected from questionnaires completed by the occupational physician or nurse at the factory. The response rate was 93%. Exposure to chemicals was more common among the cases than among the controls. For methylene chloride, a solvent commonly used in the pharmaceutical industry, the increase in odds ratio of borderline significance (odds ratio 2.3, p = 0.06). In a logistic regression model (which included oestrogen exposure, solvent exposure frequency of the usage, and heavy lifting) the odds ratio was increased for oestrogens (odds ratio 4.2, p = 0.05) and for continuous heavy lifting (odds ratio 5.7, p = 0.02). The odds ratio for spontaneous abortions was greater among those exposed to four or more solvents (odds ratio 3.5, p=0.05) than among those exposed to one to three solvents (odds ration 0.8, p=0.74).     

Spontaneous abortions among women employed in the plastics industry

A matched case-control study was done to analyze whether certain occupational exposures in the plastics industry were related to the risk of spontaneous abortions. Information on spontaneous abortions (cases) and births (controls) was obtained from the hospital discharge register; data on occupational exposures were obtained from the occupational health services of the workplaces. No increased risk of spontaneous abortions was observed among workers processing polymerized plastics or heated plastics made of vinyl chloride or of styrene. Owing to the low statistical power of the study, only strong effects can be ruled out. The odds ratio for workers actually processing polyurethane was increased (1.9, not statistically significant), and that for all workers in polyurethane-processing factories was significantly increased (3.0, p = 0.02). The finding needs to be investigated further in future studies.     

Characteristics of women with recurrent spontaneous abortions and women with favorable reproductive histories.

Women with a history of recurrent spontaneous abortions (repeaters) are compared with women who have had live births and no spontaneous abortions (multiparae) and women who have had live births and only one spontaneous abortion (sporadics) to identify characteristics of the women and their abortuses that might predict subsequent fetal loss. A number of risk factors for recurrent spontaneous abortion have been identified: the loss of a chromosomally normal conception, loss after the first trimester of pregnancy, a delay in conceiving prior to the study pregnancy, a diagnosis of cervical incompetence, and a history of very low birthweight deliveries. The odds ratios associated with being a repeater vary from 1.4 to 5.6 depending on the number of characteristics present.     

The cancer screening project for women: experiences of women who partner with women and women who partner with men

The Cancer Screening Project for Women is a study about the experiences of legally unmarried women with breast, cervical, and colorectal cancer screening. During the initial phase of the study, we conducted focus groups to explore factors that influence unmarried women's decisions about cancer screenings. Women were invited to attend one of four group discussions: (1) never married women who either partner with women (WPW) or with both women and men (WPWM), (2) previously married women who now partner either with women (WPW) or with both women and men (WPWM), (3) never married women who partner with men (WPM), and (4) previously married women who partner with men (WPM). Twenty-eight women attended the focus groups, 14 WPW and 14 WPM. Several barriers to screening were consistent across the groups and included lack of acknowledgement and validation in medical settings, administrative barriers, pain, and concerns about body image. WPW specifically discussed fears about discrimination if and when they acknowledge their sexual orientation. WPW also described how women who express their gender androgynously are more likely to avoid health care facilities. Further studies are needed to determine if the themes we identified are consistent among larger samples of unmarried women.     

Spontaneous abortions among women working in the pharmaceutical industry.

A register based study was conducted on the pregnancy outcome of female workers in eight Finnish pharmaceutical factories to determine whether they had a higher risk of spontaneous abortion than the general population or matched controls. Information about all female workers who had been employed in the factories during the years 1973 or 1975 (four factories) to 1980 was obtained from the employers. The workers' pregnancy data were collected from the nation wide hospital discharge register and polyclinic data of hospitals from 1973 to 1981. The total number of 1795 pregnancies included 1179 deliveries, 142 spontaneous abortions, and 474 induced abortions. The spontaneous abortion rate (the number of spontaneous abortions X 100, divided by the number of spontaneous abortions plus the number of births) during employment was 10.9% and before/after employment 10.6%. The rate for all the women in the corresponding central hospital districts was 11.3% [corrected] during the study period. A case-control study was also carried out in which the cases were 44 women who had a spontaneous abortion during employment in the pharmaceutical factory. Three age matched female pharmaceutical factory workers who had given birth to a child were chosen as controls for every case. The information about occupational exposures was collected from questionnaires completed by the occupational physician or nurse at the factory. The response rate was 93%. Exposure to chemicals was more common among the cases than among the controls. For methylene chloride, a solvent commonly used in the pharmaceutical industry, the increase in odds ratio of borderline significance (odds ratio 2.3, p = 0.06). In a logistic regression model (which included oestrogen exposure, solvent exposure frequency of the usage, and heavy lifting) the odds ratio was increased for oestrogens (odds ratio 4.2, p = 0.05) and for continuous heavy lifting (odds ratio 5.7, p = 0.02). The odds ratio for spontaneous abortions was greater among those exposed to four or more solvents (odds ratio 3.5, p=0.05) than among those exposed to one to three solvents (odds ration 0.8, p=0.74).