Sexuality, birth control and abortion: a decision-making sequence

Abstract

SummaryA matched group of women who conceived during a 2-month period in 1971 was used to trace some parameters involved in their decision to carry their pregnancies to term or to seek an abortion.Several specific indices to the decision were considered: whether coitus was anticipated; whether the pregnancy was planned; whether birth control methods were used; and how the pregnancy ended. The effects of age, marital status, religion, reasons for the abortion or carrying the pregnancy to term, and attitude towards a possible delivery were also studied.It was found that coitus was anticipated by the majority of women, but pregnancy was unplanned for. Two-thirds of the women who did not want to become pregnant were not using a contraceptive method; yet, regardless of whether pregnancy was planned or unplanned, one of three women chose to have an abortion.Among the most common reasons for women indicating that contraceptive measures were not used were: ‘I didn't want sex to seem planned’ and ‘I thought I was in a safe period’. The decision to have an abortion usually depended upon the woman's marital status, age, religion, and previous use of birth control. Surprisingly, among women who had not planned to become pregnant, the percentage of women choosing abortion was the same from both subgroups of women who used or did not use contraception. It was also surprising that no strong relationship seemed to exist between the type of contraceptive technique used and the decision to have an abortion.Women who planned ahead to have an abortion if they became pregnant were more often using contraception; thus for these women abortion was not a primary method of family planning but a back-up for failed contraception. Women who had their babies, infrequently considered abortion as an alternative.It was predicted and found true that women who positively viewed the prospect of having a child chose to carry the pregnancy to term while those who expressed unhappiness at having a baby chose abortion. Unexpectedly, we found the overwhelming majority of women who claimed ‘I would be neither happy nor unhappy to have this baby’ chose to have an abortion. Thus a woman's so-called neutral statement regarding a desire was generally seen not to be neutral.Our use of a pregnant population of women who conceived at the same time (conception cohort) for the analysis of the decision of whether to have an abortion or carry to term, when abortion is legal, thus seemed to be feasible and practical.