Elsevier

Contraception

Volume 85, Issue 4, April 2012, Pages 408-412
Contraception

Original research article
A need to expand our thinking about “repeat” abortions

https://doi.org/10.1016/j.contraception.2011.09.003Get rights and content

Abstract

Background

Women who have more than one abortion are often the “targets” for social and clinical interventions geared at preventing “repeat abortions.” Such an approach ignores the unique circumstances that may surround each abortion.

Study Design

We qualitatively analyzed the history of 10 women who have had more than one abortion who were participating in a larger study of women's emotional experiences following abortion. Women were recruited following their initial contact with a postabortion support talk line and from a previously completed study.

Results

Overall, women in the sample reported that each abortion was different and some abortions were more emotionally difficult than others, suggesting that the phrase “repeat” can be a misnomer and discounts the unique circumstances surrounding each abortion.

Conclusion

Rather than use the term “repeat abortions,” we advocate for the use of the less loaded term “multiple abortions,” in which each abortion is understood as a unique experience.

Introduction

Half of all induced abortions in the United States occur in women who have had a prior induced abortion [1]. Seeking to understand this statistic, several demographic studies have been conducted over the years to identify which women have repeat abortions, often with the goal of identifying who needs to be targeted for interventions [1], [2], [3], [4]. Consequently, reducing the rate of repeat abortion is an often-stated aim of recent studies of postabortion contraception [5], [6], [7], [8], and reproductive health advocates use the potential to reduce repeat abortion as a justification for policies that support access to contraception [9]. Inside the abortion clinic, the idea that women are “repeaters” creates a sense that these women need less counseling or support about the abortion itself and staff should give greater attention to these women's contraceptive practices. Women's behaviors, and thus their experiences, are seen as repeated; they are duplications, do-overs that need a contraceptive fix. To date, research has not qualitatively examined the experiences of women obtaining more than one abortion to ascertain the extent to which they indeed experience those abortions similarly.

To test the assumption that “repeat” abortions are experienced as duplications of the first abortion, we consider here interview data gathered as part of a study of the landscape of emotions women experience following an abortion. In contrast to focusing on the contraceptive or sexual behavior of women as the unit of interest, this paper focuses on the abortion itself. The data from our study suggest that some abortions can be more emotionally difficult than others, and that difficulty may not be due to the repetitive nature of the abortion experience, but rather to the unique circumstances surrounding a given abortion.

Section snippets

Materials and methods

Between March and August 2009, 21 women were interviewed about their abortion experiences. To be eligible, potential respondents had to be over 18 years of age and English speaking. Respondents were recruited in two ways. First, we partnered with two abortion support talk lines that were not religiously affiliated. Volunteer counselors from the talk lines informed eligible callers about the study. A total of 31 callers were referred. Second, we solicited participants from a previously completed

Results

Demographically, respondents were fairly diverse. Five women were white, three were Asian/Pacific Islander, one was Latina, and one was African–American. They ranged in age from 21 to 47 years: three were in their 20s, five were in their 30s and two were in their 40s at the time of the interview. Because interviews were conducted by phone, respondents were not restricted to a single geographical area. Three respondents were from the Northeast, and seven were from the West Coast.

Overall, women

Discussion

Research on women and mental health continues to demonstrate that most women cope well following an abortion [10]. Such results have led us to focus the unit of attention on the women who have abortions rather than on the context of the abortion itself. Thus, society tends to think that abortion is more or less hard for individual women. Data from this study suggest that at least some women experience their abortions as distinct events and that their emotional needs likely differ based on the

Conclusion

In a recent editorial, William Saletan, a columnist for Slate magazine and a frequent commentator on the abortion issue, wrote that the Pro-Choice Movement should “target repeaters,” arguing that the cavalier approach of these women to the use of abortion contributes to society's social conflict over the issue. He states, “One unintended pregnancy should be enough to warn you — and the doctor who vacuums out your uterus — not to risk another” [14]. He is not alone in this belief, and just a

Acknowledgments

This study was supported by a grant from the Ford Foundation. The authors thank Deb Karasek, M.P.H.; Kate Cockrill, M.P.H.; and Kira Foster, Ph.D., for their assistance with data collection.

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