Repeat aborters ? First aborters, a social-psychiatric comparison

Repeat abortion: a qualitative study

In a qualitative study of 20 women seeking a repeat abortion, interviews lasting for 1.5-2 hours were conducted after the first appointment with a gynecologist when the abortion was planned. The women were aged 20-29 years and had experienced one to five abortion(s) during the previous 5 years. The aim of the study was to attain understanding of the phenomenon of repeat abortion. The women were asked to express their thoughts related to their situation and their choices. The following categories were found: psychosocial background factors, reactions to previous abortion(s), reflections on fertility, sexuality, psychological factors, social factors, contraceptive use, the present pregnancy, motives for the planned abortion, feelings about the planned abortion and risk-taking process. Most of the women seemed to have a psychological vulnerability with many current and previous problems, as well as problems regarding sexuality. It was evident that insecurity was present in the use of contraceptives and in relation to sexual activities and to sexual partners. The main reason for an unplanned pregnancy is not a lack of information or even a lack of knowledge, but rather a failure to integrate the knowledge with situational, intrapsychic and social factors.

Multiple induced abortions: Danish experience

Experience with 50 first time aborters, 50 second time aborters, and 50 third time aborters residing in an urban area of Copenhagen suggests that women having a repeat abortion are more similar than dissimilar to women having a first induced abortion. There were no differences in socioeconomic status, educational level, or stated reasons for choosing abortion (usually socioeconomic and family considerations). Though similar to first and second time aborters in their life situations and greater contraceptive risk-taking, third timers seemed to become pregnant more readily. They were also less willing to be interviewed. Related studies and suggestions for postabortion counseling are discussed.

Repeat abortion: a comparative study

In a study of 404 women (simple random sample) 20-29 years of age, 201 women (group A) applying for abortion and 203 women (group B) continuing their pregnancies were given a questionnaire and were also interviewed. The aim of the study was to describe women applying for repeat abortion and to compare them with women having their first abortion and with women continuing their pregnancies. Variables measured were socio-economic, psychological and social problems, relationship with the partner, earlier pregnancies, how the present pregnancy was experienced and decision-making. For presentation of the results, the data have been divided into four subgroups: pregnant women applying for their first abortion (A1, n = 137), women applying for repeat abortion (A2, n = 64), women continuing their pregnancies who have never applied for abortion (B1, n = 142), and women continuing their pregnancies who had previously applied for one or more abortions (B2, n = 58). Women who had had previous abortion/abortions had experienced more psychological problems during their lifetime than the other groups studied. They had more contact with the social welfare service and evaluated their relationship with the partner as less harmonious than women having a first abortion, also in comparison with women continuing their pregnancies with no earlier applications for abortion. Women who have had previous abortion/abortions seem to have a need for special attention. This involves not only being provided with efficient and acceptable contraception, but also with social and psychological support based on the experiences of the women.

Research on repeated abortion: state of the field: 1973-1979

In January of 1973, the United States Supreme Court ruled in favor of abortion being the decision between a woman and her physician. During 1973 only 12% of all abortions performed were repetitions; in 1979 this rate climbed to 23%. A careful review of the literature indicates that the rates of repeated abortion in this country are approaching the “epidemic recidivism” rates found in Asian and European nations. Up to this point, the research on such recidivism has concentrated almost entirely on demographic features. This approach has contributed very little to identifying the repeated aborter before the fact. The present paper includes an extensive review of the current research conducted in a number of countries. Comparisons of repeated aborters shed some light on primary reasons for repeated abortions, such as failure of method of birth control, personal failure at applications, and abortion as a method of contraception. The paper examined the methodological and data collection problems in current demographic studies. Suggestions for a more productive approach are mentioned.

Repeat induced abortion: single, married and divorced women

This examination of the effects of marital status on repeat abortion assesses, by multiple classification analysis, the importance of a set of predictors of repeat abortion (age, education, occupation, residence, religion, social support for the abortion, attitudes towards abortion, ambivalence to the abortion, source of idea of the abortion, referral source, contraceptive use) in a clinic sample of 984 single, married and divorced women. The different results for the three categories of women demonstrate the centrality of man–woman relations for an understanding of repeat abortion behaviour, and the need to orient future work on repeat abortion away from a predominant concern with contraception. Abortion can be understood only in terms of the cultural values and social practices which regulate different couple relations.

Contraceptive practice and repeat induced abortion: an epidemiological investigation

The relationship between abortion experience and contraceptive practice is examined among women having a first or repeat induced abortion at the same clinic(n=443 in each group). A previous abortion was the single most important predictor of past contraceptive practices and of contraception at the conception of the pregnancy being terminated. A previous abortion was associated with greater use of all methods of contraception among women not on welfare (P < 0·001). During the 18–month study the proportion of patients who had had previous abortions rose from 13·3% to 21·1%, and those undergoing repeat abortions appeared increasingly likely to be on welfare. Contraceptive practies did not change over time except for women on welfare having repeat abortions who became less likely to have used contraception at the time of conception (p < 0·05). While the experience of abortion is generally associated with improved contraceptive practice, many women in this population, particularly those on welfare, appear to remain exposed to unprotected coitus and subsequent repeat abortion.

Third time unlucky: a study of women who have three or more legal abortions

Of 50 women who were having their third or subsequent legal abortion, 23 were pregnant because their contraceptive method had failed, 24 because of erratic contraceptive use, and three had changed their mind about an initially welcome pregnancy. There was a significant relationship between erratic use and a history of medical consultation for psychiatric reasons, and a suggestion that unsettled relationships and low educational status are also related to erratic use.

Inappropriate contraceptive advice was an important factor in several cases. Since the perfect contraceptive does not exist, and since some people are more unlucky than others, repeated abortion cannot be eliminated, but it may be reduced by giving especially careful contraceptive advice to those who are clearly at risk.

There is no evidence that abortion is being deliberately used as a method of birth control.