Abortion regret: An effect of social circumstances?

photo of abortion protestersIn the last decade or so, there has been increasing attention to the claim that women regret their abortions. Individual women have come forward with stories of the emotional hardship they experienced following an abortion, scholars have sought to quantify the breadth of this experience by analyzing national datasets, and even Supreme Court justices have stated their tacit acceptance of the likelihood—if not inevitability—of abortion regret. As scholars, activists, policy-makers, providers, and the general public continue to debate the existence of abortion regret, there are several important questions related to this issue that we at ANSIRH have taken up.

In this blog, I want to complicate some of the general thinking about abortion regret by framing abortion in its social context. Much of the debate about abortion regret has focused on simplistic assessments of mental health, emotions, and abortion: regret is framed as either permanent or avoided; women’s mental health is either good or bad following the procedure; abortion causes either harm or relief.

But abortion is a complex part of the social landscape, and we serve women best when we think about how this medical procedure is contextualized in their daily lives in richer terms. And if we’re going to understand the emotional impacts of abortion on women, we need to recognize that abortion is not simply a procedure; it is surrounded by a complex set of social interactions. In some cases, those interactions can lead to women experiencing emotional difficulty.

In an article recently published in Perspectives on Sexual and Reproductive Health, my co-authors and I offer evidence for the importance of thinking about abortion in its social context. This article comes out of a project that interviewed 21 women we anticipated had experienced some form of emotional difficulty following their abortion. We conducted interviews over the phone, affording respondents privacy and encouraging them to candidly share their stories. And they did. Respondents told deeply personal stories of their lives, their choices, and their emotional experiences. I describe some of our salient findings below.

The low prevalence of negative emotional outcomes following abortion

But first, it’s important to start out by emphasizing that the best quantitative data show that most women do not experience negative emotions following abortion. A thorough review of the literature by the American Psychological Association’s Task Force on Abortion and Mental Health demonstrates this definitively.

But just as there are a variety of emotional responses to life’s experiences, great and small, so too is there variation in women’s emotional experience of abortion. Simply put, some women do experience emotional difficulty following an abortion.

In qualitatively analyzing the stories of the women we interviewed, we were able to hone in on some of the sources of that emotional difficulty. And we found that, for many women, emotional difficulty comes from social sources. The women in our study did not have pre-existing mental health difficulties, medical complications, or related difficulties with the actual abortion procedure. Nor did they necessarily think the abortion was the wrong choice. Nonetheless, in the time following their abortion (which ranged from a few days to over 20 years), these women experienced negative emotions—and those emotions owed largely to the social circumstances of their abortion experience.

Making her own decision

The first major theme across the interviews was that women wanted the abortion decision to be their own: they wanted to be the one to choose. For anyone familiar with the prochoice movement’s slogans, this seems like a no-brainer. When these women told their stories in detail, however, it became clear that sometimes that’s easier said than done.

For many women we talked to, making a decision about an unintended pregnancy included thinking about far more than whether or not to have an abortion: it involved thinking about their social relationships. They explained that they had to consider the circumstances they would experience if they chose to carry the pregnancy to term. How would their partner respond? Would he play a role in child-rearing? Would he financially support the child?

In several cases, the answers to these questions were not encouraging, even for those in long-term relationships (including marriage). Such responses from significant people in women’s lives left some respondents feeling not explicitly coerced, but as though the decision to have an abortion had been made for them. This feeling, in turn, made the experience emotionally difficult.

Lack of social support

The second major theme among respondents’ narratives was the story of a lack of social support following abortion. Women described having no misgivings about their abortion decision beforehand, only to encounter judgments from others afterward. It was these judgments that made their abortion emotionally difficult.

In several cases, the social support theme was even more complicated. Rather than actual experiences of social disapproval, it was the anticipated judgments of others—suggested by political comments they’d made or off-hand remarks—that led women to withhold sharing their abortion experience. This silence and secrecy had negative emotional consequences, as these women feared being found out and socially judged.

Abortion in social context

In both of these themes, women who had abortions experienced emotional difficulty. But we would be oversimplifying their stories if we attributed that difficulty to the medical procedure of abortion. Instead, these cases demonstrate the value of understanding abortion—and investigating claims of abortion regret—in social context. Often, the most regrettable parts of these women’s experiences was a faulty romantic relationship, lack of emotional support from family and friends, or the political context of U.S. abortion politics that drives so many to stay silent about abortion.

Photo courtesy of SMN, via Creative Commons license.

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