Advertisement

Abortion Underreporting in Add Health: Findings and Implications

  • Katherine I. TierneyEmail author
Article
First Online:

Abstract

Well-documented, large-scale abortion underreporting on U.S. surveys raises questions about the use of abortion self-reports for statistical inference. This paper is the first to evaluate the completeness of the abortion data in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Comparisons of Add Health’s estimated abortion rates to external sources show that the Add Health data capture 35% of expected abortions. Thus, Add Health performed no better than other surveys in collecting abortion data. Further, no differences in underreporting by race/ethnicity or age at abortion were found. We suggest that the current U.S. social environment generates high levels of abortion stigma, which yields abortion underreporting. We conclude that due to underreporting, survey self-reports of abortion need to be evaluated, contextualized, and used with caution.

Keywords

Abortion Measurement Add Health Data quality 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgements

The author wishes to thank Kathleen Mullan Harris and S. Philip Morgan for their helpful and thoughtful feedback and comments on this paper. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship under Grant No. DGE-1,650,116. Any opinion, findings, and conclusions or recommendations expressed in this material are those of the author and do not necessarily reflect the views of the National Science Foundation. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis. Note: Use of this acknowledgment requires no further permission from the persons named. This paper uses data from NCHS. Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of NCHS, which is responsible only for the initial data.

Supplementary material

11113_2019_9511_MOESM1_ESM.docx (89 kb)
Supplementary material 1 (DOCX 88 kb)

References

  1. Allison, P. D. (2000). Multiple imputation for missing data: A cautionary tale. Sociological Methods & Research, 28(3), 301–309.CrossRefGoogle Scholar
  2. Astbury-Ward, E., Parry, O., & Carnwell, R. (2012). Stigma, abortion, and disclosure—Findings from a qualitative study. The Journal of Sexual Medicine, 9(12), 3137–3147.CrossRefGoogle Scholar
  3. Brownstein, N., Kalsbeek, W. D., Tabor, J., Entzel, P., Daza, E., & Harris, K. M. (2010). Non-response in wave IV of the National Longitudinal Study of Adolescent Health. Chapel Hill, NC: Carolina Population Center.Google Scholar
  4. Chantala, K., Kalsbeek, W. D., & Andraca, E. (2005). Non-response in wave II of the Add Health study. Chapel Hill, NC: Carolina Population Center.Google Scholar
  5. Cockrill, K., Upadhyay, U. D., Turan, J., & Foster, D. G. (2013). The stigma of having an abortion: Development of a scale and characteristics of women experiencing abortion stigma. Perspectives on Sexual and Reproductive Health, 45(2), 79–88.CrossRefGoogle Scholar
  6. Coutts, E., & Jann, B. (2011). Sensitive questions in online surveys: Experimental results for the randomized response technique (RRT) and the unmatched count technique (UCT). Sociological Methods & Research, 40(1), 169–193.CrossRefGoogle Scholar
  7. Fu, H., Darroch, J. E., Henshaw, S. K., & Kolb, E. (1998). Measuring the extent of abortion underreporting in the 1995 national survey of family growth. Family Planning Perspectives, 30(3), 128–138.CrossRefGoogle Scholar
  8. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York: Simon and Schuster.Google Scholar
  9. Grossman, D. (2017). Sexual and reproductive health under the trump presidency: Policy change threatens women in the USA and worldwide. Journal of Family Planning and Reproductive Health Care, 43(2), 89–91.CrossRefGoogle Scholar
  10. Groves, R. M. (2006). Nonresponse rates and nonresponse bias in household surveys. Public Opinion Quarterly, 70(5), 646–675.CrossRefGoogle Scholar
  11. Guttmacher Institute. (2015). Abortion patient survey 2008 (APS). Guttmacher center for population research and innovation and dissemination. https://www.guttmacher.org/population-center/dataset/2008-abortion-patient-survey-aps.
  12. Hanschmidt, F., Linde, K., Hilbert, A., Riedel-Heller, S. G., & Kersting, A. (2016). Abortion stigma: A systematic review. Perspectives on Sexual and Reproductive Health, 48, 169–177.CrossRefGoogle Scholar
  13. Harris, K. M. (2009). The National Longitudinal Study of Adolescent to Adult Health (Add Health), waves I & II, 1994–1996; wave III, 2001–2002; wave IV, 2007-2009 [machine readable data file and documentation]. Chapel Hill: Carolina Population Center, University of North Carolina.Google Scholar
  14. Harris, K. M. (2010). An integrative approach to health. Demography, 47(1), 1–22.CrossRefGoogle Scholar
  15. Harris, K. M. (2013). The Add Health study: Design and accomplishments. Page. Chapel Hill, NC: Carolina Population Center.Google Scholar
  16. Henshaw, S. K. (1995). 2000-01 national survey of contraception use among women having abortions (data set R3, McKean, E.A., J.J.). [machine-readable data file and documentation]. New York: The Alan Guttmacher Institute (Producer). Los Altos, CA: Sociometrics Corporation, Data Archive on Adolescent Pregnancy and Pregnancy Prevention (Producer & Distributer).Google Scholar
  17. Henshaw, S. K., & Kost, K. (2008). Trends in the characteristics of women obtaining abortions, 1974 to 2004. New York: Guttmacher Institute.Google Scholar
  18. Jagannathan, R. (2001). Relying on surveys to understand abortion behavior: Some cautionary evidence. American Journal of Public Health, 91(11), 1825–1831.CrossRefGoogle Scholar
  19. Jerman, J., & Jones, R. K. (2014). Secondary measures of access to abortion services in the United States, 2011 and 2012: gestational age limits, cost, and harassment. Women’s Health Issues, 24(4), e419–e424.CrossRefGoogle Scholar
  20. Jerman, J., Jones, R. K., & Onda, T. (2016). Characteristics of U.S. abortion patients in 2014 and changes since 2008. New York: Guttmacher Institute.Google Scholar
  21. Jones, R. K. (2008). 2008 survey of abortion patients. [Machine-readable data file and documentation]. New York: The Alan Guttmacher Institute.Google Scholar
  22. Jones, R. K. (2011). How commonly do US abortion patients report attempts to self-induce? American Journal of Obstetrics and Gynecology, 204(1), 23.e1–23.e4.CrossRefGoogle Scholar
  23. Jones, R., Darroch, J. E., & Henshaw, S. K. (2004). 2000-01 national survey of contraception use among women having abortions (data set R3, McKean, E.A., J.J.) [machine-readable data file and documentation]. New York: The Alan Guttmacher Institute (Producer). Los Altos, CA: Sociometrics Corporation, Data Archive on Adolescent Pregnancy and Pregnancy Prevention (Producer & Distributer).Google Scholar
  24. Jones, E. F., & Forrest, J. D. (1992). Underreporting of abortion in surveys of U.S. women: 1976 to 1988. Demography, 29(1), 113–126.CrossRefGoogle Scholar
  25. Jones, R. K., & Finer, L. B. (2012). Who has second-trimester abortions in the United States? Contraception, 85(6), 544–551.CrossRefGoogle Scholar
  26. Jones, R. K., & Kavanaugh, M. L. (2011). Changes in abortion rates between 2000 and 2008 and lifetime incidence of abortion. Obstetrics and Gynecology, 117(6), 1358–1366.CrossRefGoogle Scholar
  27. Jones, R. K., & Kost, K. (2007). Underreporting of induced and spontaneous abortion in the United States: An analysis of the 2002 national survey of family growth. Studies in Family Planning, 38(3), 187–197.CrossRefGoogle Scholar
  28. Kalsbeek, W. D., Morris, C. B., & Vaughn, B. J. (2001). Effects of nonresponse on the mean squared error of estimates from a longitudinal study. In Annual meeting of the American statistical association.Google Scholar
  29. Kalsbeek, W. D., Yang, J., & Agans, R. P. (2002). Predictors of nonresponse in a longitudinal survey of adoelscents. In Survey research methods section of the American Statistical Association (pp. 1740–45). Alexandria, VA: American Statistical Association.Google Scholar
  30. Kumar, A. (2013). Everything is not abortion stigma. Women’s Health Issues, 23(6), e329–e331.CrossRefGoogle Scholar
  31. Kumar, A., Hessini, L., & Mitchell, Ellen. M. H. (2009). Conceptualising abortion stigma. Culture, Health & Sexuality, 11(6), 625–639.CrossRefGoogle Scholar
  32. Lara, D., Strickler, J., Olavarrieta, C. D., & Ellertson, C. (2004). Measuring induced abortion in Mexico a comparison of four methodologies. Sociological Methods & Research, 32(4), 529–558.CrossRefGoogle Scholar
  33. Lindberg, L., & Scott, R. H. (2018). Effect of ACASI on reporting of abortion and other pregnancy outcomes in the US national survey of family growth. Studies in Family Planning.  https://doi.org/10.1111/sifp.12068.Google Scholar
  34. Little, Roderick. J. A., & Rubin, D. B. (2014). Statistical analysis with missing data. New York: Wiley.Google Scholar
  35. Mercer, A. W., Kreuter, F., Keeter, S., & Stuart, E. A. (2017). Theory and practice in nonprobability surveys: parallels between causal inference and survey inference. Public Opinion Quarterly, 81(S1), 250–271.CrossRefGoogle Scholar
  36. Nash, E., Gold, R. B., Rathbun, G., & Vierboom, Y. (2015). Laws affecting reproductive health and rights: 2014 state policy review. Guttmacher Institute. Retrieved January 22, 2017, from https://www.guttmacher.org/laws-affecting-reproductive-health-and-rights-2014-state-policy-review.
  37. Norris, A., Bessett, D., Steinberg, J. R., Kavanaugh, M. L., De Zordo, S., & Becker, D. (2011). Abortion stigma: A reconceptualization of constituents, causes, and consequences. Women’s Health Issues, 21(3), S49–S54.CrossRefGoogle Scholar
  38. Rasch, V., Muhammad, H., Urassa, E., & Bergström, S. (2000). Self-reports of induced abortion: An empathetic setting can improve the quality of data. American Journal of Public Health, 90(7), 1141–1144.CrossRefGoogle Scholar
  39. Shellenberg, K. M., Moore, A. M., Bankole, A., Juarez, F., Omideyi, A. K., Palomino, N., et al. (2011). Social stigma and disclosure about induced abortion: Results from an exploratory study. Global Public Health, 6(sup1), S111–S125.CrossRefGoogle Scholar
  40. Tennekoon, V. (2017). Counting unreported abortions: A binomial-thinned zero-inflated Poisson model. Demographic Research, 36(2), 41–72.CrossRefGoogle Scholar
  41. Udry, R. J., Gaughan, M., Schwingl, P. J., & van den Berg, B. J. (1996). A medical record linkage analysis of abortion underreporting. Family Planning Perspectives, 28(5), 228–231.CrossRefGoogle Scholar
  42. United States Census Bureau. (2016). International data base: Mid-year population by single year age groups—Custom region—United States. Retrieved January 2, 2017, from https://www.census.gov/data-tools/demo/idb/informationGateway.php.
  43. United States Department of Health and Human Services, Centers for Disease Control and Prevention, and National Center for Health Statistics. (2018). Bridged-race population estimates, United States July 1st resident population by state, county, age, sex, bridged-race, and hispanic origin. compiled from 1990–1999 bridged-race intercensal population estimates (released by NCHS on 7/26/2004); revised bridged-race 2000–2009 intercensal population estimates (released by NCHS on 10/26/2012); and bridged-race vintage 2017 (2010–2017) postcensal population estimates (released by NCHS on 6/27/2018).Google Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of SociologyUniversity of North Carolina at Chapel HillChapel HillUSA

Personalised recommendations

Cite article

Buy options