Attitudes Toward Abortion After Receiving vs. Being Denied an Abortion in the USA
The US public attitudes toward abortion have been studied extensively, but little is known about these attitudes among women who seek abortion. This mixed-methods study explores women’s attitudes about abortion after receiving or being denied an abortion. Data are from the Turnaway Study, a prospective, longitudinal study of women seeking abortions at 30 US facilities. Participants presented just before a facility’s gestational limit and received abortions or just beyond the limit and were denied abortions. Using mixed effects logistic regression, we assessed 812 participants’ attitudes about abortion over 5 years. At 5 years after abortion seeking, we conducted in-depth interviews with 31 participants; this analysis includes the comments of 19 participants who discussed their abortion attitudes in those interviews. We find that 6 months after abortion seeking, nearly all women supported abortion legality in all (80%) or some (18%) situations, yet 20% also believed abortion is morally wrong. Women denied an abortion were significantly less likely to support the legal right to abortion at 6 months (62%) and 4.5 years (77%) after abortion seeking than women who had received a near-limit abortion (78 and 88%, respectively). In open-ended interviews, women expressed nuanced views, including reporting increased empathy for others facing an unwanted pregnancy. Women’s own reproductive experiences impact their views on abortion. Distinguishing between morality and legality of abortion is critical in understanding abortion attitudes.
KeywordsAbortion Attitudes Public opinion Political attitudes Abortion policy
The authors thank Rana Barar and Sandy Stonesifer for study coordination and management; Mattie Boehler-Tatman, Janine Carpenter, Undine Darney, Ivette Gomez, Selena Phipps, Brenly Rowland, Claire Schreiber, and Danielle Sinkford for conducting interviews; Michaela Ferrari, Debbie Nguyen, and Elisette Weiss for project support; and Jay Fraser and John Neuhaus for statistical and database assistance; all the participating providers for their assistance with recruitment; and all study participants. The authors also thank the anonymous reviewers for valuable comments that materially improved this work.
Compliance with Ethical Standards
All the research described in this study received ethical approval from the University of California, San Francisco Committee of Human Research, and all procedures were performed in accordance with the ethical standards of this committee.
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
- Abelson, R. P., & Levi, A. (1985). Decision making and decision theory. In G. Lindzey & E. Aronson (Eds.), Handbook of social psychology (Vol. 1, 3rd ed., pp. 231–209). New York: Random House.Google Scholar
- Adamczyk, A. (2013). The effect of personal religiosity on attitudes toward abortion, divorce, and gender equality — does cultural context make a difference? EurAmerica, 43(1), 213–253.Google Scholar
- Altshuler, A. L., Gerns Storey, H. L., & Prager, S. W. (2015). Exploring abortion attitudes of US adolescents and young adults using social media. Contraception, 91(3), 226–233. https://doi.org/10.1016/j.contraception.2014.11.009.CrossRefPubMedGoogle Scholar
- Altshuler, A. L., Ojanen-Goldsmith, A., Blumenthal, P. D., & Freedman, L. R. (2017). A good abortion experience: A qualitative exploration of women’s needs and preferences in clinical care. Social Science & Medicine, 191, 109–116. https://doi.org/10.1016/j.socscimed.2017.09.010.CrossRefGoogle Scholar
- Bane, A., Brown, L., Carter, J., Cote, C., Crider, K., de la Forest, S., Livingston, M., & Montero, D. (2003). Life and death decisions: America’s changing attitudes towards genetic engineering, genetic testing and abortion, 1972-98. International Social Work, 46(2), 209–219.CrossRefPubMedGoogle Scholar
- Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Thousand Oaks: SAGE Publications Ltd..Google Scholar
- Cox, D., Jones, R., & Gold, R. (2011). Committed to availability, conflicted about morality. Washington, DC: Public Religion Research Institute, Inc. Retrieved from https://www.prri.org/research/committed-to-availability-conflicted-about-morality-what-the-millennial-generation-tells-us-about-the-future-of-the-abortion-debate-and-the-culture-wars/.
- Creswell, J. W. (2014). Research design: Qualitative, quantitative and mixed methods approaches (4th ed.). Thousand Oaks: SAGE Publications, Inc..Google Scholar
- Dobkin, L. M., Gould, H., Barar, R. E., Ferrari, M., Weiss, E. I., & Foster, D. G. (2014). Implementing a prospective study of women seeking abortion in the United States: Understanding and overcoming barriers to recruitment. Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health, 24(1), e115–e123. https://doi.org/10.1016/j.whi.2013.10.004.CrossRefGoogle Scholar
- Gallup Historical Trends. (2014a). Abortion. Retrieved from http://www.gallup.com/poll/1576/abortion.aspx.
- Gallup Historical Trends. (2014b). Moral issues. Retrieved from http://www.gallup.com/poll/1681/moral-issues.aspx.
- Guttmacher Institute. (2018). State policies on later abortions (State Laws and Policies). New York, NY. Retrieved from https://www.guttmacher.org/state-policy/explore/state-policies-later-abortions.
- Iyengar, S. (1991). Is anyone responsible?. University of Chicago Press. Retrieved from http://www.press.uchicago.edu/ucp/books/book/chicago/I/bo3684515.html.
- 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: Official Publication of the Jacobs Institute of Women’s Health, 24(4), e419–e424. https://doi.org/10.1016/j.whi.2014.05.002.CrossRefGoogle Scholar
- McCambridge, J., Witton, J., & Elbourne, D. R. (2014). Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects. Journal of Clinical Epidemiology, 67(3), 267–277. https://doi.org/10.1016/j.jclinepi.2013.08.015.CrossRefPubMedPubMedCentralGoogle Scholar
- Newport, F., & Bird, R. (2017). On abortion, Americans discern between immoral and illegal (Americans’ views on abortion). Gallup. Retrieved from http://news.gallup.com/opinion/polling-matters/214331/abortion-americans-discern-immoral-illegal.aspx.
- 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 Supplement), S49–S54. https://doi.org/10.1016/j.whi.2011.02.010
- Pazol, K., Creanga, A. A., Burley, K. D., Hayes, B., Jamieson, D. J., & Centers for Disease Control and Prevention (CDC). (2013). Abortion surveillance—United States, 2010. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, DC: 2002), 62(8), 1–44.Google Scholar
- Pew Research Center. (2013). Majority now supports legalizing marijuana (U.S. Politics and Policy). Washington, DC. Retrieved from http://www.people-press.org/2013/04/04/majority-now-supports-legalizing-marijuana/.
- Pew Research Center. (2017). Public opinion on abortion (Religion and Public Life). Washington, DC. Retrieved from http://www.pewforum.org/2017/01/11/public-opinion-on-abortion-2/.
- Rocca, C. H., Kimport, K., Roberts, S. C. M., Gould, H., Neuhaus, J., & Foster, D. G. (2015). Decision rightness and emotional responses to abortion in the United States: A longitudinal study. PLoS One, 10(7), e0128832. https://doi.org/10.1371/journal.pone.0128832.CrossRefPubMedPubMedCentralGoogle Scholar
- Saad, L. (2016). Americans’ attitudes toward abortion unchanged. Gallup. Retrieved from http://news.gallup.com/poll/191834/americans-attitudes-toward-abortion-unchanged.aspx.
- Smith, T. W., & Son, J. (2013). Trends in public attitudes on abortion: General social survey 2012 final report. NORC at the University of Chicago. Retrieved from http://www.norc.org/PDFs/GSS%20Reports/Trends%20in%20Attitudes%20About%20Abortion_Final.pdf.
- StataCorp LP. (2015). Stata Statistical software (version release 14). College Station: StataCorp LP.Google Scholar
- Thomas, R. G., Norris, A. H., & Gallo, M. F. (2017). Anti-legal attitude toward abortion among abortion patients in the United States. Contraception, 96(5), 357–364. https://doi.org/10.1016/j.contraception.2017.07.166.CrossRefPubMedGoogle Scholar
- Wall, S. N., Frieze, I. H., Ferligoj, A., Jarošová, E., Pauknerová, D., Horvat, J., & Šarlija, N. (1999). Gender role and religion as predictors of attitude toward abortion in Croatia, Slovenia, the Czech Republic, and the United States. Journal of Cross-Cultural Psychology, 30(4), 443–465. https://doi.org/10.1177/0022022199030004004.CrossRefGoogle Scholar
- Watson, K. (2018). Scarlet a: The ethics, law, and politics of ordinary abortion (1st ed.). New York: Oxford University Press.Google Scholar