Attitudes Toward Abortion After Receiving vs. Being Denied an Abortion in the USA

  • Katie Woodruff
  • M. Antonia Biggs
  • Heather Gould
  • Diana Greene Foster
Article
First Online:

Abstract

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.

Keywords

Abortion Attitudes Public opinion Political attitudes Abortion policy 
This is a preview of subscription content, log in to check access

Notes

Acknowledgements

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

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.

References

  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. Barkan, S. E. (2014). Gender and abortion attitudes. Public Opinion Quarterly, 78(4), 940–950.  https://doi.org/10.1093/poq/nfu047.CrossRefGoogle Scholar
  7. Brehm, J. W. (1956). Postdecision changes in the desirability of alternatives. The Journal of Abnormal and Social Psychology, 52(3), 384–389.  https://doi.org/10.1037/h0041006.CrossRefGoogle Scholar
  8. Charmaz, K. (2014). Constructing grounded theory (2nd ed.). Thousand Oaks: SAGE Publications Ltd..Google Scholar
  9. Cockrill, K., & Weitz, T. A. (2010). Abortion patients’ perceptions of abortion regulation. Women’s Health Issues, 20(1), 12–19.  https://doi.org/10.1016/j.whi.2009.08.005.CrossRefPubMedGoogle Scholar
  10. Cook, E. A., Jelen, T. G., & Wilcox, C. (1993). Measuring public attitudes on abortion: methodological and substantive considerations. Family Planning Perspectives, 25(3), 118–121 145.CrossRefPubMedGoogle Scholar
  11. 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/.
  12. Creswell, J. W. (2014). Research design: Qualitative, quantitative and mixed methods approaches (4th ed.). Thousand Oaks: SAGE Publications, Inc..Google Scholar
  13. 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
  14. Entman, R. (1993). Framing: Toward clarification of a fractured paradigm. Journal of Communication, 43(4), 51–58.CrossRefGoogle Scholar
  15. Finer, L. B., Frohwirth, L. F., Dauphinee, L. A., Singh, S., & Moore, A. M. (2005). Reasons U.S. women have abortions: Quantitative and qualitative perspectives. Perspectives on Sexual and Reproductive Health, 37(3), 110–118.  https://doi.org/10.1363/3711005.CrossRefPubMedGoogle Scholar
  16. Fisher, M. S. (2011). Are Muslims distinctive? A look at the evidence. New York: Oxford University Press.CrossRefGoogle Scholar
  17. Gallup Historical Trends. (2014a). Abortion. Retrieved from http://www.gallup.com/poll/1576/abortion.aspx.
  18. Gallup Historical Trends. (2014b). Moral issues. Retrieved from http://www.gallup.com/poll/1681/moral-issues.aspx.
  19. Gerard, H. B., & White, G. L. (1983). Post-decisional reevaluation of choice alternatives. Personality and Social Psychology Bulletin, 9(3), 365–369.  https://doi.org/10.1177/0146167283093006.CrossRefGoogle Scholar
  20. Gillespie, M. W., Ten Vergert, E. M., & Kingma, J. (1988). Secular trends in abortion attitudes: 1975-1980-1985. The Journal of Psychology, 122(4), 323–341.  https://doi.org/10.1080/00223980.1988.9915520.CrossRefPubMedGoogle Scholar
  21. 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.
  22. Hans, J. D., & Kimberly, C. (2014). Abortion attitudes in context: A multidimensional vignette approach. Social Science Research, 48, 145–156.  https://doi.org/10.1016/j.ssresearch.2014.06.001.CrossRefPubMedGoogle Scholar
  23. Iyengar, S. (1991). Is anyone responsible?. University of Chicago Press. Retrieved from http://www.press.uchicago.edu/ucp/books/book/chicago/I/bo3684515.html.
  24. Jelen, T. G., & Wilcox, C. (2003). Causes and consequences of public attitudes toward abortion: A review and research agenda. Political Research Quarterly, 56(4), 489–500.CrossRefGoogle Scholar
  25. Jelen, T. G., & Wilcox, C. (2005). Continuity and change in attitudes toward abortion: Poland and the United States. Politics & Gender, 1(02), 297–317.  https://doi.org/10.1017/S1743923X05050099.CrossRefGoogle Scholar
  26. 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
  27. Jones, R. K., & Jerman, J. (2014). Abortion incidence and service availability in the United States, 2011. Perspectives on Sexual and Reproductive Health, 46(1), 3–14.  https://doi.org/10.1363/46e0414.CrossRefPubMedGoogle Scholar
  28. Jones, R. K., & Jerman, J. (2017). Population group abortion rates and lifetime incidence of abortion: United States, 2008–2014. American Journal of Public Health, 107(12), 1904–1909.  https://doi.org/10.2105/AJPH.2017.304042.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Lizotte, M.-K. (2015). The abortion attitudes paradox: Model specification and gender differences. Journal of Women, Politics and Policy, 36(1), 22–42.  https://doi.org/10.1080/1554477X.2015.985151.CrossRefGoogle Scholar
  30. 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
  31. 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.
  32. Nickerson, A., Manski, R., & Dennis, A. (2014). A qualitative investigation of low-income abortion clients’ attitudes toward public Funding for abortion. Women and Health, 54(7), 672–686.  https://doi.org/10.1080/03630242.2014.919984.CrossRefPubMedGoogle Scholar
  33. 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
  34. 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
  35. 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/.
  36. 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/.
  37. Rocca, C. H., Kimport, K., Gould, H., & Foster, D. G. (2013). Women’s emotions one week after receiving or being denied an abortion in the United States. Perspectives on Sexual and Reproductive Health, 45(3), 122–131.  https://doi.org/10.1363/4512213.CrossRefPubMedGoogle Scholar
  38. 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
  39. Saad, L. (2016). Americans’ attitudes toward abortion unchanged. Gallup. Retrieved from http://news.gallup.com/poll/191834/americans-attitudes-toward-abortion-unchanged.aspx.
  40. Scott, J. (1989). Conflicting beliefs about abortion: Legal approval and moral doubts. Social Psychology Quarterly, 52(4), 319–326.  https://doi.org/10.2307/2786995.CrossRefPubMedGoogle Scholar
  41. Sisson, G., Ralph, L., Gould, H., & Foster, D. G. (2017). Adoption decision making among women seeking abortion. Women’s Health Issues, 27, 136–144.  https://doi.org/10.1016/j.whi.2016.11.007.CrossRefPubMedGoogle Scholar
  42. 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.
  43. StataCorp LP. (2015). Stata Statistical software (version release 14). College Station: StataCorp LP.Google Scholar
  44. Svenson, O. (1992). Differentiation and consolidation theory of human decision making: A frame of reference for the study of pre- and post-decision processes. Acta Psychologica, 80(1–3), 143–168.  https://doi.org/10.1016/0001-6918(92)90044-E.CrossRefGoogle Scholar
  45. 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
  46. 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
  47. Watson, K. (2018). Scarlet a: The ethics, law, and politics of ordinary abortion (1st ed.). New York: Oxford University Press.Google Scholar
  48. Wilcox, C., & Riches, J. (2002). Pills in the Public’s mind. Women & Politics, 24(3), 61–80.  https://doi.org/10.1300/J014v24n03_04.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Public HealthUniversity of California, BerkeleyBerkeleyUSA
  2. 2.Advancing New Standards in Reproductive Health (ANSIRH)University of California, San FranciscoOaklandUSA

Personalised recommendations