Psychological Reporrs, 1975, 37, 1143-1146.

@ Psychological Reports 1975

THERAPEUTIC ABORTION I N A MIDWESTERN CITY LESLIE MELAMED1,' Wright State University Summary.-A questionnaire was administered to 188 women undcrgo~ng therapeutic abortions in the first trimester of their pregnancy. Results showed the women to be younger than average, mainly unmarried, and representing all cross sections of the population. The women showed little knowledge of their own fertility and sparse use of birth control devices. T h e implications of these and other results are discussed.

The legalization of abortion in the United States has led to the opening of abortion clinics in a large number of cities, and a removal of some of the secrecy surrounding therapeutic abortions. The opening of one such clinic in a midwestern city provided an opportunity to investigate some demographic and behavioral characteristics of those who undergo abortions. A number of recent studies (Bracken, et al., 1973; Harris, et al., 1973; Pakter, et al., 1973; Kaltreider, 1973; Smith, 1973; Osofsky & Osofsky, 1972; Athenasiou, e$ al., 1973; Martin, 1973) have investigated, among others, factors such as the use of birth control devices, the relationship with the man responsible, reasons for having the abortion, the number of previous pregnancies and the demographic characteristics of those having abortions. Recent reviews of some of the results may be found in Osofsky and Osofsky (1972) and in David (1973). N o theoretical underpinning was assumed for the present study in that the efforts simply provided empirical data about an important social phenomenon in a new geographical area.

METHOD The subjects were 188 women who had had a therapeutic abortion in an abortion clinic in a midwestern city. The questionnaire used in the study was given to the patients by a nurse between 1 and 2 hr. after they had had the abortion and while they were resting in the recovery room. Respondents were asked to fill out the questionnaires anonymously and to place the completed questionnaires in a receptacle provided. Only one woman who was given the questionnaire refused to answer it, so that responses were available from 187 respondents. The questionnaire contained both forced-choice and open-ended questions. Included were questions designed to gather demographic information, open-ended questions about menstrual cycle length, times of maximum and minimum fertility, and questions about feelings about the abortion and the man responsible. 'The author wishes to thank: Ann Martin and Mary Sakash for their advice and assistance in all phases of the study; Herbert Colle, Ira Fritz, Martin Moss, Richard Page and Richard Vestewig for their comments o n earlier drafts of this manuscript, and Sara Melamed for her assistance in the preparation of this manuscript. 3lequests for reprints should be addressed to the author at the Psychology Department, Wright State University, Dayton, Ohio 45431.

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An additional variable was generated by combining and recoding responses to a few questions, an estimate of the interval of maximum fertility in the cycle, from respondents' answers to the question about cycle length (Katchadourian & Lunde, 1972). This variable provided an index of the respondent's knowledge of her own fertility cycle. In cases where no cycle length, or a cycle length of fewer than 12 days was given, the cycle length was assumed to be 28 days. If a respondent's answer to the question of maximum fertility lay in the estimated fertile interval, and if her answer to the question about minimum fertility lay outside of this interval, then she was scored as having some knowledge of her own fertility cycle, otherwise as not having knowledge.

RESULTSAND DISCUSSION The answers to the questions were coded and the results tabulated. The 'X (Hayes, 1973) was the primary statistical test used, both for comparison of frequencies with theoretical data and for tests of the relationship between variables. N o ~"alues are presented or considered as significant unless they are significant at the .05 level. All missing responses were excluded from consideration, so that the total number of observations varied slightly from question to question. To facilitate comprehension, all scores are represented as percentages although the statistics were calculated from raw frequencies. Table 1 presents the demographic characteristics of the sample. From these one can see that the modal patient is white, presently unmarried, under 25 yr. of age, Protestant, whose mother is a housewife and father is of a low socioTABLE 1

DEMOGRAPHIC CHARACTERISTICS Age (yr.) Under 17 17 to 20 21 to 25 26 to 30 31 to 35 Over 35 Marital Status ( f ) Single Married Divorced Widowed Separated Level

OF

THOSEUNDERGOINGABORTIONS White Black

Race

(f

84.2 15.8

Religion Catholic Protestant Jewish Moslem Other Occupation Own

18.8 76.4 1.4 0.7 2.8

+

Mother's

Father's

Low Status 32.6 26.0 53.4 25.6 20.1 46.6 High Status Housewife 18.0 46.1 23.8 7.8 Student +Socio-economic status was based on Reis's (1961) classification. All occupations above 50 were treated as high socio-economic StaNS and the others as low.

economic status. However, this modal person is a misleading concept in that there IS great variability in all these demographic characteristics. Fertility Knowledge Of respondents 19.3% who were asked the length of their menstrual cycle, either gave answers of 11 days or fewer, or gave no answer at all. This apparent lack of knowledge of their own functioning is even more vividly shown by the fact that only 18.7% were correct in stating both when they were maximally and minimally fertile. Knowledge of fertility was unrelated to variables such as age, marital status, number of prior pregnancies, or whether or not respondents had been using birth control devices when they became pregnant. It was also independent of the number of men respondents had had intercourse with, and independent of the frequency of intercourse with the same man. Respondents' knowledge of their own fertility, in fact, appears to be independent of a number of "experience" variables that, one would imagine, would give them greater access, and exposure, to information about their own functioning. Birth Control Devices Of respondents 73.3% were not using any form of birth control when they became pregnant. Among those using contracepcive devices, major contraceptive failures occurred with rhe use of foam and condoms. The presence or absence of a birth control device was unrelated either to the number of men, or to the frequency of intercourse with the man responsible. This suggests that the absence of a birth control device is not related to the single occasion of intercourse but persists as a continuing behavioral pattern. This evidence, tied in with the lack of knowledge of fertility, again suggests that the major problem is one of ignorance of reproductive functioning, independent of those factors which one would expect to influence the availability of information about birth control. Relationship W i t h the Man Reporting that they had had intercourse with only one man during the previous 2 mo. were 89.8% of respondents; only 1.6% of respondents reported 3 or more men. In addition 70.1% had had intercourse more than 5 times with the man responsible for the pregnancy; 13% had had intercourse only once. Information from these two questions suggests that a fairly stable sexual relationship existed between the respondents and those responsible for the pregnancy. This contention is further supported by the findings that 85.2% of the men were aware of the pregnancy and 82.5% aware of the abortion. Social support for having the aborcion appears ro have come from the responsible men; of those aware of the abortion, 85.3% approved of the respondents having the abortion. The approval of the man was not related to whether

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respondents were single, separated, or widowed on the one hand, or married on the other. It was also not related to the number of men with whom respondents had had intercourse during the previous 2 mo. The major findings in the present study are concerned with the apparent ignorance about their own reproductive functions, and the absence of use of birth control devices, among those having abortions. The independence of these factors from variables which should, theoretically at least, provide different degrees of access to birth-control information, suggests that theoretical access to birth control information has, in itself, no effect on use of knowledge of birth control. There is, however, no suggestion that those who have abortions are any less informed than others about techniques of birth control. Ryder (1973), for example, reports that 26% of couples who use contraceptives fail to delay or prevent a pregnancy within 1 yr. of exposure to risk of pregnancy. The relatively stable relationship with the man as observed in the present study is similar to the situation reported by Smith (1973) and Bracken, et dl. (1973). The man involved appears to have provided the major social support for the decision to have the abortion. It is interesting to speculate whether the differences between those who do and those who do not choose to have an abortion, could be partially explained by differences in the man's behavior. REFERENCES ATHANASIOU, R., OPPEL,W., MICHELSON, L., UNGER, T., & YAGER,M. Psychiatric sequelae to term birth and induced early and late abortion: a longitudinal study. Family Planning Perspectives, 1973, 5, 227-231. BRACKEN, M. B., GROSSMAN, G., HACHAMOVITCH, M., SUSSMAN, D., & SCHRIER,D . Abortion counseling: an experimental study of three techniques. American Journal o f Obstetrics and Gynecology, 1973, 117, 10-20. DAVE),H. P. Psychological studies in abortion. In J. T. Fawcett ( E d . ) , Psychological fierspectives on population. New York: Basic Books, 1973. Pp. 241-273. HARRIS, M. D., O'HARE,D., PAKTER, J., & NELSON, F. G. Legal abortion 1970-1971the New York City experience. American Journal o f Public Health, 1973, 63, 409-418.

HAYS,W. L. Statistics for the social sciences. New York: Holt, Rinehart

&

Winston,

1973.

KALTREIDER,N . B.

Emotional patterns related to delay in decision to legal abortion. California Medicine, T h e Western journal o f Medicine, 1973, 118, 23-27. KATCHADOURIAN, H. A., & LUNDE, D. T. Pundamentals o f human sexuality. New York: Holc, Rinehart & Winston, 1972. MARTIN,C. D. Psychological problems of abortion for the unwed teenage girl. Genetic Psychology Monographs, 1973, 88, 23-110. OSOFSKY, J. D., & OSOFSKY, H. J. The psychological reaction of patients to legalized abortion. American Journal o f Orthopsychiatry. 1972, 42, 48-60. PAKTER, J., HARRIS,D.. & NELSON, F. Surveillance of the abortion program in New York City: preliminary report. Clinical Obstetrics and Gynecology, 197 1, 14, 267-299. REISS, A. J. Occupations and social status. New York: Free Press, 1961. RYDER, N . B. Contraceptive failure in the United States. Family Planning Perrpectiues, 1973, 5 , 133-142. SMITH,E. M. A follow-up study o f women who request abortion. American Journal o f Orthopsychiat?y, 1973, 43, 547-585. Accepted Septembe? 26, 1975.

Therapeutic abortion in a midwestern city.

Psychological Reporrs, 1975, 37, 1143-1146. @ Psychological Reports 1975 THERAPEUTIC ABORTION I N A MIDWESTERN CITY LESLIE MELAMED1,' Wright State U...
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