Women's decision-making related to induced abortion - a cross sectional study during a period of Covid-19 pandemic, in Sweden

• Published in: The European journal of contraception & reproductive health care Vol. 28; no. 1; pp. 44 - 50
• Main Authors: Makenzius, M., Obern, C., Tydén, T., Larsson, M., Gemzell-Danielsson, K., Sundström-Poromaa, I., Ekstrand Ragnar, M.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 2023; Taylor & Francis Ltd
• Subjects: Abortion; Abortion, Induced; Child; Clinical Medicine; COVID-19; COVID-19 - epidemiology; Cross-Sectional Studies; Decision Making; Female; Humans; induced abortion; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Obstetrics, Gynecology and Reproductive Medicine; Pandemics; Pregnancy; reasoning; reproductive health; Reproduktionsmedicin och gynekologi; Sweden - epidemiology; Sweden; induced abortion; Covid-19; decision-making; reproductive health; reasoning
• ISSN: 1362-5187; 1473-0782; 1473-0782
• DOI: 10.1080/13625187.2022.2150047

For many women, deciding to have an induced abortion is a complex process, even in settings with easy access to legal and safe abortion. This disproves arguments that abortion availability results in casual abortion decision-taking.
To investigate women's decision-making on induced abortion.
A multi-centre cross-sectional survey among 623 abortion-seeking women in Sweden (2021). The perceived difficulty to decide on abortion was measured using a 7-point Likert scale, and analysed with univariate and multivariate analysis (odds ratios [OR], 95% confidence intervals [CI]).
About half (n = 322;52%) scored 1-4, suggesting the decision was perceived as easier compared to those (n = 292;48%) who scored 5-7. Reasons for the abortion were: poor economy (n = 166;27%), too early in the relationship (n = 154;25.1%), want to work first (n = 147;23.9%), want to study first (n = 132;21.5%), uncertain about the relationship (104;16.9%), and too young (n = 104;16.9%). Predictors for perceiving the decision as difficult: partner's hesitance (OR = 3.18, CI:1.76-5.73), being born outside the Nordic countries (OR = 2.23, CI:1.28-3.87), having discussed the decision with someone (OR = 2.42, CI:1.67-3.50), age ≥30 (OR = 2.22, CI:1.03-4.76), the Covid-19 pandemic (OR = 2.08, CI:1.20-3.59), and the desire to have children in the future (OR = 1.96, CI:1.18-3.28). After confirmed pregnancy, poor mental well-being was more common among those who scored 5-7 (n = 140;47.9%) compared to those who scored 1-4 (n = 122;37.9), p = .029.
Women's decision-making on abortion is complex; in times of crises, the decision procedure may be even more difficult. This valuable knowledge could be used to improve and promote satisfactory counselling beyond medical routines.