Psychological aspects of the decision to terminate pregnancy
Abstract
The study looks at the psychological aspects of the decision to terminate a pregnancy. The introduction discusses some of the influences that may affect the decision, such as a woman's perception of motherhood, attitude to pregnancy, crisis, or stress. The empirical part is based on interviews with women who have experienced the decision to terminate a pregnancy. An anamnestic questionnaire will be used as supplementary material to these interviews. The main aim of this research is to shed light on the unique experiences of women who have decided to terminate a pregnancy. More specifically, the research will focus on identifying the factors that helped women in their decision-making process. A distinction will be made between internal and external factors influencing women's decisions. Using IPA (Interpretative Phenomenological Analysis), partner support and stress resilience were identified as the main factors. Equally important were the woman's starting position in the decision-making process, her attitudes towards pregnancy and motherhood, her previous experience of motherhood, childcare or experience with children with disabilities, support from health professionals and perceived availability of services. Respondents strongly reflected the conflict between the emotional and rational components of decision-making. Although the experiences described by women vary in many aspects, we believe that this is an issue that needs to be addressed. In the conclusion, the factors that women in the research survey considered important in their decision are discussed.
https://doi.org/10.29364/epsy.485
(Fulltext in Czech)
Keywords
decision-making process, termination of pregnancy, induced abortion, motherhood, interpretative phenomenological analysis (IPA)Literature
Abboud, L., & Liamputtong, P. (2005). When pregnancy fails: coping strategies, support networks and experiences with health care of ethnic women and their partners. Journal of Reproductive and Infant Psychology, 23(1), 3–18. https://doi.org/…512331330974
Adair, L. E., & Lozano, N. M. (2022). Adaptive Choice: Psychological perspectives on abortion and reproductive freedom. Women’s Reproductive Health, 9(1), 1–26. https://doi.org/…2021.1999624
Alhusen, J. L. (2008). A Literature Update on Maternal-Fetal Attachment. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 37(3), 315–328. https://doi.org/…2008.00241.x
Allanson, S., & Astbury, J. (1995). The Abortion Decision: Reasons and Ambivalence. Journal of Psychosomatic Obstetrics & Gynecology, 16(3), 123–136. https://doi.org/…829509024461
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. https://doi.org/…2011.02604.x
Bell, M., & Stoneman, Z. (2000). Reactions to prenatal testing: Reflection of religiosity and attitudes toward abortion and people with disabilities. American Journal on Mental Retardation, 105(1), 1. DOI: 10.1352/0895–8017(2000)105
Cecil, R. (1994). “I wouldn't have minded a wee one running about”: Miscarriage and the family. Social Science & Medicine, 38(10), 1415–1422. DOI: 10.1016/0277–9536(94)90279–8
Côté-Arsenault, D., & Denney-Koelsch, E. M. (2016). “Have no regrets:” Parents’ experiences and developmental tasks in pregnancy with a lethal fetal diagnosis. Social Science & Medicine, 154, 100–109. https://doi.org/….2016.02.033
Hamilton, J. G., & Lobel, M. (2008). Types, patterns, and predictors of coping with stress during pregnancy: Examination of the Revised Prenatal Coping Inventory in a diverse sample. Journal of Psychosomatic Obstetrics and Gynecology, 29(2), 97–104. https://doi.org/…820701690624
Hendl, J. (2008). Kvalitativní výzkum: základní teorie, metody a aplikace (2., aktualiz. vyd). Portál. Choi, H., Van Riper, M., & Thoyre, S. M. (2012). Decision making following a prenatal diagnosis of Down syndrome: An integrative review. Journal of Midwifery & Women’s Health, 57(2), 156–164. https://doi.org/…2011.00109.x
Korenromp, M. J., Page-Christiaens, G. C., Van Den Bout, J., Mulder, E. J. H., & Visser, G. H. A. (2007). Maternal decision to terminate pregnancy in case of Down syndrome. American Journal of Obstetrics and Gynecology, 196(2), 149.e1–149.e11. https://doi.org/….2006.09.013
Kumar, U. A., Baraitser, P., Morton, S., & Massil, H. (2004). Decision making and referral prior to abortion: A qualitative study of women’s experiences. Journal of Family Planning and Reproductive Health Care, 30(1), 51–54. https://doi.org/…904322702009
Lalor, J., Begley, C., & Galavan, E. (2008). A grounded theory study of information preference and coping styles following antenatal diagnosis of foetal abnormality. Journal of Advanced Nursing, 64(2), 185–194. https://doi.org/…2008.04778.x
Lawson, K. L. (2006). Expectations of the parenting experience and willingness to consider selective termination for Down Syndrome. Journal of Reproductive and Infant Psychology, 24(1), 43–59. https://doi.org/…830500475351
Lindgren, K. (2001). Relationships among maternal-fetal attachment, prenatal depression, and health practices in pregnancy. Research in Nursing & Health, 24(3), 203–217. https://doi.org/…002/nur.1023
Lokubal, P., Corcuera, I., Balil, J. M., Frischer, S. R., Kayemba, C. N., Kurinczuk, J. J., Opondo, C., & Nair, M. (2022). Abortion decision-making process trajectories and determinants in low- and middle-income countries: A mixed-methods systematic review and meta-analysis. EClini-calMedicine, 54, 101694. https://doi.org/….2022.101694
Major, B., Appelbaum, M., Beckman, L., Dutton, M. A., Russo, N. F., & West, C. (2009). Abortion and mental health: Evaluating the evidence. The American Psychologist, 64(9), 863–890. https://doi.org/…037/a0017497
Masopustová, Z., Daňsová, P., & Lacinová, L. (2018). Jak to mají mámy: psychologický výzkum mateřství. Masarykova univerzita.
Mihelic, M., Filus, A., & Morawaska, A. (2016). Correlates of prenatal parenting expectations in new mothers: Is better self-efficacy a potential target for preventing postnatal adjustment difficulties? Prevention Science, 17(8), 949–959. https://doi.org/…1-016-0682-z
Miovský, M. (2006). Kvalitativní přístup a metody v psychologickém výzkumu. Grada.
Paulík, K. (2010). Psychologie lidské odolnosti. Grada.
Pines, D. (1972). Pregnancy and motherhood: interaction between fantasy and reality. British Journal of Medical Psychology, 45(4), 333–343. https://doi.org/…72.tb02216.x
Ratislavová, K. (2008). Aplikovaná psychologie porodnictví: [psychologie těhotenství, porodu a šestinedělí : psychosomatická medicína : učební texty pro porodní asistentky]. Reklamní atelier Area.
Revenson, T. A., Schiaffino, K. M., Majerovitz, S. D., & Gibofsky, A. (1991). Social support as a double-edged sword: The relation of positive and problematic support to depression among rheumatoid arthritis patients. Social Science & Medicine (1982), 33(7), 807–813. https://doi.org/…16/0277-9536(91)90385-p
Roberts, C. D., Stough, L. M., & Parrish, L. H. (2002). The role of genetic counseling in the elective termination of pregnancies involving fetuses with disabilities. Journal of Special Education, 36(1), 48–55. https://doi.org/…020360010501
Robinson, G., Stotland, N. L., Russo, N. F., Lang, J. A., & Occhiogrosso, M. (2009). Is There an “Abortion Trauma Syndrome”? Critiquing the Evidence. Harvard Review of Psychiatry, 17(4), 268–290. https://doi.org/…220903149119
Rudnicki, S. R., Graham, J. R., Habboushe, D. F., & Ross, R. D. (2001). Social support and avoidant coping: Correlates of depressed mood during pregnancy in minority women. Women & Health, 34(3), 19–34. https://doi.org/…013v34n03_02
Řiháček, T., Čermák, I., & Hytych, R. (2013). Kvalitativní analýza textů: čtyři přístupy. Masa-rykova univerzita.
Salisbury, A. (2003). Maternal-Fetal Attachment. JAMA, 289(13), 1701. https://doi.org/….289.13.1701
Skutilová, V. (2013). Psychologické aspekty a kompliance diagnostických metod v těhotenství. [Disertační práce]. Univerzita Palackého v Olomouci. Lékařská fakulta.
Smith, J. D., Flowers, P., & Larkin, M. (2009). Interpretative Phenomenological Analysis: Theory, method and research. QMiP Bulletin, 1(10), 44–46. https://doi.org/…2010.1.10.44
Speckhard, A., & Rue, V. M. (1992). Postabortion syndrome: An emerging public health concern. Journal of Social Issues, 48(3), 95–119. https://doi.org/…92.tb00899.x
Stotland, N. L. (1992). The Myth of the Abortion Trauma Syndrome. JAMA, 268(15), 2078. https://doi.org/…490150130038
Špaňhelová, I. (2015). Prázdná kolébka: jak překonat ztrátu dítěte před porodem nebo těsně po něm. Portál.
Špatenková, N. (2004). Krize: psychologický a sociologický fenomén. Grada.
ÚZIS. (2022). Potraty 2020: zdravotnická statistika. https://www.uzis.cz/…raty2020.pdf
Vágnerová, M., Strnadová, I., & Krejčová, L. (2009). Náročné mateřství: být matkou postiženého dítěte. Karolinum.
Vodáčková, D. (2020). Krizová intervence (4., aktualizované vydání). Portál. Vymětal, J. (2003). Lékařská psychologie. Portál.
Williams, D. (1982). Religion, beliefs about human life, and the abortion decision. Review of Religious Research, 24(1), 40. https://doi.org/10.2307/3510981
Zaręba, K., La Rosa, V. L., Ciebiera, M., Makara-Studzińska, M., Commodari, E., & Gierus, J. (2020). Psychological effects of abortion. An updated narrative review. Eastern Journal of Medicine, 25(3), 477–483. https://doi.org/…m.2020.82246