Decision-making in case of an unintended pregnancy: an overview of what is known about this complex process

Figures & data

Figure 1. Flowchart of literature search.

Table 1. ID number, year of publication, authors, title, study design, location and type of source of included literature.

ID No.	Year	Author(s)	Title	Study design	Location	Source
1	2008	Font-Ribera, et al.	Socioeconomic inequalities in unintended pregnancy and abortion decision	Quantitative, registry data, 1263 participants with unintended pregnancies	Spain	1^st
2	2020	Klann & Wong	A pregnancy decision-making model: psychological, relational and cultural factors affecting unintended pregnancy	Literature review	US	2^nd
3	2004	Kumar, et al.	Decision making and referral prior to abortion: a qualitative study of women’s experiences	Interviews, 21 participants	UK	1^st
4	2008	Rowlands	The decision to opt for abortion	Review	Global	1^st
5	2009	Ekstrand, et al.	An illusion of power: qualitative perspectives on abortion decision-making among teenage women in Sweden	Interviews, 25 participants	Sweden	1^st
6	2013	Costescu & Lamont	Understanding the pregnancy decision-making process among couples seeking induced abortion	Quantitative, survey 30 couples	Canada	1^st
7	2014	Goenee,et al.	Decision-making concerning unwanted pregnancy in general practice	Quantitative, GP data	Netherlands	1^st
8	2015	Hayes & Lowe	A hard enough decision to make: anti-abortion activism outside clinics in the eyes of the clinic users	Secondary analysis of qualitative data	UK	2^nd
9	2015	Rocca, et al.	Decision rightness and emotional responses to abortion in the US: a longitudinal study	Survey, 667 participants	US	1^st
10	2013	Brown	Is counseling necessary? Making the decision to have an abortion	Interviews, 23 participants	UK	1^st
11	2016	Sisson, et al.	Adoption decision making among women seeking abortion	Mixed method, interviews 31 women	US	1^st
12	2016	Smith, et al.	Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama	Focus groups (6) and interviews, 12 participants	US	1^st
13	2017	Vandamme, et al.	The decision to have an abortion from both partners’ perspectives: a dyadic analysis	Quantitative, survey 106 couples	Belgium	1^st
14	2018	Ferrer-Serret & Solsona-Pairo	The place of abortion in the pregnancy decision-making process of young adult women in Catalonia, Spain	Focus group and interviews, 25 pregnant participants	Spain	1^st
15	2018	Frederico, et al.	Factors influencing abortion decision-making processes among young women	Interviews, 14 participants	Mozambique	1^st
16	2018	O’Donnell, et al.	"I wouldn’t know where to start": unwanted pregnancy and abortion decision-making in Central Appalachia	Interviews, 31 participants	US	1^st
17	2018	Sullivan, et al.	Women’s reproductive decision-making and abortion experiences in Cape Town, South Africa: a qualitative study	Interviews and participant observations, 16 participants	South Africa	1^st
18	2019	van Ditzhuijzen, et al.	Dimensions of decision difficulty in women’s decision-making about abortion: a mixed methods longitudinal study	Mixed method, quantitative data (332 participants) and interviews (69 participants)	Netherlands	1^st
19	2019	Hoggart	Moral dilemmas and abortion decision-making: lessons learnt from abortion research in England and Wales	Secondary analysis of interviews, 47 participants	England and Wales	1^st
20	2020	Hanifa, et al.	Teenagers’ decision making about abortion as an action to terminate unwanted pregnancy	Review	Global	1^st
21	2020	Huang & Ngai	Decision making, abortion narratives and identity construction toward abortion among rural-urban single migrant women in mainland China: insights for social work practice and education	Interviews, 33 participants	China	1^st
22	2015	Boeva	Factors influencing the decision for abortion and not using contraception	Survey, 243 participants	Bulgaria	1^st
23	2020	Mavuso, et al.	‘Choice’ in women’s abortion decision-making narratives: introducing a supportability approach	Narrative interviews, 43 participants	South Africa, Zimbabwe	1^st
24	2003	Rabindranathan	Women’s decision to undergo abortion: a study based in Delhi clinics	Interviews, 60 participants	India	1^st
25	2007	Adamczyk	The effect of religious contextual norms, structural constraints, and personal religiosity on abortion decisions	Data ADD Health study (survey and interviews), N = 1497	US	1^st
26	2007	Allanson	Abortion decision making and ambivalence: insights via an abortion decision balance sheet.	Longitudinal, survey and interviews, 96 participants	Australia	1^st
27	2007	Puri, et al.	Factors affecting abortion decisions among young couples in Nepal	Cluster sample survey (997 women + 499 men) and case studies (19 women + 11 men)	Nepal	1^st
28	2008	Scharwächter	Abortion decision making by focusing: a preliminary study	Theoretical, two cases	Netherlands	2^nd
29	2012	Brauer, et al.	Besluitvorming rondom ongewenste zwangerschap	Interviews, 122 participants	Netherlands	3^rd
30	2012	Foster et al.	Attitudes and decision making among women seeking abortions at one US clinic	Questionnaire at clinics, 5109 participants	US	1^st
31	2013	Cameron & Glasier	Identifying women in need of further discussion about the decision to have an abortion and eventual outcome	Retrospective case note review, 191 participants	UK	1^st
32	2013	Ralph, et al.	The role of parents and partners in minors’ decisions to have an abortion and anticipated coping after abortion	Data medical charts and needs assessment forms, 476 participants	US	1^st
33	2015	French, et al.	Influence of clinical referral on Nebraska women’s decision to abortion time	Survey, 356 participants	US	1^st
34	2016	Maharana	Abortion decision making in India: whose role is vital?	District level household survey, 37.192 women with induced abortions	India	1^st
35	2017	Rice, et al.	Norms and stigma regarding pregnancy decisions during unintended pregnancy: development and predictors of scales among young women in the US South	Validation of survey, 642 participants without pregnancy	US	1^st
36	2017	Chiweshe, et al.	Reproductive justice in context: South African and Zimbabwean women’s narratives of their abortion decision. Comparing South Africa and Zimbabwe	Narrative interviews, 43 participants	South Africa, Zimbabwe	1^st
37	2018	Lee, et al.	Female and male decision-making regarding whether to continue or abort an unintended pregnancy: a secondary analysis of the FECOND study	Telephone interviews, 4785 participants with unintended pregnancy	France	1^st
38	2019	Brauer, et al.	Understanding decision-making and decision difficulty in women with an unintended pregnancy in the Netherlands	Mixed method, survey (272 participants) and interviews (109 participants)	Netherlands	1^st
39	2019	Jansma & Sondeijker	Kennissynthese Onbedoelde zwangerschap en kwetsbaar (jong) ouderschap	Theoretical study	Netherlands	3^rd
40	2019	Khodabandeh & Kahani	Pre-abortion decision-making conflict in pregnant women seeking legal abortion	Cross sectional stud, 2 surveys, 282 pregnant participants	Iran	1^st
41	2019	Pereira, et al.	Decision-making trajectories leading to termination of an unplanned pregnancy: specificities among adolescent and adult women	Self-report questionnaire post abortion, 422 participants	Portugal	1^st
42	2019	Ples, et al.	Factors affecting the decision to undergo abortion in Romania: experiences at our clinic	Questionnaire at clinic, 119 participants	Romania	1^st
43	2020	Ploem, et al.	Tweede evaluatie Wet afbreking zwangerschap	Mixed method, interviews professionals and online survey women with abortion (n = 57)	Netherlands	3^rd
44	2020	Rocca, et al.	Emotions and decision rightness over five years following an abortion: an examination of decision difficulty and abortion stigma	Data from Turnaway study, 956 participants baseline interview	US	1^st
45	2020	Steinberg	Decision rightness and relief predominate over the years following an abortion	Personal review	Global	2^nd
46	2021	Jovel, et al.	Abortion waiting periods and decision certainty among people searching online for abortion care	Data Google Ads Abortion Access Study, 2 surveys, 750 participants	US	1^st
47	2022	Mahanaimy & Moseson	The need for social support during unintended pregnancy decision-making: a qualitative analysis of in-depth interviews with young people in California	Interviews, 25 pregnant participants	US	1^st
48	2005	Hallden, et al.	Meanings of being pregnant and having decided on abortion: young Swedish women’s experiences	Interviews, 10 women seeking abortion	Sweden	1^st
49	2021	Rowland, et al.	Certainty and intention in pregnancy decision-making: an exploratory study	Cross sectional study, 2 scales, 196 pregnant participants	US	1^st
50	2013	Chibber, et al.	The role of intimate partners in women’s reasons for seeking abortion	Data Turnaway study and telephone interviews, 954 participants	US	1^st
51	2022	Biggs, et al.	Unwanted abortion disclosure and social support in the abortion decision and mental health symptoms: a cross-sectional survey	Burden study data (cross sectional survey), 746 participants	US	1^st

Figure 2. Visualization of entangled layers in the decision-making process regarding unintended pregnancy.

Data availability statement

Data sharing is not applicable to this article as no new data were created or analyzed in this study.