Decision-making trajectories leading to termination of an unplanned pregnancy: specificities among adolescent and adult women

ABSTRACT

Objective: To describe the decision-making trajectories leading to termination of an unplanned pregnancy and to explore the differences according to women’s age.

Background: Although decision-making regarding abortion has been conceptualised as a multiphase event, the different trajectories leading to termination of an unplanned pregnancy remain unexplored.

Methods: In this cross-sectional study, 422 women (248 adolescents, 174 adults) who had an abortion were recruited. Data were collected through self-report questionnaires at 16 Portuguese healthcare services.

Results: Eight decision-making trajectories leading to termination of an unplanned pregnancy were identified according to the sequence: consideration (or not) to continue the pregnancy, conceal (or not) the decision from the family, the main decision-maker, and reasons for abortion. The most frequent trajectory included women who did not consider its continuation, did not conceal the reproductive decision from their family, were the main decision-maker and referred as reasons for abortion ‘education/job would be more difficult to continue’. Adolescents more frequently not considering pregnancy continuation, not concealing the decision from their family and referred as reasons for abortion the prioritisation of their academic plans and immaturity; or considering its continuation, but were pressured into abortion by their parents. Adults more frequently (not) considering pregnancy continuation, concealed the decision from their family and reported economic reasons for abortion; or considering its continuation, but were pressured into abortion by their partners.

Conclusion: Our study may contribute to more informed intervention by healthcare providers involved in supporting women’s decisions, highlighting the need to promote an informed, weighted, developmentally adapted and free decision-making process.

KEYWORDS:

• Abortion
• adolescents
• adults
• decision-making process
• unplanned pregnancy

Acknowledgements

The authors wish to thank all the adolescent and adult women who collaborated with this research project, the healthcare services that enabled the sample collection, the Portuguese Family Planning Association, and the Sexual, Maternal, and Child Health Division of the Portuguese Directorate-General of Health.

Disclosure statement

No potential conflict of interest was reported by the authors.