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Abstract
Decision ambivalence is a key concept in abortion literature, but has been poorly operationalised. This study explored the concept of decision ambivalence via an Abortion Decision Balance Sheet (ADBS) articulating reasons both for and against terminating an unintended pregnancy. Ninety-six women undergoing an early abortion for psychosocial reasons participated in a prospective, longitudinal study with repeated measures (Impact of Event Scale; Positive and Negative Affect Schedule) taken at initial consultation (T1) and 3 months postoperatively (T2). Participants responded to the ADBS at T1. Confronting the problem pregnancy and abortion decision was a high stress event. Women experienced significant improvement 3 months after abortion. Findings did not support balance sheet assumptions of ambivalence, or maternal attachment – grief models, but instead recommended models of decision complexity and cognitive overload. Up to 40% of variability in women's emotional wellbeing at T1, and up to 19% of variability at T2, was predicted by fewer than five ADBS items. These items gave insight into the importance of a woman's concern about her current mothering capacity; abortion role models; and stability of the relationship with the partner in the pregnancy.
Acknowledgements
This paper is based on a 1999 doctoral dissertation by Susie Allanson undertaken at the Key Centre for Women's Health at the University of Melbourne, and supervised by Dr Jill Astbury, to whom I am most grateful. This research was supported by a Commonwealth Postgraduate Award and a University of Melbourne Research Scholarship. Thank you to Pete Dean for computing assistance and Peter Elliott for statistical advice. Special gratitude must be extended to the Fertility Control Clinic staff and the women who generously participated in this study during a demanding time in their lives.