Abortion study finds no long-term ill effects on emotional well-being

Family Planning Perspectives, Jul/Aug 1997 by Edwards, S

Although women may experience some distress immediately after having an abortion, the experience has no independent effect on their psychological well-being over time, according to a study of longitudinal data from a large, national sample. The data show that the most important predictor of a woman's sense of well-being after having an abortion is her level of self-esteem before the pregnancy. This remains true regardless of race or affiliation with a religious group, even if the denomination opposes abortion.l

The study was based on data collected between 1979 and 1987 through the National Longitudinal Survey of Youth. Respondents, who were aged 14-21 when the survey was launched, participated in annual interviews, during which they provided information about their socioeconomic and demographic characteristics, including their reproductive experiences. The 1980 and 1987 interviews also contained a standardized scale that measures self-esteem by asking respondents their level of agreement with a variety of statements relating to their worth, capability, self-respect and attitude; the investigators considered mean scores below 20 (out of a possible 80) indicative of low self-esteem and scores above 30 representative of high self-esteem.

To examine the factors that are associated with women's self-esteem according to their race and religiosity, the investigators conducted analyses of variance, multivariate analyses of variance and multiple regression analyses. The study was based on data from 4,977 respondents.

Initial analyses indicated that the same proportion of black and white respondents had had an abortion (15%), but that black women had had significantly more abortions than whites. Blacks also were more likely to be mothers and had had more children, were less educated and had a lower income than whites. The two groups had similar levels of self-esteem in 1987, and self-esteem was not significantly associated with having had an abortion, even when the effects of education, income and number of children were taken into account.

To examine the independent contributions of previous self-esteem, reproductive experiences and background characteristics to women's emotional well-being in 1987, the investigators conducted multiple regression analyses using a subsample of 3,147 white women and 1,189 blacks who had not had an abortion before 1980. The two groups were similar with respect to age, education, work role and the proportion who had had at least one abortion after 1980. However, a greater proportion of whites than of blacks were currently married (56% vs. 31%), and among those who had had an abortion, a larger proportion of blacks than of whites had had repeat abortions (33% vs. 21%).

Neither having had one abortion nor having had repeat abortions was significantly associated with self-esteem among women of either race. Rather, for both groups, the best predictor of self-esteem in 1987 was the level of self-esteem in 1980, and education was the next most important factor. Among whites, self-esteem was also associated with income and the woman's number of children; among blacks, it was associated with work status.

The researchers used four measures to examine the role of religiosity: whether or not the women had reported a religious affiliation in 1979, their frequency of church attendance, the religion they identified and that religion's attitude toward abortion. Similar proportions of black women and white women reported a religious affiliation (92% and 90%, respectively), but blacks were more likely than whites to say they went to religious services more than once a month (72% vs. 54%). Black women generally were affiliated with religions that had a mixed or neutral stance toward abortion (90%), while sizable proportions of white women belonged to religious groups that opposed abortion (47%) or had mixed attitudes (40%).

Analyses of variance revealed no association between self-esteem and being affiliated with a religious group or frequency of church attendance. The researchers conducted a multivariate analysis of variance to determine whether belonging to a religion that opposed abortion, combined with frequent church attendance, influenced women's reproductive choices and their emotional well-being subsequent to an abortion.

The results indicated no difference in the number of women having abortions according to the religious group's attitude; furthermore, women belonging to religions that supported reproductive choice had higher self-esteem in 1987 than did those whose religion had mixed or negative attitudes about abortion. In analyses that controlled for education, income and number of children among women who had reported a religious affiliation in 1979, women's self-esteem in 1987 was not related to their religion s attitude toward abortion or to whether or not they had had an abortion.

Since the Catholic Church has consistently promoted an antiabortion stance, the researchers sought to determine if having an abortion has a different effect on the psychological well-being of Catholic women than on other women. To do so, they compared abortion status, church attendance and self-esteem among Catholic women with the same factors among nonCatholic women.