Paradoxes in legal abortion a longitudinal study of motives, attitudes and experiences in women and men

Sammanfattning: Background: About one in four pregnancies in Sweden are terminated by legal abortion. However, women seeking abortion constitute a relatively invisible group. This is even more accentuated when it comes to the men involved in induced abortion.Aim: The general aim of the present thesis was to investigate psychosocial background, current living conditions, motives, attitudes and experiences of legal abortion in women and men.Methods: The five papers included in the thesis are based on a questionnaire study and a longitudinal interview study. Women seeking abortion were asked consecutively as they come to the hospital for the first time if they were willing to participate in the questionnaire study, which ultimately included 211 women and 75 men. The interview study comprised 58 women and 26 men and was conducted just after abortion and four and twelve months later.Results: Most women and men had stable partner relationships and adequate finances. More than half were married or cohabiting and already had children. About half the women gave motives for abortion related to family planning. They wanted either to postpone childbirth or limit the number of children so they would be able to combine good parenting with professional employment. Motives for abortion in men were strikingly in accordance with the women's motives. Most men were in favour of abortion, 20 stressed they supported the decision and two wanted the woman to continue the pregnancy. Contradictory feelings in relation to both pregnancy and the coming abortion were common in women as well as men, but were very seldom associated with doupts about the actual decision to have an abortion. Social perspectives, connected with responsibility for all concerned (the foetus included) were found to legitimise the decision to have an abortion, whilst positive feelings in relation to the pregnancy and ethical perspectives concerning the rights of the foetus made in more difficult. In addition, the complexity increased in cases when the abortion could be simultaneously experienced as both a relief and a loss. However, at the follow-ups, the majority of the women did not report any emotional distress, either directly after the abortion or four or 12 months later, and the predominant reactions were relief and mental growth. As concerns contraceptives, about half the respondents had not used any contraceptive method at the time of conception. Common explanations for not preventing pregnancy were: thought it was a safe-period or let sexual feelings take over or took a chance. Furthermore, in 12 % of cases, the woman had felt pressure or threat from the man in connection with the conception.Conclusions: Women resort to legal abortion in all kinds of psychosocial contexts. The motives reveal that women and men want to have children with the right partner at the right time and to limit the number of children. Despite painful and contradictory feelings almost no one regretted the abortion, either directly after the abortion or one year later. It is essential that both clinical work and research are open to contradictory feelings and paradoxical thinking in relation to abortion. In addition, it is necessary also to focus on the involvement and role of the males in order to obtain a proper picture of the phenomenon of abortion.