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Rebecca Wind
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MOST WOMEN SEEKING ABORTIONS HAVE EXPERIENCED ONE OR MORE DISRUPTIVE EVENTS IN THE PAST YEAR

Poor Women Lead More Disrupted Lives

More than half of women who obtained abortions in 2008 (57%) had experienced at least one disruptive life event during the 12 months preceding the abortion, and a higher proportion of poor women (63%) than better-off women (49%) reported such events, according to a new study, "More Than Poverty: Disruptive Events Among Women Having Abortions in the USA," by Rachel K. Jones et al., of the Guttmacher Institute. Most commonly, women who had abortions reported having experienced unemployment (20%), separation from a partner (16%), falling behind on rent or mortgage (14%) or having moved multiple times (12%).

The study, which combined quantitative findings from a national survey of women who had obtained abortions in 2008 with qualitative data from 49 in-depth interviews with abortion patients, found that many abortion patients make pregnancy-related decisions while experiencing a range of difficult life circumstances.

More than 40% of abortion patients in 2008 were poor, and of these, many had been exposed to disruptive events at a higher rate than their nonpoor counterparts. For example, 25% of poor abortion patients had been unemployed for at least one month, compared with 14% of better-off women; additionally, a higher proportion of poor patients had separated from a partner, fallen behind on rent or mortgage, moved two or more times, or had a baby within the previous year. One woman shared the following story on the day of her abortion:

"Well, at the time [that I became pregnant] my boyfriend, […] we were good, things were stable between us. And then his mom had kicked us out of the house, so we were living out of a motel. We were going from motel to motel and […] he was trying to bring in money, because I was sick, I couldn't work: I [was] constantly throwing up. And then, I guess the pressure on him of taking care of me and knowing that I was pregnant got to him, and just all of a sudden, out of the blue, he said, 'Go your way, I will go my way. I have to take care of my own and you take care of your own.'"

Seven percent of all abortion patients had been exposed to intimate partner violence; however, poor patients were at least twice as likely to have been exposed as nonpoor women.

The study reveals that more than half (51%) of abortion patients reported having used a contraceptive method during the month in which they got pregnant, and poor women were less likely than better off women to have used a method. In the qualitative interviews, nearly half of the women revealed that disruptive events had interfered with their contraceptive use. Several mentioned the loss of a job, which led to the loss of health insurance and in turn, access to hormonal contraceptives. Six of the women interviewed reported partners who had sabotaged their birth control efforts, for example by refusing to withdraw or tampering with contraceptives. Most abortion patients reported becoming pregnant after having unprotected sex or using less effective contraceptive methods, such as condoms or withdrawal.

The authors suggest that easier access to highly effective contraceptive methods (i.e., making methods available free of cost, over the counter or with multiple refills at once) could reduce unintended pregnancies among all women, and especially among those who experience disruptive events. In addition, increased access to long-acting reversible contraceptive methods such as the IUD or implant, which do not require ongoing maintenance, could reduce the potential for disruptive events to interfere with contraceptive use.

"That poor women were more likely to experience events such as unemployment and breaking up with a partner may be both a cause and a consequence of economic strain," says lead author, Rachel K. Jones. "While it might not be possible to prevent these disruptions from occurring, we can help women in these situations by making it easier for them to access and use the most effective contraceptive methods."

"More Than Poverty: Disruptive Events Among Women Having Abortions in the USA" will appear in a forthcoming issue of the Journal of Family Planning and Reproductive Health Care and is currently available online.

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