Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the ‘red states v. blue states’ hypothesis

Abstract

Recently, the hypothesis that state-level political context influences individuals' cultural values--the 'red states v. blue states' hypothesis--has been invoked to explain the hyper-polarisation of politics in the USA. To test this hypothesis, we examined individuals' knowledge about abortion in relation to the political context of their current state of residence. Drawing from an internet-survey of 586 reproductive-age individuals in the USA, we assessed two types of abortion knowledge: health-related and legality. We found that state-level conservatism does not modify the existing relationships between individual predictors and each of the two types of abortion knowledge. Hence, our findings do not support the 'red states' versus 'blue states' hypothesis. Additionally, we find that knowledge about abortion's health effects in the USA is low: 7% of our sample thought abortion before 12 weeks gestation was illegal.

State-Mandated (Mis)Information and Women's Endorsement of Common Abortion Myths

“…These findings mirror other studies that have highlighted pervasive misperceptions about the physical and emotional risks of abortion among the general public and, more importantly, among women presenting for an abortion (Bessett et al, 2015;Kavanaugh et al, 2013;Littman et al, 2014;Wiebe et al, 2014). The extent that our study indicates a lower prevalence of misinformation may be due to differences in study populations, but is more likely due to our inclusion of a "don't know/unsure" response option rather than using a dichotomous true/false measure.…”

“…(See Table 1.) These five myths are frequently presented in state-mandated documents (Guttmacher Institute, 2016) and have been considered in prior research (Bessett et al, 2015;Littman et al, 2014;Wiebe et al, 2014). "Don't know/not sure" was offered as a response option for each item.…”

“…The promotion of misinformation is of particular concern as many people lack basic information about abortion and its associated health risks. An online survey of women and men of reproductive age found that knowledge of the prevalence, risks and legality of abortion is low, and notably the lowest of all sexual and reproductive health topics (Bessett, Gerdts, Littman, Kavanaugh, & Norris, 2015;Kavanaugh, Bessett, Littman, & Norris, 2013). A recent national poll found that people underestimate how many women have had an abortion, are unaware that abortion rates are declining, and erroneously believe abortion is much more dangerous than other common procedures, such as wisdom tooth removal (Vox, 2016).…”

Support for and interest in alternative models of medication abortion provision among a national probability sample of U.S. women

“…Additional apprehension about the safety of these alternative models of care likely stems from limited knowledge regarding the safety, effectiveness and process of having a medication abortion, and misperceptions that an abortion requires inclinic screening to be safe. People tend to be less knowledgeable about abortion than other RH care topics [24] and tend to overestimate the physical and psychological risks of an abortion [25,26]. Women's knowledge about the safety of abortion may be compromised in part by exposure to messages that exaggerate the risks of abortion, including mandated counseling laws in some states that require that the risks of abortion be overstated or which mandate discussion of scientifically inaccurate information [27,28].…”

Measuring decisional certainty among women seeking abortion

“…Women were asked about their relationship status with the man involved in the pregnancy and his awareness of and support for the abortion, as well as who they had talked to about their abortion decision. To capture levels of misperceptions about abortion, women were presented with a series of statements summarizing common abortion myths derived from previous research [18][19][20] and asked which statement was closer to the truth (e.g., "abortion causes breast cancer" versus "abortion does NOT cause breast cancer," see Table 1 for all myths presented). Women who incorrectly identified the myth as closer to the truth, or responded "Don't know," were categorized as endorsing that myth.…”