Intervals and Outcomes of First and Second Pregnancies in Low-Income Women: A Record-Linkage Longitudinal Prospective Cohort Study

Reardon, David C.; Craver, Christopher

doi:10.12659/msm.931596

Cited by 3 publications

(6 citation statements)

References 12 publications

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“…It is clear that the outcome of a first pregnancy is at least a strong marker, and perhaps an important influencer, of the frequency and outcomes of subsequent pregnancies, including rapid repeat pregnancies 24 and the risks associated with exposure to multiple induced abortions. The robust and enduring effect of the first pregnancy outcome on a woman's reproductive life and aspirational goals must be honestly and widely communicated.…”

Section: Discussionmentioning

confidence: 99%

“…Abortion, especially repeat abortion, is linked to increased risk of premature deaths from all causes, including suicide, and also other mental health disorders such as anxiety, depression, substance abuse or overdose, and excessive risk-taking behavior. 10 It is clear that the outcome of a first pregnancy is at least a strong marker, and perhaps an important influencer, of the frequency and outcomes of subsequent pregnancies, including rapid repeat pregnancies 24 and the risks associated with exposure to multiple induced abortions. The robust and enduring effect of the first pregnancy outcome on a woman's reproductive life and aspirational goals must be honestly and widely communicated.…”

Section: Discussionmentioning

confidence: 99%

“…23 We also found that 23% of Medicaid beneficiaries whose first pregnancy ended in an abortion were pregnant a second time within 12 months with approximately 60% undergoing a second abortion. 24 An important Finnish study followed a cohort of 1269 women who underwent chemical abortion for a follow-up period of 4.2 years ( + /− 1.5) and determined that young women with previous abortions were most likely to experience abortion in the subsequent pregnancy. 25 Since abortion increases the risk of abortion in a subsequent pregnancy, an important question is whether the risk has perseverance.…”

Section: Introductionmentioning

confidence: 99%

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The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study

Studnicki¹,

Longbons²,

Reardon³

et al. 2022

Health Services Research and Managerial Epidemiology

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Introduction Multiple abortions are consistently associated with adverse health consequences. Prior abortion is a known risk factor for another abortion. Objective To determine the persistence of the association of a first-pregnancy abortion with the likelihood of subsequent pregnancy outcomes. Methods Data was extracted for a study population of 5453 continuously eligible Medicaid beneficiaries in states which funded and reported elective abortions 1999–2015. Women age 16 in 1999 were organized into three cohorts based upon the first pregnancy outcome: abortion, birth, natural loss. Results Women in the abortion cohort are more likely than those in the birth cohort to experience another abortion rather than a birth or natural loss, and less likely to experience a live birth rather than an abortion or natural loss, for every subsequent pregnancy. The tendency toward abortion (OR 2.99, CL 2.02-4.43) and away from birth (OR 0.49, CL 0.39-0.63) peaks at the sixth pregnancy, but persists throughout the reproductive period ages 16–32. The pattern is reversed, but similarly consistent, for women in the birth cohort. They remain likelier to have another birth rather than an abortion or natural loss in subsequent pregnancies. Compared to the birth cohort, the abortion cohort had 1.35 times as many pregnancies: 4.31 times the abortions, 1.53 times the natural losses, but only 0.52 times the births. They were 4.3 and 5.0 times as likely to have 2-plus and 3-plus abortions, but only 0.47 times and 0.31 times as likely to have 2-plus and 3-plus births. Of the abortion cohort, 37.1% had no births. By contrast, 73.6% of the birth cohort had no abortions. Conclusion The first-pregnancy abortion maintains a strong and persistent association with the likelihood of another abortion in subsequent pregnancies, enabling a cascade of adverse events associated with multiple abortions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study

Studnicki¹,

Longbons²,

Reardon³

et al. 2022

Health Services Research and Managerial Epidemiology

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“…This finding is consistent with previous research which indicates that abortion results in a higher number of rapid repeat pregnancies which result in more abortions. 15,16 Within the group of women with both births and abortions, 38.5% had an abortion timed consistent with an attempt to delay a first birth, 17.9% had an abortion that spaced live births, and 52.3% had an abortion that could indicate a desire to end childbearing. The estimated period prevalence for each of these patterns is 2.2%, 1.0%, and 3.0% respectively.…”

Section: Discussionmentioning

confidence: 99%

“…This finding is consistent with previous research which indicates that abortion results in a higher number of rapid repeat pregnancies which result in more abortions. 15,16…”

Section: Discussionmentioning

confidence: 99%

Estimating the Period Prevalence of Mothers Who Have Abortions: A Population Based Study of Inclusive Pregnancy Outcomes

Studnicki¹,

Fisher²,

Longbons³

et al. 2021

Health Services Research and Managerial Epidemiology

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Introduction: The prevalence of induced abortion among women with children has been estimated indirectly by projections derived from survey research. However, an empirically derived, population-based conclusion on this question is absent from the published literature. Objective: The objective of this study was to describe the period prevalence of abortion among all other possible pregnancy outcomes within the reproductive histories of Medicaid-eligible women in the U.S. Methods: A retrospective, cross-sectional, longitudinal analysis of the pregnancy outcome sequences of eligible women over age 13 from the 17 states where Medicaid included coverage of most abortions, with at least one identifiable pregnancy between 1999 and 2014. A total of 1360 pregnancy outcome sequences were grouped into 8 categories which characterize various combinations of the 4 possible pregnancy outcomes: birth, abortion, natural loss, and undetermined loss. The reproductive histories of 4,884,101 women representing 7,799,784 pregnancy outcomes were distributed into these categories. Results: Women who had live births but no abortions or undetermined pregnancy losses represented 74.2% of the study population and accounted for 87.6% of total births. Women who have only abortions but no births constitute 6.6% of the study population, but they are 53.5% of women with abortions and have 51.5% of all abortions. Women with both births and abortions represent 5.7% of the study population and have 7.2% of total births. Conclusion: Abortion among low-income women with children is exceedingly uncommon, if not rare. The period prevalence of mothers without abortion is 13 times that of mothers with abortion.

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The Effects of Abortion Decision Rightness and Decision Type on Women’s Satisfaction and Mental Health

Reardon¹,

Rafferty²,

Longbons³

2023

Cureus

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Background A case series report based on the Turnaway Study has previously concluded that 99% of women with a history of abortion will continue to affirm satisfaction with their decisions to abort. Those findings have been called into question due to a low participation rate (31%) and reliance on a single yes/no assessment of decision satisfaction. Aim To utilize more sensitive scales in assessing decision satisfaction and the associated mental health outcomes women attribute to their abortions. Method A retrospective survey was completed by 1,000 females, aged 41-45, living in the United States. The survey instrument included 11 visual analog scales for respondents to rate their personal preferences and outcomes they attributed to their abortion decisions. A categorical question allowed women to identify if their abortions were wanted and consistent with their own values and preferences, inconsistent with their values and preferences, unwanted, or coerced. Linear regression models were tested to identify which of three decision scales best predicted positive or negative emotions, effects on mental health, emotional attachment, personal preferences, moral conflict, and other factors relevant to an assessment of satisfaction with a decision to abort. Results Of 226 women reporting a history of abortion, 33% identified it as wanted, 43% as accepted but inconsistent with their values and preferences, and 24% as unwanted or coerced. Only wanted abortions were associated with positive emotions or mental health gains. All other groups attributed more negative emotions and mental health outcomes to their abortions. Sixty percent reported they would have preferred to give birth if they had received more support from others or had more financial security. Conclusions Perceived pressure to abort is strongly associated with women attributing more negative mental health outcomes to their abortions. The one-third of women for whom abortion is wanted and consistent with their values and preferences are most likely over-represented in studies initiated at abortion clinics. More research is needed to understand better the experience of the two-thirds of women for whom abortion is unwanted, coerced, or otherwise inconsistent with their own values and preferences.

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Intervals and Outcomes of First and Second Pregnancies in Low-Income Women: A Record-Linkage Longitudinal Prospective Cohort Study

Cited by 3 publications

References 12 publications

The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study

The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study

Estimating the Period Prevalence of Mothers Who Have Abortions: A Population Based Study of Inclusive Pregnancy Outcomes

The Effects of Abortion Decision Rightness and Decision Type on Women’s Satisfaction and Mental Health

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