Moderators and mediators of the relationship between receiving versus being denied a pregnancy termination and subsequent binge drinking

Abstract

Background Women who terminate pregnancies drink more subsequent to the pregnancy than women who give birth, including women who give birth after seeking to terminate a pregnancy. Methods Data are from the Turnaway Study, a prospective, longitudinal study of 956 women who sought to terminate pregnancies at 30 U.S. facilities. This paper focuses on the 452 women who received terminations just below facility gestational limits and 231 who were denied terminations because they presented just beyond facility gestational limits. This study examined whether baseline characteristics moderate the relationship between termination and subsequent binge drinking and whether stress, feelings about the pregnancy, and number of social roles mediate the relationship. Results Only having had a previous live birth modified the termination-binge drinking relationship. Among women with previous live births, binge drinking was reduced among women carrying to term compared to terminating the pregnancy. Among women who had not had a previous live birth, however, the reduction in binge drinking among those denied termination was not sustained over time, and binge drinking of those who had and had not had terminations converged by 2.5 years. Neither stress, negative emotions, nor social roles mediated effects on binge drinking. Positive emotions at one week mediated effects on binge drinking at six months, although positive emotions at two years did not mediate effects on binge drinking at 2.5 years. Conclusions Higher levels of binge drinking among those who terminate pregnancies do not appear due to stress or to negative emotions. Only parous women – and not nulliparous women – denied terminations experienced sustained reductions in binge drinking over time.

Changes in Alcohol, Tobacco, and Other Drug Use Over Five Years After Receiving Versus Being Denied a Pregnancy Termination

“…We did not find differences in potential alcohol problem symptoms (eye-opener or blackout) or in drug use between groups (Roberts et al, 2014(Roberts et al, , 2015. We also did not find evidence that having abortions increased heavy episodic alcohol, problem alcohol, tobacco, or drug use or that differences in heavy episodic alcohol use between groups were explained by stress or negative emotions about the pregnancy Roberts et al, 2014Roberts et al, , 2015Roberts et al, , 2016. Together, these findings indicate that-over 2 to 2.5 years-women continuing unwanted pregnancies reduce/cease some, but not all, substance use, whereas women who have abortions tend to continue substance use patterns from before their abortions.…”

“…In addition to broader mental health (Biggs et al, 2015(Biggs et al, , 2016(Biggs et al, , 2017Foster et al, 2015), the Turnaway Study includes assessment of ATOD use and alcohol misuse. We have published mid-study (2-to 2.5-year) findings for ATOD use Roberts et al, 2014Roberts et al, , 2015Roberts et al, , 2016. We found that women who had abortions had higher levels of any alcohol use, heavy episodic alcohol use, and tobacco use over 2 to 2.5 years than women denied abortions, but these differences were attributable to reductions among women denied , not increases among women receiving, abortions.…”