Predictors and Correlates of Abortion in the Fragile Families and Well-Being Study: Paternal Behavior, Substance Use, and Partner Violence

Abstract

This study was designed to identify predictors of the choice to abort or deliver a child within 18 months of a previous birth and to compare mothers who chose to abort or deliver relative to substance use and adverse partner behavior. Using a systems perspective, data from the Fragile Families and Well-Being Study were examined. The sample included participants from 16 cities, and within the selected cities, hospitals with high rates of unmarried births were chosen for inclusion in the survey. The data analysis process entailed two steps: 1) predictors of the choice to abort were identified statistically; 2) mothers who chose to abort and deliver were compared relative to heavy drinking, cigarette smoking, and adverse partner behavior after controlling for potentially confounding factors identified in step one. The results indicated that several variables pertaining to the father's commitment to raising a previously born child and to his relationship with the mother predicted the choice to abort. Further, a recent abortion was related to substance use and partner perpetrated physical aggression after the effects of confounding variables were removed. Professionals who work with women from impoverished environments facing an unplanned pregnancy should be encouraged to sensitively explore the woman's support system. If the father is unavailable, counselors can assist women in identifying other sources of support within and outside the family.

Fatal flaws in a recent meta-analysis on abortion and mental health

“…Ten letters to the editor were highly critical of the methodology used [8–17], with 2 calling for a retraction of this meta-analysis [10, 16]. In addition, the final version of a review by the Royal College of Psychiatrists (RCPsych) [1] stated that (p. 18) “A number of methodological problems with the meta-analysis conducted in the Coleman review have been identified, which brings into question both the results and conclusions.” And, a commentary published in January 2012 [7], written by authors of the Royal College of Psychiatrists’ review concluded that the Coleman meta-analysis (p. 12) “cannot be regarded as a formal systematic review.” Like others [1, 7–17], we strongly question the quality of this meta-analysis of 22 papers [18–39] just as the reliability, validity, and replicability of some of the studies [e.g., 26, 37] in the meta-analysis have been questioned [40, 41]. …”

“…Rather than conducting a meta-analysis on all 44 reviewed studies, only 4 were included in these meta-analyses. Moreover, 13 studies included in Coleman’s meta-analysis (Coleman was an author of 7 of these) were excluded from the RCPsych analysis that compared women who aborted to other women for reasons shown in Table 1 [18, 19, 21, 22, 26–28, 30, 32, 33, 37–39]. Of the other 10 studies 1 that were included in Coleman’s meta-analysis, 3 were rated as poor [20, 24, 25], 1 as fair [34], 4 as good [23, 29, 31, 36], and 2 as very good [31, 35] by the RCPsych review.…”

“…Coleman fails to adequately distinguish conceptually among mental health outcomes, giving equal weight to risk behavior outcomes like alcohol or marijuana use during pregnancy [19, 27] or any marijuana use [33] or any alcohol use [18, 33] as to more severe psychiatric outcomes like suicide [22]. In addition, methods of assessment such as clinical diagnoses made by structured psychiatric interviews [e.g., 26, 28, 31, 35] and those of single item measures [e.g., 18, 19, 27, 33, 38] are not distinguished.…”

“…In addition, methods of assessment such as clinical diagnoses made by structured psychiatric interviews [e.g., 26, 28, 31, 35] and those of single item measures [e.g., 18, 19, 27, 33, 38] are not distinguished. These conceptual and measurement issues influence a study’s validity and reliability regarding the effect of abortion on mental health.…”

Abortion and sex-related conditions in substance-dependent Brazilian patients

“…Cigarette use is common among women seeking abortion 51,53,54 and this relationship has been found to be associated to unplanned pregnancy, indicating that smoking is not pregnancy-resolution related but rather pregnancy-occurrence related 16 . Studies have reported positive associations between abortion and subsequent tobacco use 23,54 .…”