The Change in Attitudes Towards Abortion in Former West and East Germany After Reunification: A Latent Class Analysis and Implications for Abortion Access

Abstract

Introduction The legal status of abortion has changed in the regions of former East Germany after reunification due to the adoption of restrictive West German abortion policies. The aim of this study was to evaluate the impact on attitudes towards abortion and the associated health care implications in Western and Eastern Germany. Materials and Methods Nationally representative data on public support for legally restricting abortion access were taken from the German General Social Survey and included the surveys 1992, 1996, 2000, 2006 and 2012 (N = 14 459). Two indicators of barriers to access to abortion care were calculated for each federal state, based on the number of abortion facilities and the proportion of women seeking abortion outside their state of residency. Data were analysed using latent class analysis. Results Results suggested that abortion attitudes could be classified into three distinct subgroups: 1) support for abortion access independent of womenʼs reason; 2) support on the basis of maternal or foetal health reasons but not for socio-economic reasons (e.g. financial restrictions); and 3) no support. The size of subgroups in favour of partial or complete restriction on abortion access increased in both regions over the study period and this trend could not be explained by changes in socio-demographic characteristics. Respondents living in a federal state with more barriers to access to abortion care were more likely to hold restrictive abortion attitudes. Conclusion Negative attitudes towards abortion have increased in Western and Eastern Germany during the two decades following reunification and may harm women by limiting acceptability and accessibility of abortion care. Abortion policies, public discourse and provision of abortion care should be informed by international guidelines protecting womenʼs health and rights.

Identifying Profiles of Support for Legal Abortion Services in Zambia: A Latent Class Analysis

“…Using LCA, this population-based study of reproductive-age women uncovered three distinct profiles of support for legal abortion services in Zambia; two of these groups clustered exclusively around support of (legal abortion advocates, ∼23 percent prevalence) and opposition to (legal abortion opponents, ∼58 percent prevalence) pregnancy termination irrespective of grounds for abortion-seeking, while the third (conditional supporters of legal abortion, ∼19 percent prevalence) consisted of women who support legal abortion services in circumstances where continuing the pregnancy would threaten the life of the mother or fetus. These findings complement emerging evidence from the United States (Osborne et al 2022) and Germany (Hanschmidt et al 2020), where studies have found that conditional support for legal abortion services (primarily in circumstances where maternal/fetal health is compromised) persists amidst highly polarized attitudes, specifically universal support or objection, towards legalized abortion. Even in the presence of a relatively progressive legal framework, these results reaffirm globally observed discrepancies between public attitudes towards legalized abortion and the broader legal environments governing abortion care provision (Scoglio and Nayak 2023;Smith et al 2022).…”

“…2022) and Germany (Hanschmidt et al. 2020), where studies have found that conditional support for legal abortion services (primarily in circumstances where maternal/fetal health is compromised) persists amidst highly polarized attitudes, specifically universal support or objection, towards legalized abortion. Even in the presence of a relatively progressive legal framework, these results reaffirm globally observed discrepancies between public attitudes towards legalized abortion and the broader legal environments governing abortion care provision (Scoglio and Nayak 2023; Smith et al.…”

Assessment of person-centeredness in healthcare and social support services for women with unintended pregnancy (CarePreg): protocol for a mixed-method study

“…The care situation of women with an unintended pregnancy is recently an important topic within political healthcare discussions in Germany. 1 2 The high relevance is reflected by several cases of lawsuits against the current legal regulations on abortion rights [2][3][4][5][6] as well as a reduction of the number of medical institutions performing abortions of almost 50% from 2003 to 2012 in Germany. 7 The federal statistical office counted 100 000 abortions per year for the past 10 years.…”