Women's decision-making related to induced abortion - a cross sectional study during a period of Covid-19 pandemic, in Sweden

ObjectivesTo investigate women's decision-making on induced abortion.Materials and methodsA multi-centre cross-sectional survey among 623 abortion-seeking women in Sweden (2021). The perceived difficulty to decide on abortion was measured using a 7-point Likert scale, and analysed with univariate and multivariate analysis (odds ratios [OR], 95% confidence intervals [CI]).ResultsAbout half (n = 322;52%) scored 1-4, suggesting the decision was perceived as easier compared to those (n = 292;48%) who scored 5-7. Reasons for the abortion were: poor economy (n = 166;27%), too early in the relationship (n = 154;25.1%), want to work first (n = 147;23.9%), want to study first (n = 132;21.5%), uncertain about the relationship (104;16.9%), and too young (n = 104;16.9%). Predictors for perceiving the decision as difficult: partner's hesitance (OR = 3.18, CI:1.76-5.73), being born outside the Nordic countries (OR = 2.23, CI:1.28-3.87), having discussed the decision with someone (OR = 2.42, CI:1.67-3.50), age >= 30 (OR = 2.22, CI:1.03-4.76), the Covid-19 pandemic (OR = 2.08, CI:1.20-3.59), and the desire to have children in the future (OR = 1.96, CI:1.18-3.28). After confirmed pregnancy, poor mental well-being was more common among those who scored 5-7 (n = 140;47.9%) compared to those who scored 1-4 (n = 122;37.9), p = .029.ConclusionWomen's decision-making on abortion is complex; in times of crises, the decision procedure may be even more difficult. This valuable knowledge could be used to improve and promote satisfactory counselling beyond medical routines.

Automated summary

This study investigates women's decision-making on induced abortion in Sweden. The results show that half of the women find the decision relatively easy, while the other half finds it difficult. Reasons for choosing abortion include economic difficulties, early stage in the relationship, desire to work or study first, uncertainty about the relationship, and being too young. Factors predicting difficulty in decision-making include partner's hesitance, being born outside the Nordic countries, discussing the decision with someone, age over 30, the Covid-19 pandemic, and the desire to have children in the future.