Evidence-Based Advocacy: Expanding Our Thinking About “Repeat” Abortions
Evidence-Based Advocacy is a bi-monthly column seeking to bridge the gap between the research and activist communities. It will profile provocative new abortion research that activists may not otherwise be able to access.
About 1.2 million abortions are performed in the United States every year, and of women seeking abortions, about half have had an abortion before. Women who have had more than one abortion are often targets of public-health interventions designed to increase women’s use of post-abortion contraception, or, to put it another way, to prevent them from having another abortion. Instead of seeing these women as “repeaters,” it’s time we viewed each abortion as a unique experience with its own set of complex circumstances.
Tracy Weitz and Katrina Kimport, sociologists with Advancing New Standards in Reproductive Health (ANSIRH), analyzed the interviews of ten women who’d had multiple abortions (full disclosure: I interned at ANSIRH this summer). Their research was part of several larger studies. The women interviewed varied in age, race, and geographic location, although most were from the Northeast or the West Coast. Together, they’d had a total of 35 abortions. Weitz and Kimport examined how these women thought about each abortion experience. Were they similar or different from each other? How did the circumstances of each abortion affect women’s emotional outcomes?
The researchers found that women talked about their abortions as separate events. Each abortion came with its own set of unique emotional and social circumstances, some more difficult or easy than others. In other words, a woman who’s had three abortions wasn’t repeating the same experience each time. Health interventions and policies that target women who have had more than one abortion should take into account that each abortion — and the circumstances of that pregnancy — may reflect a different emotional experience.
Weitz and Kimport argue, “It is important to recognize that some abortions can be emotionally easier or harder; it is problematic to instead think about abortion as being harder or easier for some women.” That is, just because a woman has had multiple abortions does not mean that each one was a product of the same circumstance. In fact, women reported that they wanted different types of support based on the circumstances of each abortion.
Similarly, providers should not assume that a woman with a history of multiple abortions will have the same emotional or contraceptive needs after each abortion. In fact, Weitz and Kimport found that some women avoided going to the same provider for each abortion because they feared being judged for having multiple abortions or having to hear the same contraceptive-counseling script. Providers should not make assumptions about their patients’ needs based on the number of abortions they’ve had.
Even our so-called pro-choice allies place judgments on women who have had multiple abortions. Mainstream pro-choice organizations often shy away from acknowledging that some women have more than one abortion. Instead of worrying that discussing multiple abortions will rile up the anti-choice movement, we should focus on de-stigmatizing the experience of abortion, no matter how many times a woman needs to access this service.
Women who have had multiple abortions should not be viewed as a separate class of people from women who have had one abortion. Indeed, it may be that the women who have only one abortion over an average of 35 years of trying not to become pregnant, are the rarer ones. Instead of targeting just the women who have had multiple abortions for public-health interventions, the researchers suggest that we offer emotional support based on the context of each abortion.
We should understand women who have had multiple abortions through their individual life experiences rather than judging them on their pregnancy history. If we want to better meet women’s emotional needs around abortion, we can start by using the phrase “multiple abortions” instead of “repeat abortions,” and moving away from policies that seek to prevent “repeat abortions.” To support women who have had multiple abortions, we need to acknowledge that some abortions may be more difficult than others.