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The role of depression, anxiety, and negative emotions in post-abortion contraceptive decision-making

Julia Steinberg, University of California San Francisco, 2010

Project abstract

The goal of this research is to examine how women's levels of depression, anxiety, and negative emotions around the time of an abortion relate to contraceptive choice in abortion care settings. While prior research has shown that mental health and emotions prior to an abortion are strong predictors of post-abortion mental health and coping, research understanding their role in other important post-abortion outcomes such as contraceptive choice is lacking.

This work stems from recent studies demonstrating that women who have abortions have a higher prevalence of prior mental health problems compared to other women. Building upon a small study underway at the Women's Options Center at San Francisco General Hospital, we propose to conduct research at three additional abortion clinics to investigate how women's mental health and their emotional state at the time of the contraceptive counseling influence post-abortion contraceptive decisions. Collecting data at more than one clinic will allow us to examine how mental health and emotions influence post-abortion contraceptive choice among different patient populations, independent of provider factors.

We will collect data with measures of depression, anxiety, and negative affect that are validated instruments in the psychological literature, by administering questionnaires at two points: before contraceptive counseling and after the contraceptive choice is made. We will use logistic regression models and path modeling to test our research hypothesis that women with higher levels of depression, anxiety, and negative affect will choose less effective contraceptive methods.

Results are expected to inform contraceptive counseling as well as clinical practices regarding assessment and referrals for mental health problems in order to prevent future unintended pregnancies. In addition, these findings may be used as evidence to counter the claim that abortion causes mental health problems.

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