Sex education attitudes and outcomes among North American women

Attitudes and outcomes of sex education received by North American women are examined via an Internet survey (N = 1,400). Mean age was 19.5, with 24% reporting one or more unplanned pregnancies. Women were more satisfied with sex education from informal sources than from parents, schools, and physicians. Those receiving sex education from parents or schools reported fewer pregnancies and abortions. In school, women receiving a combination of contraceptive and abstinence education and those receiving primarily abstinence education were least likely to experience unplanned pregnancy. Religious identification was significantly related to unplanned pregnancy and type of sex education received from parents. These factors seem to play a significant role in reducing unplanned pregnancy and abortion.     

Reasoning in the personal and moral domains: Adolescent and young adult women's decision-making regarding abortion

The present investigation of adolescent and young adult women's reasoning, and decision-making about abortion was conducted to determine whether reasoning about abortion could be described by moral, social-conventional, and personal concepts and to examine relationships between domain of reasoning and action choices. Seventy single women, ranging in age from 13 to 31 and divided between 25 women having abortions, 23 women continuing their pregnancies, and 22 never-pregnant women, were administered a semi-structured clinical interview about abortion and two hypothetical moral judgement dilemmas. A classification task was developed to provide an additional measure of reasoning in different domains. Another 29 single, first-pregnant women provided a comparison of the effects of these procedures on decision-making. Content analysis of the protocols revealed that responses to the abortion interview could be reliably distinguished between concepts of morality and personal issues and their coordination or lack of coordination. Subjects treating abortion as a moral issue were more likely to continue their pregnancies while subjects treating abortion as a personal issue were more likely to obtain an abortion. Differences in reasoning between pregnant and nonpregnant subjects were not observed. Moral responses to the abortion interview were found to be highly related to hypothetical moral judgments.     

Severity and cost of unsafe abortion complications treated in Nigerian hospitals

CONTEXT: Each year, thousands of Nigerian women have unintended pregnancies that end in illegal abortion. Many such procedures occur under unsafe conditions, contributing to maternal morbidity and mortality. METHODS: In a 2002-2003 survey of women and their providers in 33 hospitals in eight states across Nigeria, 2,093 patients were identified as being treated for complications of abortion or miscarriage or seeking an abortion. Women's abortion experiences and the health consequences and associated costs were examined through bivariate analysis. Multivariate analysis was used to examine the characteristics of women by type of pregnancy loss and to compare characteristics among three groups of women who had induced abortions in differing circumstances. RESULTS: Among women admitted for abortion-related reasons, 36% had attempted to end the pregnancy before coming to the hospital (including 24% with and 12% without serious complications), 33% obtained an induced abortion at the facility (not withstanding the country's restrictive law) without having made a prior abortion attempt and 32% were treated for complications from a miscarriage. Of women with serious complications, 24% had sepsis, 21% pelvic infection and 11% instrumental injury; 22% required blood transfusion and 10% needed abdominal surgery. The women in this group were poorer and later in gestation than those who sought abortions directly from hospitals. They paid more for treatment (about 13,900 naira) than those who went directly to the hospital for an abortion (3,800 naira) or those treated for miscarriage (5,100 naira). CONCLUSIONS: Policy and program interventions are needed to improve access to contraceptive services and postabortion care in order to reduce abortion-related morbidity and mortality.     

The psychosocial factors of the abortion experience: a critical review

The literature on the psychosocial factors of abortion is critically reviewed. It is concluded that due to faulty methodology no general statements can be made about these factors for women receiving illegal abortions. It appears that the data showing that women receiving therapeutic abortions experienced favor- able psychological conseuqences are stronger than the data indicating negative consequences. Studies of abortion on request, which, for the most part, have been methodologically sound, indicate that the new abortion patients are mostly young, unmarried women who are not in a social position to bear and care for a child. They tend to end their pregnancies for social and economic reasons. Further, they are either not aware of or not concerned about the possibility of getting pregnant at the time of intercourse, or they have a contraceptive failure. Finally, the psychological consequences of abortion on request appear to be most1 y benign.     

The Relationship of Pregnancy Status to Job Satisfaction: An Exploratory Analysis

Forty-three women who had worked outside of the home prior to becoming pregnant and had returned to the same place of employment after the birth of their children participated in the study. To do so, they responded to a two-part questionnaire asking about their work lives (e.g., level of job satisfaction before, during, and after their pregnancies) and demographic characteristics (e.g., occupation). The results indicated that their job satisfaction was significantly greater before their pregnancies than either during or after their pregnancies. Job satisfaction during pregnancy had a significant, positive correlation with satisfaction with organizational maternity leave policies. Perceived reactions from women's coworkers and supervisors were also examined. Implications for these findings for organizations are discussed. Limitations of the study, and how they might be rectified in future research, are also addressed.     

The Experience of Genetic Counselors Working with Patients Facing the Decision of Pregnancy Termination after 24 Weeks Gestation

Prenatal genetic counselors are health care professionals who counsel women making reproductive decisions which include decisions such as terminating pregnancies due to fetal anomalies. Little is known about the experiences and practices of prenatal genetic counselors working with women who have the option of termination after 24 weeks gestation. In this national survey of 168 genetic counselors who have practiced prenatal genetic counseling, we asked about their general practice patterns, including indications for which termination is offered and types of abortion care services that are coordinated by genetic counselors. We report respondents’ self-assessments of level of understanding of federal abortion law and abortion procedures. Seventy-six percent of respondents have offered and counseled on termination after 24 weeks and 93% of respondents believe it is the responsibility of the counselor to discuss this option with patients. However, one-third report that they have some or no understanding of the procedures and three-quarters report that they have some or no understanding of federal abortion law. The results of this study provide insight into knowledge and experiences of genetic counselors working with these patients, allowing for improved genetic counselor training and continuing education to provide better guidance and develop more effective means of assisting patients.     

Alcohol use as a situational influence on young women's pregnancy risk-taking behaviors

Recent studies have found that many young women just beginning their sexual lives use alcohol prior to intercourse. A large number appear to drink heavily enough prior to sex to compromise their ability to use contraceptives. The question emerges whether there is a relationship between drinking before intercourse, the nonuse of birth control methods, and unplanned pregnancies. The present research describes 43 instances of intercourse which resulted in unplanned pregnancies in 14- to 21-year-olds. Variables examined included alcohol use prior to sex, amount of alcohol consumed, the use of other drugs, the planning of intercourse, respondents' stated reasons for nonuse of contraceptives, and other general demographic data.     

Low Rates of African American Participation in Genetic Counseling and Testing for BRCA1/2 Mutations: Racial Disparities or Just a Difference?

Low rates of genetic counseling among African American women have generated concerns about disparities; however, to the extent that women's decisions to accept or decline counseling are consistent with their values, then lower participation may reflect preferences and not disparities. We evaluated the extent to which women were satisfied with their decision about participating in genetic counseling for BRCA1/2 mutations and identified variables that were associated significantly with satisfaction. Prospective study of decision satisfaction with 135 African American women who had a minimum 5% prior probability of having a BRCA1/2 mutation. Decision satisfaction was evaluated one month after women were offered participation in genetic counseling using a structured questionnaire. Women were satisfied with their participation decision; more than 80% reported that their decision was consistent with their family values. However, women who declined pre-test counseling had significantly lower satisfaction scores. Our findings highlight the importance ensuring that racial differences that are due to preferences and values are not misclassified as disparities in order to identify and address the root causes of disparate treatment.     

Indian college students' attitudes toward abortion in different contexts

Two experimental studies used the hypothetical situation of a pregnant woman (the stimulus person) considering the possibility of an abortion and obtained from Bombay college students estimates of the likelihood of an abortion and their own recommendations in favor of abortion. The first study had a 2 (subject's sex) × 2 (reason for abortion: unplanned child vs. female child) × 2 (person more in favor of abortion: stimulus person vs. her husband) × 3 (stimulus person's socioeconomic status: upper, middle, or lower class) factorial design with 15 subjects per cell. Male subjects indicated greater likelihood of abortion than female subjects. Recommendations were stronger for the unplanned rather than female child and for the lower class rather than upper and middle class stimulus persons. The second study had a 2 (subject's sex) × 3 (reason for abortion: unplanned marital pregnancy, premarital pregnancy, or rape pregnancy) × 3 (stimulus person's socioeconomic status: upper, middle, or lower class) factorial design with 15 subjects per cell. Perceived likelihood and strength of recommendation were highest for rape pregnancy followed by premarital pregnancy and marital pregnancy in that order. The interactions in this study suggested a greater vulnerability of the middle class as compared to the other two classes with respect to sexual morality.     

The psychological impact of reproductive difficulties on women's lives

Little is known about the long-term impact of reproductive experiences on women's lives. This paper uses questionnaire data collected from 107 White female college graduates, when they were approximately 47 years old. More than half the sample had experienced at least one type of reproductive difficulty (abortion, miscarriage, or infertility). The stress and coping model of life difficulties (Lazarus and Folkman, 1984) was used to examine the relationship between the women's reproductive difficulties and emotional sequelae, politicization, and orientation to motherhood at midlife. As predicted, emotional responses to the reproductive difficulties varied according to the particular nature of each experience. In addition, women who had abortions and no other difficulties were more politicized at midlife than other women. Women whose reproductive experiences were especially likely to arouse feelings of not being in control of their life (those who had miscarriages or infertility) described a more agentic orientation to motherhood when compared with other women.     

Through a different lens: Examining professional women's interrole coping by focus and mode

An alternative method for classifying women's interrole coping efforts is proposed based upon current stress and coping theory. This coping classification method is then used to examine the coping responses and reported satisfaction of a sample of 135 professional women employed full-time as college faculty. Distinctive patterns of coping response use emerged for this group of women when the coping response strategy was expanded to include whether the response was problem focused or emotion focused and active or passive. The women report greater use of problem-focused than emotion-focused coping responses across several different types of work role conflict situations. Differences in rated satisfaction were reported, with the highest satisfaction reported when active coping responses that involved others were used.     

The Decision to Continue a Pregnancy Affected by Down Syndrome: Timing of Decision and Satisfaction with Receiving a Prenatal Diagnosis

In order to provide the best genetic counseling possible for women who learn of a diagnosis of Down syndrome prenatally, we sought to assess the timing of the decision to continue a pregnancy and the satisfaction these women had with learning this information. Fifty-six mothers of children with Down syndrome diagnosed prenatally between 2007 and 2010 completed a survey regarding their experience with decision-making after prenatal diagnosis. Approximately one third (17/56) of participants reported they knew before getting pregnant that they would not terminate for any reason, and almost half of the participants (24/56) reported they did not decide to continue their pregnancy until after the diagnosis. Many participants (82 %; 42/56) stated that learning the diagnosis during pregnancy increased their anxiety. The majority (88 %; 45/56) also reported that if they could do it over again, they would undergo prenatal testing for preparation purposes, despite increased anxiety. Religious and spiritual beliefs as well as feeling attached to the baby were the personal factors that had the greatest impact on most women’s decision-making. Despite increased anxiety caused by learning the diagnosis prenatally, most women favored prenatal diagnosis as it allowed them time to process the information and prepare for the birth of their child.     

Women’s Sexual Compliance with Male Dating Partners: Associations with Investment in Ideal Womanhood and Romantic Well-Being

Sexual compliance involves willing acquiescence to unwanted sex for the good of the relationship. Northeastern U.S. undergraduate women in exclusive relationships (N?=?193) anonymously reported on their sexual behaviors and motives, investment in ideal womanhood, and romantic well-being. About 37% (n?=?72) reported sexual compliance. As expected, sexually compliant women reported greater investment in ideal womanhood than non-compliant women, although unexpectedly, they reported less overall satisfaction and similar commitment. Women’s compliance was motivated more by pursuing relationship enhancement than by avoiding conflict. Regardless, only avoidance motives were associated (negatively) with relationship satisfaction. Compliant women who reported more frequent compliance motivated by conflict avoidance reported particularly low satisfaction. These findings challenge conceptualizations of women’s sexual compliance as beneficial.     

Factors associated with responses to sexual harassment and satisfaction with outcome

This study examined contextual and behavioral factors and types of responses to sexual harassment in relation to harassed employees' satisfaction with the outcome of sexual harassment situations. Subjects were 105 male and female faculty and staff members (89.5% Caucasian; 5.7% multiethnic/multicultural; 4.8% unspecified) employed by a midwestern university who reported experiencing unwanted sexual attention on the job. Results undicated that employees responded more strongly to unwanted sexual behavior if they perceived it as sexual harassment and if they perceived their work climate as encouraging the problem. Harassed employees' gender, power, and perceptions of the work climate were all associated with their satisfaction with the situation outcome. Although making a formal or informal complaint was not associated with greater satisfaction, talking to the harasser without using aggressive communication strategies increased the likelihood of a satisfactory outcome for the employee. Talking to family or friends, a response used by women more often than men, was associated with dissatisfaction. Suggestions for further research are discussed.This research was primarily funded by the Center for Public Affairs Research at the University of Nebraska at Omaha. The authors gratefully acknowledge the research assistance of Jami Winters, Gena Ritter, Sarah Holmes, Kim Gangwish, and Mary Lou Costanzo.     

Sequelae of cesarean and vaginal deliveries: psychosocial outcomes for mothers and infants

Mother-infant dyads grouped according to whether the infants had been delivered vaginally (n = 74) or by planned (n = 37) or unplanned cesarean (n = 56) were compared on psychosocial outcomes at 4 and 12 months postpartum. Hypotheses were that unplanned cesarean delivery would be related to less optimal outcomes and that this relationship would be mediated by mother's appraisal of the delivery and would attenuate over time. No delivery-related differences in mother-infant interactions were found at 4 or 12 months postpartum with one exception: Women low in neuroticism who delivered by unplanned cesarean showed less positive affect toward their infants at 4 months than did women high in neuroticism who delivered by unplanned cesarean or women in any other group. There was some evidence of the mediating role of maternal appraisal of the delivery on these effects. In general, the results indicate little cause for concern about the quality of mother-infant interactions following cesarean deliveries.     

Pregnancy decision making: predictors of early stress and adjustment

Pregnancy decision making was examined among pregnant and non-pregnant women seeking pregnancy testing. The majority of women had decided upon and were certain of a decision to either abort or carry a possible pregnancy before learning the pregnancy-test results. Adjustment to pregnancy decision making was examined longitudinally among the women who tested positive for pregnancy. Pregnant participants were interviewed about their decisions to carry or abort their pregnancies at three times–immediately prior to pregnancy testing, a day after receiving positive test results, and 4 weeks later. Nearly all maintained their original decision over the course of the study. Adjustment was related primarily to which outcome was chosen and, to a lesser degree, to whether a woman was initially decided or not upon the outcome. The time surrounding pregnancy testing was stressful for women who decided to abort their pregnancies. However, negative feelings at the time of pregnancy testing among those who later aborted their pregnancies subsided by the end of the study and did not differ from those who carried their pregnancies.     

Episodic emotions of Tshivenda cultural community mothers towards their adolescent children’s pregnancies

This study explored Tshivenda mothers’ emotional reactions to the learning of unplanned pregnancies of their adolescent daughters. Ten purposively selected mothers with early parent adolescent children were informants (age range = 40 to 55 years). They responded to semi-structured face-to-face interviews on their reactions to the learning of the pregnancies of their daughters. The interview data were thematically analysed. Findings suggest the mothers experienced anger and embarrassment, objective and subjective burdens supporting their early parent daughter, and fears for the health of their mother-to-be daughters. The mothers reported to cope with pregnancy of their daughters by religion supplication, acceptance and social support, as well as open communication with their adolescent daughters about the pregnancies.     

Emotional response to abortion: a critical review of the literature

Anti-abortion groups in the US cite the existence of a post-abortion syndrome--a sense of loss, emptiness, and grief similar to that reported by trauma survivors. Although research on the longterm effects of induced abortion is marred by methodological errors, most studies have found no adverse psychological sequelae; rather, there appears to be a sense of relief and opportunity for personal growth. Nevertheless, there is a small group of women who do experience emotional distress after abortion and it is important to identify the demographic, social, and psychological factors that place women at risk of such a reaction. In terms of demographic factors, young age (adolescence), low or nulliparity, 2nd-trimester procedures, and Catholicism have been characteristics of women who suffered post-abortion depression. Of the social variables that have been examined, a lack of support from significant others (parents or partner) has been linked in some studies to emotional distress after abortion. A relatively consistent finding is that women who feel coerced to abort or are ambivalent about their decision at the time of the procedure are most likely to experience regret, depression, and anger. Women whose coping style involves avoiding responsibility are also prone to post-abortion distress. As noted, the literature does not support the contention that abortion causes longterm trauma. On the other hand, given the fact that 1.5 million abortions take place each year in the US, the existence of some post-abortion distress in even as small percentage of acceptors is enough to indicate a need for pre- and post-abortion counseling to help women determine the meaning of the experience and own their decisions.     

Pregnancy reduction in Jewish law

10% of infertile women who become pregnant with the aid of hormonal stimulation become pregnant with multiple fetuses. 20% of mothers of triplets experience preeclampsia and 35% risk serious postpartum hemorrhage. Risk increases with the number of fetuses for venous stasis, varicose veins, phlebothrombosis, thrombophlebitis, and embolic phenomena. Risk increases proportionally with increased number of fetuses for fetal morbidity and mortality. Selective abortion is often used as a method of reducing risk to both the woman and the fetuses, thus increasing the chance that 1 or 2 fetuses will be born healthy. A related issue is the selective reduction of fetuses in multiple pregnancies that may have a genetic defect like Hurler's syndrome, microcephaly, Tay-Sachs disease, spina bifida, hemophilia A, or thalassemia major. In cases where 1 fetus in a set of twins is so inclined, the reduction of the defective fetus increased the success of the remaining co-twin. Selective reduction should not pose a problem for Jewish women since the procedure does not violate any Jewish legal or moral rules. In Jewish law an unborn fetus is not considered a person until it is born. Until the 40th day of pregnancy it is considered as 'mere fluid.' In order to stress the positive aspect of selective reduction it should be called "enhanced survival of multifetal pregnancies."     

The balance of power in lesbian relationships

A questionnaire study investigated the balance of power in lesbian relationships and factors that affect it. Seventy-seven lesbian women currently in a romantic/sexual relationship participated. Although lesbians strongly endorsed an egalitarian ideal of equal power in love relationships, nearly 40% reported an unequal balance of power in their relationship. As social exchange theory predicts, the partner who was relatively less dependent on the relationship and who had greater personal resources tended to have greater power. Compared to women in equal power relationships, women in unequal power relationships reported less satisfaction and anticipated more problems in their relationships. No evidence of butch-femme role playing was found. It is suggested that the determinants of the balance of power go beyond attitudes and reflect processes of social exchange that can occur regardless of ideology or sexual orientation.The authors wish to thank Susan D. Cochran, Naomi McCormick, Karen S. Rook, and Richard R. Lau for their helpful comments on an earlier version of this article, and Christine Padesky for her assistance in data analysis.