A Survey of Emotional and Mental Health Effects Women Attribute to Their Pregnancy Outcomes

Materials and Methods

Experts in abortion and mental health research were consulted in preparing a questionnaire into the prevalence and effects of abortions that conflict with women’s own maternal preferences and moral beliefs.

Study Population

Invitations to complete a topic blind survey were electronically distributed to Cint.com panelists over a three-day period in July of 2024. Cint panelists are persons who voluntarily complete surveys using their own electronic devices in exchange for small rewards with a value, for this invitation, of under $2 per completed survey. The Cint survey panels include over 28 million U.S. residents. For this survey, a random sample of United States residents Cint pre-identified as females 41 to 45 years of age were invited to complete a survey housed on the LimeSurvey.org platform without any disclosure of the subject matter. The narrow age range, 41-45 years of age, was chosen to (a) eliminate the confounding effects of age, and (b) to maximize the proportion of respondents with a history of abortion since this age group will have completed the majority of their reproductive lives. Investigation of younger women has been deferred until we can test the survey instrument with this limited age group.  

The survey exposure rate, response rates, and exclusion rates are shown in Figure 1. Respondents who did not complete all questions were excluded from the analysis, as were any respondents who were out of our gender and age range. Among the 2,361 people who completed the first page of demographic questions, 123 (5.2%) dropped by failing to complete the psychiatric history and another 25 (1.1%) dropped out when presented with questions relating to abortion. Another 22 (1.0%) dropped out when asked their own pregnancy outcomes histories and 166 (7.0%) dropped out, after reporting their pregnancy histories, before completing the survey. The survey was designed to be completed in approximately five to seven minutes by respondents reporting any pregnancies. Of those who completed the survey, 100 (4.6%) were excluded for completing the survey in an unreasonably short period of time, under four minutes. The exclusion of these “speedsters” reflected the likelihood that some respondents, seeking to earn credit for completing the survey as quickly as possible, were randomly responding without reading or considering the questions.

Figure 1: Study Population

Variables used

The first page of the questionnaire asked about age and gender to qualify respondents. The second page included a list of eleven mental health diagnoses and asked respondents to identify which, if any, they had ever been diagnosed.

Only after this page were respondents asked if they had ever had an “unplanned, mistimed, unwanted, or otherwise difficult pregnancy,” which was defined and thereafter referred to as a “problematic pregnancy.” They were then asked to identify the number of times they had “given birth to a live born child,” “had a miscarriage, still birth or other pregnancy loss” and “had an induced abortion.” From this pregnancy history women were divided by a program algorithm into one of five groups, by order of priority: those who had a history of induced abortions, had experienced natural pregnancy losses, had problematic pregnancies carried to term, or had live births, or had never been pregnant. Results from this grouping is shown in Table 1. Notably, given the algorithm prioritization, women in the abortion group may also have had one or more live births, natural pregnancy losses, and problematic pregnancies ending in a live birth. But women were included in the live birth group only if they had none of the other pregnancy outcomes.

The rest of the variables are described in the repository document "2nd USA Survey Instrument.pdf" and in the limesurvey code, "2nd USA survey limesurvey.lss."