Attitudes towards abortion in male and female adolescents with diverse sexual and pregnancy experiences: a cross-sectional study
Jacqueline Hendriks A B K , Sue Fyfe C , Dorota A. Doherty D , Angela Jacques E F , Irene Styles G , Martha Hickey H I and S. Rachel Skinner B JA Collaboration for Evidence, Research and Impact in Public Health, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
B School of Paediatrics and Child Health, University of Western Australia (M501), 35 Stirling Highway, WA 6009, Australia.
C Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
D Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia (M550), 35 Stirling Highway, WA 6009, Australia.
E School of Population Health, University of Western Australia (M410), 35 Stirling Highway, WA 6009, Australia.
F School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
G Graduate School of Education, University of Western Australia (M428), 35 Stirling Highway, WA 6009, Australia.
H Gynaecology Research Centre, The Royal Women’s Hospital, Locked Bag 300, Flemington Road, Parkville, Vic. 3052, Australia.
I Department of Obstetrics and Gynaecology, The University of Melbourne, Vic. 3010, Australia.
J Discipline in Paediatrics and Child Health, University of Sydney, Locked Bag 4001, Westmead, NSW 2145, Australia.
K Corresponding author. Email: jacqui.hendriks@curtin.edu.au
Sexual Health 17(1) 77-86 https://doi.org/10.1071/SH19084
Submitted: 20 May 2019 Accepted: 10 September 2019 Published: 21 January 2020
Abstract
Background: Research focused on adolescents’ attitudes towards abortion is limited, and validated scales are not routinely used. A greater understanding of adolescents’ attitudes towards abortion could better inform the sexuality education strategies targeted at this age group. Methods: A cross-sectional survey was completed by 1470 adolescents (437 males, 1033 females) aged 12–19 years and living in Perth, Australia. Participants were recruited from secondary schools, antenatal clinics and termination clinics to capture varying experiences of sexual activity and pregnancy. Survey items investigated abortion attitudes, sexual behaviour and pregnancy history alongside other demographic and psychosocial factors. Analyses included comparative means and adjusted linear regressions. Results: Sexually active participants (n = 554) and females reporting a previous abortion (n = 196) held more supportive attitudes towards abortion (P < 0.001 for both). Among sexually active females, more supportive attitudes were held by those reporting a previous abortion (β = 2.60, 95% confidence interval 0.93–4.27, P = 0.002), later age (≥16 years) at first vaginal intercourse (P < 0.001), use of oral contraception at last sex (P = 0.029), previous condom use (P < 0.001) and/or three or more oral sex partners in the previous 12 months (P = 0.005). For sexually active males, more supportive attitudes were reported by those whose female partners had used oral contraception at last sex (P = 0.013) or ever (P = 0.017). Multivariable analyses indicated that other correlates, including risky sexual behaviour, had minimal or no effect on attitudes. Conclusions: Adolescents’ attitudes towards abortion appear to be influenced by their ability to personalise and contextualise the effect of a pregnancy. Associations between less-effective contraceptive use and reduced support for abortion may be explained by a diminished perceived risk of parenthood. Educational strategies should acknowledge and respond to differences in abortion attitudes as adolescents commence and navigate sexual relationships.
Additional keywords: Australia, Rasch analysis, sexual behaviour, teenager.
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