Family Planning| Volume 27, ISSUE 2, P136-144, March 2017

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Adoption Decision Making among Women Seeking Abortion

Published:January 30, 2017DOI:



      Little is known about how adoption factors into pregnancy decision making, particularly when abortion is unavailable.


      We used data from the Turnaway Study, a longitudinal study of 956 women seeking abortion, including 231 women denied abortions owing to gestational limits. Through semiannual quantitative interviews, we assessed the frequency with which women denied abortion consider and choose adoption, and, among adoption participants, decision satisfaction. We compared differences in the demographic profiles of parenting and adoption participants using mixed effects regression models. We conducted in-depth interviews with 31 women who received or were denied wanted abortions, including 2 adoption participants, focused on understanding pregnancy decision making and feelings about their choice. Interviews were coded using inductive and deductive methods.


      Most women who received abortions were aware of but uninterested in adoption. A minority of women denied abortions (n = 231; 14%) were considering adoption at 1 week after denial. Of participants who gave birth (n = 161), most (91%) chose parenting. Parenting participants (n = 146) did not differ from adoption participants (n = 15) on measures of age, race, or poverty status, although adoption participants were somewhat less likely to be employed (20% vs. 43%; p = .1), and somewhat more likely to have completed high school (87% vs. 74%; p = .08). Although satisfaction with their decision was high among adoption participants, in-depth interviews revealed mixed emotions.


      Among women motivated to avoid parenthood, as evidenced by abortion seeking, adoption is considered or chosen infrequently. Political promotion of adoption as an alternative to abortion is likely not grounded in the reality of women's decision making.
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      Gretchen Sisson, PhD, is a research sociologist with Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology, and Reproductive Sciences, at the University of California, San Francisco. Her research focuses on social constructions and representations of parenthood and reproductive choice, including abortion/adoption.


      Lauren Ralph, PhD, MPH, is an epidemiologist at the ANSIRH at the University of California, San Francisco. Her research analyzes the consequences of unintended pregnancy, with a particular focus on adolescents and young adults.


      Heather Gould, MPH, is a senior research analyst at ANSIRH at the University of California, San Francisco and research director of the Turnaway Study. She is interested in women's reproductive health outcomes related to unintended pregnancy, abortion, and childbirth, and experiences accessing and receiving health services.


      Diana Greene Foster, PhD, is a demographer, Director of Research at ANSIRH at the University of California, San Francisco, and principal investigator of the Turnaway Study. Her work examines family planning policies and the effect of unintended pregnancy on women's lives.