Factors Affecting Women’s Decision Making

Unplanned pregnancy is one of the most difficult life experiences for young women. Women are often confused and seek help and support. When the problem occurs, a woman has three choices: parenting the baby, planning for adoption, or terminating the pregnancy. Choosing one of these three options is often difficult. This study aimed to identify the factors (variables) influencing women’s decision making when choosing the options available to them. The study was conducted in five shelters and low-income communities in the Bangkok area. Data were collected for five months, November 2003 to March 2004. Young women, age 13-24, who experienced an unplanned pregnancy at least once, or currently experiencing an unplanned pregnancy, were recruited into the study. One hundred and twenty volunteer cases were recruited. Discriminant analysis was used to determine the factors that affecting the choices of young women with unplanned pregnancies. There were 6 potential influencing variables, in three broad categories of factors that influenced their choices. In this study, the influencing factors from the personal history variables were, age of the most recent unplanned pregnancy. The individual psychosocial variables were: attitude towards unplanned pregnancy, attitude towards contraception, and making a decision without consultation. The relationship variables were: relationship with partner, and consulting partner when having a problem. The results from discriminant analysis yielded 68.3% predictive accuracy. This result was satisfactory compared with a 33% chance of accuracy (classified as chance alone would yield a 33% accuracy). Knowing the influencing factors for the choices of young women with unplanned pregnancies allows us to understand the women’s decisions and their utilization of services with some degree of confidence. The program managers or implementers should do as much as possible to support the decision making process in these young women in order to provide better information and services to reduce the impact, both physical and mental, of the selected choice. SOUTHEAST ASIAN J TROP MED PUBLIC HEALTH 776 Vol 36 No. 3 May 2005 (Deemar, 1980 cited in Soonthornthada, 1996; Porapakkham et al, 1986; Boonmongkon et al, 2000). In Thailand, youth abortion rates are increasing, and the numbers of young women treated for the complications of illegal abortions has increased. More than half of these complication cases were aged 24 years and younger. Of all illegal abortion cases among unmarried women, 48.6% were performed on women age 20-24 years, and 40.5% on those age 15-19 (Warakamin and Boonthai, 2001). Warakamin and Boonthai (2001) also found that 28.8% of cases admitted to hospitals had severe complications, including sepsis (21.6%) and perforated uterus (0.4%). These severe complications may be fatal if left untreated. The study also found 14 cases (0.11%), of all the cases admitted, resulted in death. Major and Gramzow (1999) found that apart from the physical consequences, women who feel stigmatized about their pregnancy are more likely to feel the need to keep it hidden from their families and friends. Secrecy was related positively to suppressing thoughts of abortion and negatively to disclosing related emotions to others. More importantly, suppression was associated with experiencing intrusive thoughts and distress. Both suppression and intrusive thoughts were positively related to psychological distress over time. Moreover, the complications resulting from unsafe abortions were a major cause of death among these young women. Because these young women had a limited knowledge of their options, they lacked the confidence and could not afford access to the health care system, which often resulted in complications. Apart from the physical consequences, psychological trauma can occur in many women. This study aimed to identify the factors (variables) influencing women’s decision making when choosing from the options available to them (abortion, parenting, and adoption) to allow us to understand women’s use of services with some degree of confidence. MATERIALS AND METHODS