Attitudes of inner-city female adolescents toward medical and surgical abortion

Study Objective: To explore the attitudes of inner-city minority female adolescents toward medical and surgical abortion to determine if medical abortion methods, which have been shown to be both effective and safe, might have greater appeal than surgical abortion. Design: A cross-sectional, self-administered survey. Setting: The waiting room of an inner-city hospital-based adolescent clinic. Participants: At total of 157 female adolescents aged 13 to 21 years; Hispanic (56%) and African American (31%). Most (94%) were sexually active, 43% had been pregnant, and 29% had previously had a surgical abortion. Outcome Measures: An 86-item questionnaire examining attitudes toward medical and surgical abortion safety and impact on future fertility, and pregnancy, abortion, and sexual history. Results: A total of 68% believe that abortion is safe, and 55% believe that having an abortion is better than having an unwanted child. Belief in the safety of abortion was significantly associated with older age and with never having had an abortion. Almost three fourths (72%) believe that having an abortion might impair future fertility either from surgical damage (73%) or 'as a punishment for having an abortion' (38%). The majority (72%) believe that 'the more abortions you have, the harder it will be to get pregnant in the future.' Regardless of personal abortion experience, 51% believe that a medical abortion would be safer than a surgical abortion. A minority (34%) believe that it would be easier to get pregnant after a medical abortion than after a surgical one. Conclusions: Although most inner-city, minority adolescents believe that abortion is safe, they also believe they risk their future fertility by having an abortion. The availability of medical abortion regimens would greatly influence decisions regarding abortion.