Psychosocial Risk Factors of Elective Abortion: A Structural Equation Modelling Approach

Abstract

Introduction: In Romania, although the number of elective abortions (EAB) has decreased, the percentage is still quite high, given the large variety of contraceptive methods and their ease of use. The principal factors that influence the decision of EAB are family, education, and income. Our study aimed to determine to what extent the psychosocial factors had an influence on EAB. Material and Methods: A sociological survey-based study was conducted, including women who presented for abortion on request during the period 2015-2018 at the "Bega" University Clinic of Obstetrics-Gynecology, Timişoara. The study investigated the degree of information and the use of contraceptive methods at the moment of pregnancy’s termination request. The extracted latent constructs were women’s general perception of abortion, emotional involvement regarding the pregnancy, relationship and family context, knowledge about the abortion’s consequences, and social status. A structural equation model of EAB was derived, describing the direct (and indirect) effects among latent variables. Results: The EAB model showed significantly adequate fit (χ²(45)=382.262, GFI (Goodness-of-fit index) =0.91, CFI (Comparative Fit Index) =0.951, RMSEA (Root Mean Square Error of Approximation) =0.03, and p<0.001). The model also showed adequate fit with significant indirect effects on EAB of general perception of abortion (β=1.132, p=0.004), emotional involvement regarding the pregnancy (β=0.036, p=0.492), knowledge about abortion consequences (β=0.184, p=0.001), relation and family context (β=0.268, p=0.034), and social status (β=0.061, p=0.422). Conclusions: Results support the use of structural equation modeling for investigating the moderating and mediating effects, while simultaneously measuring latent constructs. Also, results showed that five main factors have an influence on EAB.