Social Support Regarding Abortion Decision and Mental Health Outcomes at Time of Seeking Abortion Services

Background: While the relationship between social support and mental health in the general population is well established, little is known about the role of social support, particularly decision support, in the mental health of people seeking abortion services. The objective of this study was to investigate the association between social support regarding abortion decision and mental health outcomes at the time of seeking abortion. Methods: We analyzed data from a cross-sectional survey of people seeking abortion services recruited from four reproductive health clinics in California, New Mexico, and Illinois in 2019. Multivariate Poisson regression was used to examine the association between social support regarding abortion decision from six individual sources (mother, father, other family members, friends, current intimate partner, and man involved in pregnancy) and risk of depression and anxiety. Multivariate Poisson regression was also used to examine the association between unwanted disclosure of abortion decision and risk of depression and anxiety. Results: Among 717 participants, a lack of social support regarding abortion decision from the man involved in the pregnancy was associated with greater prevalence of depression risk (48.7% versus 32.0%; adjusted Prevalence Ratio [aPR]: 1.55; 95% CI: 1.05, 2.30) compared to those with full support. A similar trend was observed for prevalence of anxiety risk, though results were not statistically significant (40.5% vs. 32.7%; aPR: 1.25; 95% CI: 0.83, 1.89). Partial support regarding abortion decision from a current intimate partner was associated with greater prevalence of anxiety risk (47.8% versus 37.7%; aPR: 1.46; 95% CI: 1.05, 2.05) compared to those with full support. A similar trend was observed for prevalence of depression risk, though results were not statistically significant (43.1% versus 33.5%; aPR: 1.34; 95% CI: 0.89, 2.04). Social support regarding abortion decision was not associated with risk of depression or anxiety for other sources of support. Unwanted disclosure of abortion decision was associated with higher prevalence of depression risk (49.5% versus 32.1%; aPR 1.41; 95% CI: 1.08, 1.83). A similar trend was observed for anxiety risk, though the results were not statistically significant (49.5% versus 34.6%; aPR: 1.27; 95% CI: 0.98, 1.65). Conclusions: Social support regarding abortion decision from intimate partners (whether a current intimate partner, the man involved in the pregnancy, or both) may play a prominent role in the mental health outcomes of people seeking abortion services, particularly during the decision-making process.