Faculty of Philosophy, Theology and Religious Studies, Radboud University, Nijmegen, The Netherlands.
Fiom, Centre of Expertise in Unwanted Pregnancy and Ancestry, 's-Hertogenbosch, The Netherlands.
J Psychosom Obstet Gynaecol. 2024 Dec;45(1):2321461. doi: 10.1080/0167482X.2024.2321461. Epub 2024 Mar 12.
Unintended pregnancies are a worldwide health issue, faced each year by one in 16 people, and experienced in various ways. In this study we focus on unintended pregnancies that are, at some point, experienced as unwanted because they present the pregnant person with a decision to continue or terminate the pregnancy. The aim of this study is to learn more about the decision-making process, as there is a lack of insights into how people with an unintended pregnancy reach a decision. This is caused by 1) assumptions of rationality in reproductive autonomy and decision-making, 2) the focus on pregnancy outcomes, e.g. decision-certainty and reasons and, 3) the focus on abortion in existing research, excluding 40% of people with an unintended pregnancy who continue the pregnancy. We conducted a narrative literature review to examine what is known about the decision-making process and aim to provide a deeper understanding of how persons with unintended pregnancy come to a decision. Our analysis demonstrates that the decision-making process regarding unintended pregnancy consists of navigating entangled layers, rather than weighing separable elements or factors. The layers that are navigated are both internal and external to the person, in which a 'sense of knowing' is essential in the decision-making process. The layers involved and complexity of the decision-making regarding unintended pregnancy show that a rational decision-making frame is inadequate and a more holistic frame is needed to capture this dynamic and personal experience.
意外怀孕是一个全球性的健康问题，每年每 16 个人中就有 1 个人面临这个问题，而且每个人的经历也各不相同。在这项研究中，我们关注的是那些在某个时候被认为是不想要的意外怀孕，因为它们让怀孕的人面临继续或终止妊娠的决定。这项研究的目的是更多地了解决策过程，因为人们对意外怀孕者如何做出决定缺乏了解。这是由于 1）对生殖自主权和决策的合理性的假设，2）对妊娠结局的关注，例如决策确定性和原因，以及 3）对现有研究中堕胎的关注，排除了 40%继续妊娠的意外怀孕者。我们进行了叙事文献综述，以研究人们对意外怀孕决策过程的了解，并旨在更深入地了解意外怀孕者如何做出决定。我们的分析表明，意外怀孕的决策过程包括在纠缠的层面上进行导航，而不是权衡可分离的元素或因素。被导航的层面既存在于个人内部，也存在于个人外部，其中“知道感”是决策过程中的关键。意外怀孕决策所涉及的层面和复杂性表明，理性决策框架是不够的，需要更全面的框架来捕捉这种动态和个人的体验。
