Adolescents seeking abortions in Israel: a longitudinal study examining health behaviours

Abstract

Background: Adolescents undergoing abortions of unwanted pregnancies are a unique population requiring special attention. They are often characterized by omnipotent thoughts leading to risky behavior. Immature judgment and poor social support also affect adherence to treatment recommendation. The current study investigated health behavior patterns of this understudied population in order to establish health-promoting interventions. Methods: Eleven hospitals in Israel took part in this quantitative longitudinal study. Participants <19 years old were recruited by social workers during intake at the abortions committees (T1) and were asked about socio-demographic characteristics and obstetric history. They were followed up by phone one (T2) and two months (T3) post-abortion and questioned about adherence to post-abortion care guidelines and contraceptives use. Results: Initial analyses of data from 77 of the participants revealed that only 23% were accompanied by their parents and 10% came alone. Almost half reported not using contraceptives before becoming pregnant, while the rest mostly reported condom failure. At T2, 53% did not have a post-abortion check-up. Of them, 66%, had not seen a doctor at T3. Parents’ involvement increased the likelihood of seeing a doctor. At both follow-ups, almost half of the participants had not used contraceptives, though at T2, 77% of them reported planning to use them. Discussion: Non-adherence to recommended post-abortion care seems to be a major problem, which might cause health disparities and more unwanted pregnancies. Effective interventions to promote behavior change are needed, especially those that increase parents’ involvement and continuity of care in the community.