Motivations for Abortion or Continuation of an Unwanted Pregnancy: A Scoping Review of the Global Literature.

Context: The aim of this scoping review was to provide an overview of recent studies in peer reviewed journals investigating self-reported motivations to have an abortion or to continue an unwanted pregnancy in different countries and settings, including both qualitative and quantitative results.

Methods: We searched for English language publications published between 2008 and 2023 indexed in four scientific databases. We included studies if they captured people's own motivations for abortion and/ or for continuing an unwanted pregnancy.

Results: Of the included 19 studies, all focused on abortion, and four also included motivations to carry an initially unwanted pregnancy to term. Motivations for abortion often related to family planning (e.g., complete family, no desire for children, not the right time), the relationship with the person involved in the pregnancy, and life or material circumstances (such as financial resources, housing or future plans), and sometimes with stigma, shame, or expected negative reactions. Motivations to continue an unwanted pregnancy were having a supportive partner and personal beliefs about the pregnancy. Despite different settings, different methods, and methodological limitations, studies showed similar multifactorial and interrelated motivations in decision making around unwanted pregnancies.

Conclusions: This research showed that in different places throughout the world multiple interrelated motivations play a role in a decision to have an abortion or to continue an unwanted pregnancy. The findings mainly provide insight into retrospective explanatory accounts, which may be biased because respondents may feel the need to justify their choice. Future research should discontinue asking people to rationalize unwanted pregnancy decisions.