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Does state legal context modify the association between abortion and distress among women in the United States? Adjusting for individual characteristics that could be associated with distress based on stress and stigma frameworks, I examine if state legal context modifies the association between abortion and distress using a nationally representative sample of American women ages 25-45. The use of state-level factors as a proxy for social context in this research has not been part of previous studies of the consequences of abortion. In order to appropriately examine the cross-level modifying effects of state level legal context on abortion status with depressive symptoms (measured on a CES-D scale), I used hierarchical linear modeling. I compare women who have had abortions to women who have had an unintended birth or an intended birth. According to the stress process theory, a lack of control should be associated with higher distress; therefore I use pregnancy intention and outcome as a proxy for reproductive control. The results indicate that women who have had an intended birth experience significantly less distress than women who have had an unintended birth or an abortion, regardless of state context. Contrary to what the stigma framework suggests, state legal
context does not modify the association between abortion history and distress. State legal context does, however, modify the association between unintended pregnancy history and distress. In states with more restrictive laws the association between unintended birth history and distress is lower than in states with fewer restrictive laws. These results suggest that distress associated with pregnancy intention and outcome is only partly influenced by state contexts. The stigma associated with abortion is likely to be more national than state specific. Further research is necessary to more fully explain the association between pregnancy intention and outcome, distress, and social context.
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