Conceiving risk and responsibility: a qualitative examination of men's experiences of unintended pregnancy and abortion.
Keywords: men, abortion, pregnancy outcome, contraceptive responsibility, cross-gender interviews
There are approximately 62 million women of reproductive age living in the United States. While approximately 6 million become pregnant each year, about half are unintended pregnancies (Alan Guttmacher Institute [AGI], 2004). In turn, half of these unintended pregnancies are terminated by abortion (AGI, 1999). Although women from a wide range of socioeconomic, racial, religious, marital, and childbearing backgrounds seek abortions, abortion remains controversial. A portion of this controversy swirls around questions of what the appropriate role for men who co-conceive should be.
Beginning in the 1990s, the call for men to exercise greater responsibility around fatherhood (including child support) received increased attention from policy makers, grassroots campaigns, and researchers (AGI, 1999; Brindis, Barenbaum, Sanchez-Flores, McCarter, & Chand, 2005; Gohel, Diamond, & Chambers, 1997; Marsiglio, Amato, Day, & Lamb, 2000; Marsiglio, Hutchinson, & Cohan, 2001; Ringheim, 1999). From the desire to see men behave responsibly has grown an increasing focus on men as "partners in reproduction" (Dudgeon & Inhorn, 2004). For example, the United Nations International Conference on Population and Development in 1994 identified ways that men should "understand their joint responsibilities, so that men and women are equal partners in public and private life" (ICPD, 1994). Research suggests that involving men in post-abortion or post-partum counseling may prevent future unintended pregnancies and that men would benefit from having their own targeted contraceptive services (Beenhakker et al., 2004; Blaney, 1997). This approach has prioritized a client-based framework that aims to provide high-quality reproductive health services to men, "without compromising (and hopefully improving) services for women" (Dudgeon & Inhorn, 2004, p. 1382).
Although this approach attempts to balance women's autonomy with efforts to create greater equality between partners, a dearth of research on men's experiences with unintended pregnancy and abortion may hinder the development and implementation of such an approach. In many cases, the generic advocacy for such inclusion suggests a "one size fits all" approach, without exploration of the diversity of experiences among men and how such efforts at inclusion might need to be tailored.
Some research has been conducted regarding the perceptions of men's roles in contraception, reproduction, or pregnancy in general (Brindis et al., 1998; Edwards, 1994; Grady, Tanfer, Billy, & Lincoln-Hanson, 1996; Marcell, Raine, & Eyre, 2003; Marsiglio et al., 2001; Wegner, Landry, Wilkinson, & Tzanis, 1998), but far less research has been conducted in the area of men's experiences with abortion. A small body of research attempts to identify what roles men play in abortion, including when they were informed about unintended pregnancy and abortion (Henshaw & Kost, 1992), which characteristics among men and women predict abortion (Zavodny, 2001), and how men affect decisions regarding pregnancy outcome (Evans, 2001; Kero, Lalos, Hogberg, & Jacobsson, 1999). Few studies explore how men feel about "their" unintended pregnancy and abortion, or how they construct meaning around it. These studies often draw on data collected in interviews or surveys of non-randomly sampled men, largely from abortion clinic waiting rooms (Holmberg & Wahlberg, 2000; Shostak, 1987; Shostak, McLouth, & Seng, 1990; Wade, 1978) or a men's counseling group that met during the partners' abortion procedure (Gordon & Kilpatrick, 1977). Because of such sampling, these studies inevitably overrepresent the perspectives of those most engaged in their relationships and do not reflect the majority of abortions. One recent study found that only 22-25% of women came or left the abortion procedure with the man by whom they became pregnant (Beenhakker et al., 2004). Thus, not enough is known of the men who did not accompany partners, including those informed of the pregnancy only after its termination. This reflects the fact that the bulk of existing research only describes women's experiences with abortion while ignoring the "other half" of the responsible party. This research aims to address this void.
It is perhaps this last point that suggests the potential problems in assuming "men as partners" when considering men's roles in the termination of unintended pregnancies. Separate from men's roles vis-a-vis women, some research has shown that adolescent and adult males identify responsibility as central to definitions of masculinity, and that the abortion experience may be an expression of responsibility (Kero & Lalos, 2000; Marcell et al., 2003). Yet, even as men articulate the importance of responsibility and may internalize expectations to behave responsibly, it is not clear how that value is actualized in pregnancy prevention or abortion decisions. This paper uses men's own accounts of their abortion "experience" to examine how men account for unintended pregnancy, including who they identify as responsible for pregnancy prevention and the decision to terminate that pregnancy. In conducting this exploratory study, we aim to provide a better initial understanding of the myriad meanings these experiences hold for individual men. In doing so, we hope to provide a broader context in which policies and programs that aim to include men in pregnancy prevention and outcome decisions can better recognize the highly personal and variable nature of these issues.
This research analyzes the narrative accounts of 30 abortions collected from 20 different men during in-depth, one-on-one interviews, shown to be an excellent way of collecting information on sensitive topics (Hutchinson, Marsiglio, & Cohan, 2002). Multiple abortion experiences of the same man are sometimes referenced independently of each other, as men reported feeling differently about each and, in all but two cases, had conceived with different women. In doing so, we are able to demonstrate how the experiences are not only different between men but also between relationships involving the same man. Subjects were recruited through advertisements in two southern California regional newspapers--one daily and one free weekly paper--that ran for approximately two weeks, through flyers placed around a large public university campus and the surrounding communities, and through snowball sampling techniques, where one participant refers another. Given the stigma often associated with abortion, multiple recruiting methods were necessary. Participants were recruited "to share your personal experiences with abortion," with an understanding that data were for a research study. In all, 30 volunteered; eight were excluded after they disclosed that, although they felt they had faced the prospect of dealing with an unplanned pregnancy, they eventually learned that the woman had not actually been pregnant, while two others did not attend interview appointments. Overall, we aimed to be as inclusive as possible to best understand how men, irrespective of age or background, experience abortion. Thus, we did not exclude any men who volunteered to participate who claimed to have experienced the abortion of a fetus they co-conceived. In total, 20 interviews were completed.
Interviews were conducted in comfortable private or semi-private locations suggested by the participants. Interviews were guided by an interview schedule of open-ended, semi-structured questions that asked men about their past and present romantic or sexual relationships; context and detail of any pregnancies in which they were involved; the details surrounding the abortion(s), including how the pregnancy occurred and how the decision was reached; how they felt, looking back, about the abortion, including what they wished had gone differently; and how they felt the abortion had affected their lives. This guide was developed to build on prior substantive research on reproductive decision-making and experiences, as well as on broader topics such as concepts of family, familial and intimate relations, and men's own experiences with their fathers. Interviews lasted between 40 minutes and three hours. Interviews with 14 of the 20 men were tape recorded, while six involved detailed note-taking. These latter interviews were not taped in three situations because the men asked to be interviewed immediately, when equipment was unavailable, and were unable or unwilling to schedule for a future time. In another three situations, the men requested that the interviews not be taped. These informal interviews, which followed the same format as the tape-recorded interviews, were included because they yielded information that might have been otherwise unavailable and allowed respondents to feel comfortable participating (Schwalbe & Wolkomir, 2001; Weiss, 1994).
Tape-recorded interviews were transcribed verbatim. These transcripts and the notes of interviews not tape-recorded were analyzed using what Charmaz has called constructivist grounded theory method, where data are collected and analyzed "to learn participants' implicit meanings of their experiences to build a conceptual analysis of them" (Charmaz, 2002, p. 678). The original study goal was, in a general sense, designed to better understand the experiences of men whose partners had sought an elective abortion. As such, the use of open-ended questions allowed participants to articulate their own narratives and most important experiences. Interviews were transcribed immediately afterward and open-coded for emerging themes, with data collection on-going. With additional data, codes were refined to better represent the emerging themes. The first author and a research assistant separately coded all transcripts. On the few times that differences in coding emerged, these differences were discussed until both coders agreed on an appropriate code for the data. Additionally, the interviewer kept a notebook to record or "memo" impressions immediately following interviews and to reflect on the interview experience more generally. These reflections, which recorded broad themes that emerged during interviews, helped shape the codes used by marking patterns. To be clear, we did not enter this study presuming that notions of responsibility would emerge as an overwhelming pattern in men's accounts. Rather, the authors aimed to provide men an opportunity to identify the aspects they felt were most salient to the abortion experience. From there, we identified themes and patterns in response. Notions of responsibility, the focal point of this paper, emerged as significant in virtually every man's account. All of the men's stories contributed to this analysis; quotations are taken verbatim from transcriptions. Interviews not tape-recorded provided evidence of themes and patterns but are not excerpted.
All interviews were conducted by the primary author, a young white woman. A growing body of work provides reflexive analysis of qualitative data collection and suggests that gender informs the interactions between interviewer and subject, even as it is unclear how it influences the information yielded (Arendell, 1997; Behar & Gordon, 1995; Krieger, 1991; Schwalbe & Wolkomir, 2001). Presumably, as men are inevitably defining masculinity in their interview, they do so in ways differently than they might for a male interviewer or older researcher. Discussing abortion, contraception, and reproduction can be sensitive. We believe that by providing participants a comfortable location and assurance of confidentiality, the men disclosed honestly to the interviewer. Nonetheless, it is important to acknowledge that the interview is in itself a social interaction that affects how information is communicated (Hutchinson et al., 2002; Schwalbe & Wolkomir, 2001).
DESCRIPTION OF PARTICIPANTS
At the time of the interview, participants ranged in age from 20 to 67, with eight men between the ages of 20 and 24, four men between 26 and 30, seven men between 34 and 45, and one man aged 67. All self-identified as heterosexual. Fifteen of the 20 men had never been married, two were married at the time of the interview, two were divorced, and one was both divorced and widowed. Only one man--the 67-year-old man--had been married to the woman who had the abortion (they eventually divorced, and he went on to become twice widowed). Only one of the men interviewed (age 24) was still involved with the woman who had had the abortion, and only one participant (age 21) reported asking the woman who had had the abortion if she objected to his participation in the interview (the two were no longer involved). Fifteen participants self-identified as white, three as Latino, one as African American, and one as biracial (African American and white).
The men reflected a wide array of professions, including student (both graduate and undergraduate), homemaker, waiter, security guard, retail salesman, auto mechanic, security guard, counselor, nightclub disk jockey, writer, self-employed, and retired. Thirteen of the 20 were raised within a religion; of those, eight reported that they are still religious, although four had changed their religious affiliation sometime during their adult life (not reported as connected to any particular experience). (1) None self-identified as pro-life or anti-abortion, although few questions deliberately attempted to clarify their political beliefs. Although several expressed general discomfort with abortion, none voiced a desire to see abortion outlawed or criminalized, and none reported involvement with any abortion-related organization. All of the elective abortions were described as occurring in the first trimester and resulting from unintended pregnancies. Of the twenty men, six were involved with multiple abortions: one with five, one with three, and four with two. Of the latter four, two of the men experienced two abortions with the same woman. The other two men were involved with two abortions with two different women. The men with three or more abortions reported that each was with a different woman.
STRENGTHS AND LIMITATIONS OF THE SAMPLE
This study is not based on a random sample and, thus, cannot be generalized. Because participation was voluntary, these men presumably applied some amount of significance to the abortion to motivate them to volunteer. (2) We do not wish to further a belief that most men whose partners have had abortions, with or without their knowledge, apply equal significance. However, studying the qualitative responses of these men offers unique insight into how men understand their role in an accidental pregnancy and the decision to terminate that pregnancy, and how they view the experience.
This study has the advantage of sampling men beyond the clinic waiting room and accessing men who are, in all but one case, no longer involved with the women who had been pregnant. The men often had temporal distance from the experience and had shaped their sense of the pregnancy and the accompanying relationship over time. This distance provided narratives that were less emotionally laden than those of men actively involved in the termination of a pregnancy. Simultaneously, the study was limited by relying on men's more distant recollections that were more divorced emotionally from the experience. We did not interview couples and have no way of knowing how the men's accounts of events may differ or be similar to those of their partners.
In drawing our sample, we aimed to cast as wide a net as possible to capture the range of men's views and experiences. As with many research studies that do not purposively sample, we are limited in many ways by the sample we were able to access. We nonetheless believe this sample provides an excellent opportunity to examine the range of ways men account for accidental pregnancy and the decision to terminate such pregnancies.
ASSIGNING RESPONSIBILITY FOR UNINTENDED PREGNANCY
All but one of the men (age 34) in this study described the unplanned pregnancy as a negative experience and source of anxiety. For example, one man described his reaction to being told of the pregnancy: "I felt numb.... I had that feeling you get in your stomach, that ache ... it was shock and realization of what had happened.... And I sat down and everything just came crashing down." Similarly, another man who was told about a pregnancy during his freshman year of college explained the sense of being overwhelmed: "For the first two months of school I was in a new place, new as far as academics, everything like that and I was trying to cope, and I was also trying to deal with her and decide what to do and things like that. I mean it was hell."
Although not happy, and not intending to cause pregnancy, a few men recalled viewing their ability to impregnate a woman--or as one 35-year-old man described it, "siring" a child--to be an accomplishment. A 26-year-old man who was responsible for three accidental pregnancies with three different women initially joked about the experiences, noting, "Maybe it's the Hispanic in me. I just want to have kids." He quickly considered his behavior at the time, recalling, "Unfortunately, I thought it was some sort of pride thing."
In light of the descriptions of the pregnancies as overwhelmingly negative experiences, it is important to consider how men understand responsibility (or fault) for the occurrence of the unintended pregnancy. Questions of male responsibility in non-marital sex and pregnancy have increasingly become the focus of programs, public policy reforms, and perceptions of men themselves (Marcell et al., 2003; NFI, 2004). This focus of popular concern seems to have infused men's perceptions of their own experiences, for notions of responsibility were central to men's accounts of the abortion experience and emerged in every interview. In some ways, the pregnancy itself marked a lack of responsible behavior. Several respondents communicated that accidental pregnancy was a form of punishment for non-marital (or non-monogamous) sexual behavior. In doing so, they defined their feelings about their partner as central to acting responsibly. Several men described the unplanned pregnancy as "getting caught," to communicate their acceptance of the consequences of being sexually active. At least two men employed phrases like "if you play, you have to pay" or that the abortion experience was a matter of "paying the piper." Illustrating this understanding, one man explained how abortion is necessary but is something that should only be permitted as a one-time fix:
It should be a woman's choice, but I don't think she should be able to, you know, after the first time. There should be severe repercussions, somethin' ... a DUI factor. I mean, because you can't be doin' that sh-t all the time as a method of birth control. I don't think that should happen.... I think we should all be allowed one mistake, but you know, you can't be doing that sh-t all the time.
In this quote, this man reveals his view that, although mistakes happen, future unintended pregnancies should be carried to term as a repercussion for sexual irresponsibility. As such, he envisions one accidental pregnancy to be an error, with additional pregnancies representing a lapse in responsibility. Men also defined their feelings about their partner as central to acting responsibly. Illustrating this view, one 20-year-old college student explained how, since the abortion, he chooses not to be sexually intimate with anyone to whom he might not be willing to commit long-term, explaining, "It seems the older I get the more moral I become.... I don't pull the trigger unless the feeling is there." Thus, potential reproduction flows from feelings about potential co-parenting.
In the following sections, we explicate how men perceive responsibility for unintended pregnancy and the decision to terminate an unplanned pregnancy and show that a majority of the men felt they were able to behave responsibly by helping to execute the decision to terminate. In describing how the accidental pregnancy happened and what their roles were in preventing pregnancy, the men provided a variety of responses that fell along a continuum. On one side, men assigned primary or exclusive responsibility to women. At times, this was communicated by referencing pregnancy in impersonal third-person terms and, at others, when men blamed women for what they described as carelessness or irresponsibility. A second type of response included those from men who neither assigned responsibility nor communicated about contraception with their partners. This was illustrated when men described that they knew they were having sex without birth control and chose to do so. At the other end of the spectrum, some men described pregnancy prevention as a shared responsibility. No man communicated an expectation that he should be primarily responsible for contraception. It is important to note that the same man might have fallen in different parts of the spectrum in different relationships, as was the case for four of the six men involved in multiple abortions.
IDENTIFYING WOMEN'S RESPONSIBILITY
A majority of the abortion stories reflected a belief that pregnancy prevention is the primary responsibility of women. Some men communicated this in neutral terms, not necessarily describing their own partners as specifically responsible but instead explaining how women are generically responsible. For example, one man speculated that there must be "something inside the organism, something that supersedes the ego, or the conscience, or the intellect that the organism doesn't really want to prevent conception."
Several men employed terms that communicated a lack of responsibility, using terms like "the female" and "the male" to describe themselves and their partners. As one man explained, birth control methods "depend on the responsibility of the female to provide the protection; males are not generally interested in whether protection against pregnancy is really there."
Some respondents expressed the belief that contraception was women's primary or exclusive responsibility and that females were to blame for the pregnancy. For example, one 24-year-old man reported that he figured out his girlfriend was pregnant and "sent her back" to the doctor to confirm his suspicions, and later he claims to have "made her get on the pill." Months after the abortion, there was a second pregnancy scare that turned out to be unfounded. Illustrating his assignment of responsibility to her, he recalled,
I was really pissed then ... because she'd done that sh-t twice. Come on.... That's her responsibility. It is. When it boils down to it, I'm not getting pregnant, you know, and if you are, you should do whatever.
Further distributing responsibility to their female partners, a small group of men (three) described feeling that women became pregnant deliberately to trap them:
She was going to go on the pill. She went down, got the pills, and would actually take them out of the pack and throw them away. She told me how much she liked me and how she would do anything for us to stay together and that she wanted to have the baby and wanted to carry my child.... It just showed me how conniving some women can be. I think she wanted the child, she wanted to get married, but there was a bit of entrapment there, especially after the second [pregnancy]. It was like she, I felt like she was trying to get pregnant so that, that I'd marry her.
Although these men expressed their belief that women intentionally became pregnant, none appeared to recognize their own ability to prevent the pregnancy, and none voiced regret for failing to use condoms.
The second and less common way men accounted for accidental pregnancy was by explaining that they neither assigned responsibility nor discussed contraception with their partners. In some instances, men seemed not to consider pregnancy prevention and referred to the pregnancy as having "just happened." Others offered that they were aware they were having sex without protection:
Oh yeah, we had been doing it for a while ... I mean, it was just something that we just kind of were doing, just into the body-on-body thing. We didn't want to have anything separating it, which was, of course, wonderful for me and she was on the pill for a while, but um, she just didn't want to take the drug for a long time anymore. So she took it for about a year and a half and then we just kept going.
Another man described his choice to have unprotected sex that led to an unintended pregnancy as originating in another relationship in which unprotected sex did not result in pregnancy:
I thought that I couldn't make babies. I thought that I was sterile ... because when I went out with this girl.., we would blatantly have unprotected sex a lot of times. We would have sex and I would not withdraw. We would just do it all the way, and she was fine with it and I was fine with it, and we were willing to accept the consequences if she got pregnant and we did this for about six months and never once did I get her pregnant that I know of.... So I thought I had a low sperm count or something and I was kind of fine with it for the time being.
From this perspective, men recognized that they were having unprotected sex and believed their partners were equally aware of the risks doing so presented, yet never discussed this issue with them. Rather, the men seemed to have imagined that their partners' perceptions were the same as theirs and, thus, were equally complicit.
At the other end of the spectrum, some men communicated that contraception was a shared responsibility. For example, one man described the anomaly of having sex one night without contraception:
We ended up making love that night and I don't know what was going on and why, but I didn't use birth control and I know she didn't and um, I, the situation, I don't know why because I'm always thinking about that.... Besides, I've always tried to be responsible. One of my things as far as birth control, I'm as responsible for it as the woman.
Another man communicated his shared responsibility, explaining, "Mistakes happen, I mean, we were, she was on the pill, I used a rubber, everything. Mistakes happen."
From this perspective, men expressed equal responsibility for contraception or contraceptive failure. More broadly, outlining these three positions as existing on a continuum explicates how men define their own and their partner's contraceptive responsibility in a variety of ways. By identifying this spectrum, we can see how men are all engaging with concepts of responsibility, even as they envision the meaning--or applications in their own lives--in dramatically different ways.
ACCOUNTING FOR THE PROCESS OF DECIDING PREGNANCY OUTCOMES
Just as there was variation in men's descriptions of responsibility for pregnancy prevention, there was a continuum in how men described their own involvement in determining the pregnancy outcome; some men had no involvement in determining the outcome because they were either not told about the pregnancy until after it had been terminated, or because they felt they were blocked from participating. Other men had limited involvement because they chose to disengage from the process, allowing the women to decide for themselves. In several cases, men communicated their belief that they and their partners had mutually reached the decision to end the pregnancy. A portion of men at the other end of the spectrum communicated their belief that they had been primarily responsible for choosing to seek an abortion, either because their partner deferred to them or because they convinced her to have the abortion.
EXCLUDED FROM PROCESS
Some men's roles were limited because they only learned about the pregnancy--and subsequent abortion--after it occurred. For the three men in this study for whom this is true, each said that they would not have done anything to dissuade the woman from having an abortion, but they wished they could have been involved:
This was a girl who I'd been going out with, we'd been together for almost six months, and it was, we had broken up a couple times, and it was like after the last time that we had gotten back together and, she started trippin' out again, so we broke up. I didn't know. I didn't know anything about it. I had no clue until the one time, after we broke up that I saw her, she told me. I felt saddened later that she never told me. She never let me in on the process of decision [making] .... I think if two people are involved, then two people should be involved in the process. When it comes down to the nitty gritty, I don't think any man could force a woman to have a child, but I think that it should really be talked about and should really be discussed from all angles.... I felt that then and I feel it now.
Almost a third of the respondents reported that women notified them of their decision before getting an abortion but did not give them an opportunity to meaningfully participate in the decision making. At least four of the men voiced a desire for the pregnancy to continue but felt they had little or no opportunity to disagree with the woman who wanted to end the pregnancy. For example, one 27-year-old man wanted to see the pregnancy continue, explaining that it might have represented his "only chance to have a child." Despite his objections, his ex-girlfriend chose to have an abortion.
Another man remembered feeling excluded from the decision process when his wife became pregnant for a third time and opted to terminate the pregnancy. Frustrated by his lack of opportunity to provide input, he recalled, "I was thoroughly browbeaten by [my wife] and her mother, and a decision like this, I felt that I was not entitled to even an opinion."
Even when the men did not disagree with the outcome, many felt disconnected from the process of deciding. Illustrating this, one man recalled the chilly reception his efforts to support his girlfriend in any outcome received:
I actually did offer ... because I said that if you were ever interested in keeping the baby, that I would love to keep it, but I'm not putting any kind of pressure on you, but I wouldn't mind or I wouldn't--I would be there and I wouldn't run away or anything like that. I'd rise to the challenge ... and she said, "No way." ... In fact, I think she got kind of upset that I said that. And, uh, I think she misunderstood me, like I was trying to put pressure on her and all I really wanted to do was give her that option if she wanted to have it.
Men thus felt excluded from decision-making either because they were not told about the pregnancy until after it was terminated or because they perceived their input was not welcome. As such, their efforts to behave in ways they believed would demonstrate responsibility were thwarted.
Some men felt that they were behaving responsibly by choosing not to participate in the process of deciding pregnancy outcome. A number of men recalled having an opportunity to participate in decision making but, instead, chose to remain peripherally involved by deferring to women's decisions, sometimes without expressing their own preferences:
I was hoping she wouldn't want to have the baby because I'd feel such responsibility, and at this point there was no way that I could have contributed.... We talked about it and it was her decision, I mean, I left it totally up to her. I kind of withheld my feelings. She already had two kids. They were eight and twelve. It really wasn't my say.... She didn't want to have it and it was hard for me after a year ago trying to adopt [with my ex-wife].... It was her decision. I told her that, "It's up to you, you've already had kids; it's up to you." She's a very emotional person. If I would have come at her with, "I think you should keep it," and give her more complications, I don't know what she would have done.... Let it be understood that I had all good intentions, that I was removed from that decision, you know. And why I didn't try to persuade her? ... I needed to not complicate her emotions anymore, and see it in her terms. I finally let that happen.
In each of these narratives, men had their own preferences yet felt that the decision rested primarily with the woman who would carry the pregnancy and serve as the primary caregiver. Some men communicated their choice to defer because they recognized they had little influence over the final decision. For example, one man, although pleased that his girlfriend chose "out of love" for him to have an abortion, also recognized the limits of his influence:
I realized I didn't have the right or I didn't want to make ultimatums; what kind of ultimatum am I in a position to make? You better have this child or else? Or else what? I'll take you to court or what's the else? I don't want you to have this child or else, or else when you do I am going to abuse the child? You know, what possibly could you [do]?
REACHING A MUTUAL DECISION
The majority of the men indicated that they agreed with the decision to have an abortion (this includes men who may also have disengaged). Thirteen of the 20 men in our study faced an unplanned pregnancy during their teen or early college-aged years. Most of these men described the abortion as a necessity. Illustrating this sentiment, one man recalled that continuing the pregnancy "was not an option." Other men described the process as a longer one of considering different options and then mutually agreeing that abortion was the best. One man explained,
It was about how I feel about myself, about my partner, about--what's best for the child? What's best for me? What's best for her? How does this all fit together? How do I actually feel inside? ... We had several long talks along the way. It wasn't just one. Because we were both changing a lot along the way and it was a big decision.... If things were different, then it would be fine in terms of her health, my health, the child's health, financially, taking everything into--it's really hard to encompass everything because you have to think, you know, my God, eighteen years.
For some this was an obvious choice; for others it represented the best outcome in an unfortunate situation. It is worth reiterating that, in the face of much publicity about and concern for contentious battles over disputed pregnancy outcome, indeed, a majority of the men interviewed recalled mutually agreeing to terminate the pregnancy, even when relations had already ended or ended shortly after the abortion.
MEN AS THE DECISION MAKER
Even though mutual decisions were common, contentious ones were described as well. Seven men, involved in 10 abortions, described themselves as responsible for having made the decision to end the pregnancy. In several cases, men said they had to persuade the woman to do so. (3) These men identified themselves as having to make the decision for the woman:
She got pregnant and I knew that I didn't want to marry her, so ultimately I had to make the decision.... She could have had the kid against my will, but I don't, quite frankly, think she wanted the responsibility of making that choice, so she left the choice up to me and I said, "No."
Several men reported actively persuading women who were seriously considering carrying the pregnancy to term into having abortions:
I told her everything possible that would make her ... swayed her in any way. Anything that could possibly make her not want to have it, I drilled into her.... Yes, I served my interests, but I felt those were the interests that I needed to look out for first and then second, I'd look out for her interests. If I had wanted to keep it--I would have made her I guess, you know ... I mean, I did [initially want to keep it], but then I thought about how it would affect me, and I don't think I could have. Uh, I was definitely not interested in doing it at this point.
In these cases, the men described themselves as efficacious in determining the outcome. Of course, the women in these relationships may have perceived the exchange differently, information to which we lack access. Yet in narrating the decision-making process, the men who claim to have made the decision themselves or to have persuaded women to terminate identified their motivation as concern for their own interests.
ACTING RESPONSIBLE AND SEEING IT THROUGH
Most of the men interviewed communicated the importance of behaving responsibly when faced with an unintended pregnancy. All the men who were told about the pregnancy and abortion before it occurred said that they helped to pay for the procedure, a symbol to them of taking responsibility. One man indicated that taking cash out of the bank and bringing it to the clinic helped "in making this whole process seem real." One 20-year-old college student learned that a woman with whom he had had sex before leaving for college had called his mother to tell her she was pregnant; his mother arranged to pay for the abortion. Voicing his frustration and intention to take responsibility, he explained, "I didn't want my mother to get involved. I thought I was gonna take care of it myself."
Another respondent remembered that money was his only permitted contribution:
She wanted to split the cost and she didn't want me to come with her; she had a girlfriend for support. All there was was a money exchange. She came to my house in the morning, I gave her the cash, she ran out, and that was it. I didn't talk to her for quite awhile after that until she called me [about a month later].
In addition to providing money, several men reported taking control of setting up the medical appointments and feeling that they had to work toward a quick resolution. One participant (aged 23) recalled feeling as though he had to keep his girlfriend on task, making progress toward resolving the situation. Similarly, a 26-year-old man reported making all the appointments for the procedure and trying to take care of his girlfriend, explaining, "I got, almost a fatherly attitude, toward her ... because I knew it was going to be traumatic.... I was concerned about how she was gonna react to it."
Efforts to pay for the procedure and/or manage appointments reflected respondents' attempts to do something that could be seen as taking responsibility, a perception that was important to them. One man described the process of arranging for the abortion as "a matter of expediency." Others described it as the least they could do given their own or their partner's unwillingness to take responsibility for a child:
If you can't take the responsibility to bring the child to term, to bring this to term, you have to have some responsibility to follow up your decision to terminate the pregnancy. I was willing to accept that responsibility if she wanted to, because if I was man enough to have sex with her then I was man enough to raise a kid and to be there for it. And I was willing to do that, to pay for that mistake, you know, not even pay, but I was willing to accept the responsibility.... She already made up her mind and made the appointment and it was all ready to go. She gave me a price and I told her I'd give her the money the next day, and I even started saving up more money in case there was any complication or anything.
Consistent with findings by Kero and Lalos (2000), for these men the abortion came to be a way of exercising responsibility in a situation they themselves defined as resulting from irresponsibility. Yet these stories also suggest that meanings of responsibility are complicated and often ill-defined. For example, some men communicated their desire to see the pregnancy continue as a willingness to take responsibility for irresponsible sexual behaviors. Others discussed a willingness to take responsibility for the child, even when they were not interested in a long-term relationship with the would-be mother. For men who felt excluded from decision making, assuming financial or logistical responsibility for seeing the procedure through represented an acknowledgement that they could not see the pregnancy through and so this was the "least [they] could do." Although conceptions of responsibility permeated the narratives, there was little consensus of what such a term means.
In part, the lack of consensus on the meanings of male responsibility extended to the participants' own social networks. A significant portion of these men reported that they had never confided in anyone about the pregnancy nor the abortion until this interview. One 24-year-old participant estimated that "six outta twenty" men he knows were responsible for unplanned pregnancies that ended in abortions. Yet, he was adamant that his experience should remain private, explaining, "It's not something I would tell somebody.... I like my business to be my business." Another man confessed that he had never told his best friend, with whom he shares an auto repair shop. Given the frequency with which abortion occurs, it seems that men, who overwhelmingly share a belief in the nonspecific concept of responsibility, could be highly influential in reshaping understandings of men's roles in contraception and pregnancy outcome. Men's responses suggest that responsibility is individual not collective; men did not perceive a duty to share information with other men or to disclose their own experiences, even when they could have helped other men to behave responsibly. Men reported resistance to disclosing their role in abortion, even though they knew other men had also had similar experiences.
The results of this study suggest that men experience pregnancy prevention and outcome in myriad ways. Although limited by the size and composition of our sample, we did not identify ways in which these experiences were mediated in any patterned way by age, relationship status or duration, educational or socioeconomic level, or ethnicity. Although we recognize that the context of the relationship affects negotiations over contraception and pregnancy outcome, we could not identify a pattern for how the form of relationship predicts these things. The most consistent pattern in these interviews was men's desire to be seen as behaving responsibly in matters of reproduction and sexual behavior, even though they appeared to define or actualize it differently in their lives. In accounting for how the accidental pregnancy happened and what their roles were in preventing pregnancy, men's responses ranged from assigning total responsibility to women, to ignoring the issue entirely, to seeing it as a shared duty. In describing the process of deciding to end a pregnancy, there was an even wider range of replies. Some men were excluded from the process, either because they were not told about it until it was over or because they felt that their opinion was not welcomed by their female partners. Other men chose to defer to the women, often refusing to disclose their own preference until their female partners had reached their own decisions. Consistent with Kero et al. (1999), this strategic disengagement represented men's belief that pregnancy is, in the end, a woman's decision since she carries the responsibility not only of bearing the child but of serving as the primary caretaker. Several men felt that the decision was mutually reached, while others claimed primary responsibility for deciding to end the pregnancy, even when it required persuading the woman to do so.
Most of the men were never married, with only one married at the time of the pregnancy. This likely reflects the increased likelihood of an unintended pregnancy continuing to term in marriage and, thus, not reflected in a study of terminated unintended pregnancies. Not surprisingly, young men at the time of the abortion were more likely to report that continuing the pregnancy "was not an option." However, no other pattern relating to men's ages was identified, perhaps reflecting the overrepresentation of young men in our sample. Although we expected men who were involved in multiple abortions to have communicated an increased effort to prevent pregnancy in subsequent sexual relationships, this was not necessarily true. Because the subsequent abortions were, in all cases but two, with different women, the men seemed to approach each relationship as unique. This is not dissimilar to women's experience, in which almost half of women obtaining an abortion had previously had an abortion (Jones, Darroch, & Henshaw, 2002).
A common thread that ran through virtually all these stories reflected a desire to behave responsibly. Consistent with other research, many of the men alluded to accidental pregnancy as either the result of gambling with sex or as a punishment for participating in nonmarital sex (Landry & Camelo, 1994). These worldviews frame men's perceptions of their responsibility for pregnancy prevention and abortion.
Most men also felt they needed to provide financially for the abortion procedure and/or to assist by organizing appointments. This is logical given the plethora of cultural messages about nonmarital sex, child support, and fatherhood that successfully communicate a mandate for men to behave responsibly through financial or material support (NFI, 2004). The men in this study appeared to have taken these sentiments to heart, each communicating a desire to be seen as taking responsibility for the unplanned pregnancy, even when they did not identify pregnancy prevention as their responsibility. Part of the transformation in the meaning of responsibility may require an evolution in cultural norms, including the disclosure of a difficult topic to both their partners and their peers. As mentioned, a significant portion of the men in this study reported having never disclosed their abortion experience to anyone before this study. Part of the unwillingness to discuss topics like contraception and abortion extended into men's own accounts of silence with their partners. And while a few men described dramatic changes in their own post-abortion sexual behavior, ranging from extensive condom use to self-described abstinence, the majority of the men did not describe themselves as having changed their pregnancy prevention strategies. This point is underscored by the fact that six men in this study were involved in multiple abortions, with several others reporting later pregnancy scares. In part this is due to men's insistence that women are primarily responsible for pregnancy prevention. However, a significant portion of our sample reported their choice not to discuss contraception or their perceived joint responsibility that failed.
Implementing programs to specifically address men's views must also take into account the range of experiences men identify. Future research can help this agenda on two fronts. First, a larger sample of men who have been involved in abortions would allow a greater understanding of the spectrum of views through which men understand pregnancy responsibility. Second, more research that measures the experiences of both members of the pregnancy dyad would help measure more precisely how pregnancy outcome decisions are reached and how conflict is resolved when the partners do not share the same goal. Existing research suggests that as many as half of women seek abortions because they do not want to be a single parent or are having problems with their husband or partner; many women sometimes choose to exclude men from the process (Glander, Moore, Michielutte, & Parsons, 1998; Tortes & Forrest, 1988). As such, proposed policies or programs must also recognize that decisions about pregnancy outcome will always likely have a degree of discord. Thus, additional dyad research to better understand the complex and personal nature of these decisions is needed. We recognize the methodological complexities in doing so; nonetheless, such research could make an important contribution. Beyond dyad research in couples, examination of the experiences and views of couples in unintended pregnancies, even when those pregnancies continue to term, would also contribute to our understanding of perceptions of contraceptive responsibility and decision making about pregnancy outcome.
Results from this study point to the need to reconceptualize joint contraceptive responsibility that begins before sexual intercourse and, perhaps more broadly, policy prescriptions for ill-defined male "responsibility." This study provides testimony that the message of male responsibility has indeed been heard but perhaps not enacted as envisioned by policy makers. By recognizing the diversity of experiences and perspectives among men facing the termination of an unintended pregnancy, it is our hope that policy and programs that aim to include men in pregnancy prevention and decisions can better recognize the highly personal and variable nature of these issues. This is especially important as policy makers increasingly call for male involvement and fiscal responsibility.
The authors are grateful for comments from the members of the writing seminar at the Institute for Health Policy Studies at the University of California, San Francisco, as well as Dan Dohan, Christopher Jewell, Stephanie Reich, David Scudamore, Carole Joffe, and Scott Coltrane. Beth Schneider, Denise Bielby, and Nancy Gottlieb provided valuable assistance in the early stages of this project. We are also indebted to the feedback provided by the two anonymous reviewers and IJMH editor Miles Groth.
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JENNIFER A. REICH
University of Denver
CLAIRE D. BRINDIS
University of California, San Francisco
San Francisco, CA
(1.) Three respondents were raised Jewish, of which two still practice. One is Mormon, one is Protestant, and one is Baptist. Three were raised Presbyterian; one still practices, one is now Episcopalian, and one reports exercising Eastern philosophy. One was raised Episcopalian and Baptist and only loosely identifies with either. Three were raised Catholic, of which two loosely still practice.
(2.) Similar observations were made by Arendell (1997), who conducted interviews with divorced men.
(3.) For obvious reasons, men who persuaded women to continue a pregnancy are not included in this study of abortion experiences. This is an important alternative outcome ripe for future research.
Correspondence concerning this article should be addressed to: Jennifer A. Reich, Ph.D., Department of Sociology and Criminology, University of Denver, 2000 E. Asbury Avenue, Denver, CO 80208. Electronic mail: firstname.lastname@example.org.
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|Author:||Brindis, Claire D.|
|Publication:||International Journal of Men's Health|
|Date:||Jun 22, 2006|
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