Chapter 4: Discussion of Strengths and Weaknesses
Choosing a longitudinal study was considered while gathering data on post-abortion cases. A post-hoc study was chosen because of the limitations of longitudinal studies and the financial issues that are also a part of that type of study. The lack of studies that follow-up on women several years post-abortion has been a prevalent problem in past research (Major et al, 2000; Congleton & Calhoun, 1993; Lewis, 1997; Butler, 1996).
The proposed research will account for regional differences within the United States by interviewing women from various states within the east, west, midwest, and south. Few articles have mentioned the importance of where a woman lives and how that affects her choice concerning abortion. Particular attention will be paid to how the women differ in their experiences in correlation with their region of the United States.
Using the MCMI-III as a standard measure provides a foundation for all that will be discovered through the interview process. The reliability of a standardized test will help validate discoveries of problematic symptoms uncovered during the interview process (Congleton & Calhoun, 1993; Barnard, 1990).
Other studies have failed to provide a comparison group or control group along with the women who have had abortions (Congleton & Calhoun, 1993). The women selected for the comparison group in this proposal will be receiving care at the health center, but will not have experienced an abortion. Significant differences in their scores on the MCMI-III could be foundational for future research.
Open-ended interview questions provide more strength to this proposal because of the potential for substantial amounts of new information that other standardized measures would overlook. It also seeks to compensate for the methodological weakness mentioned by Reardon (1997) and his concern that many of the ways women are suffering post-abortion have yet to be discovered.
There will also be the possibility of follow-up with the women who had an abortion one year ago. A longitudinal study will be proposed as an option to these women with the hope that the development of rapport with the primary investigator will keep them in contact over a period of several years after the initial research project is completed.
The greatest weakness of the present design is that it is non-experimental in nature. There is no set scale for measuring a person’s experience related to abortion, and the researcher would need to separate that data from the woman’s economic, cultural, social, and familial background, which is relatively impossible. More studies are necessary that will assess the many different facets of the woman’s life and how it relates to her choice to abort or keep her child. A standardized measure also needs to be created that can be used with several post-abortion populations.
Further, calculating whether the problems that could potentially be discovered were prevalent in the woman’s life before the abortion or if they were only aggravated or brought to the surface by the abortion experience has yet to be accounted for. Other articles have recognized this limitation, but provide no way to compensate for it (Major et al, 2000; Reardon, 2000; Butler, 1996; Zolese & Blacker, 1992).
Another factor that cannot be controlled involves the number of women who will drop out or be lost for other reasons. It is also unknown whether these women will have a greater risk for PAS. Therefore, the concern remains that the women who would benefit most from this process could be the ones who avoid being part of the study (Franz & Reardon, 1992). The women who refuse to participate in studies such as this and the possible bias their absence creates should also be considered.
Although the open-ended interview questions will be given with careful consideration of the participant’s privacy and respect for their story, there is no way to measure levels of honesty and openness of women being interviewed. They may omit details or intentionally not mention specific problems out of shame, lack of understanding, denial, or many other possible rationales. Some women may also feel pressured by society’s views on abortion and their expectations for how a woman should cope with this process. The burden to appear undaunted by this event may prevent them from sharing openly about their abortion. For this reason, a post-interview assessment has been devised (see Appendix E).
The personal biases of the primary researcher could also affect the results of the open-ended interview questions and other parts of the experimental process. It is possible that the beliefs of the researcher could be revealed to the participants. Tape-recording the interviews could help to eliminate this problem to an extent, but that may infringe on the comfort level of the women to share openly about their abortion.
The Hawthorne effect presents a weakness in the research model. The researcher will be unable to assess whether the interview process, continued in a longitudinal study with GP1, may begin the process of self-examination and confound our results.