Sex Roles, Vol. 40, Nos.

9/10, 1999

The Psychological Impact of Reproductive

Dif® culties on Women’s Lives1
A lyssa N. Zucker2
University of Michigan

Little is known about the long-term impact of reproducti ve experiences on

women’ s lives. This paper uses questionnaire data collected from 107 white
female college graduates, when they were approxim ately 47 years old. More
than half the sam ple had experienced at least one type of reproducti ve dif® -
culty (abortion, miscarriage, or infertility). The stress and coping model of life
dif® culties (Lazaru s & Folkman, 1984) was used to examine the relatio nship
between the women’ s reproducti ve dif® culties and emotional sequelae, politi-
cization , and orientation to motherhood at midlife. As predicted, emotional
responses to the reprod uctive dif® culties varied according to the particular
nature of each experience. In ad dition, women who had abortio ns and no
other dif® culties were more politicized at midlife than other women. Wom en
whose reproductive experiences were especially likely to arouse feelings of
not being in control of their life (those who had miscarriages or infertility)
described a more agen tic orientation to motherhoo d when compared with
other women.

One consequence of the radically changing work and family patte rns of
the past forty years is that many social scientists have begun to examine
previously unque stione d assumptions about gender roles and the impor-
tance of pare nthood in American culture. Historically, Western culture has
idealized women who become mothe rs. The expectation that a woman’ s
most important and de® ning role is that of mothe r has been called the
1
This research was supported by a grant from the National Institute of Mental Health (RO1
MH47408) to Sandra Tangri. Thanks to Abigail Stewart for advice and comments at all stages
of the project, Joseph Veroff for comments on an earlie r draft of the article, Amy Young
for coding assistance , and Joan Ostrove, Lisa Saaf, and Isis Settles for encouragement.
2
To whom correspondence should be addressed, Institute for Research on Women and
Gender, University of Michigan, 460 West Hall, Ann Arbor MI 48109-1092; e-mail:
anzucker@umich.edu

767
0360-0025/99/0500-0767$16.00/0 Ó 1999 Plenum Publishing Corporation
768 Zucker

myth of mothe rhood (Hare -Mustin & Broderick, 1979), the cult of true
mothe rhood (Collins, 1987; Rhode s, 1988; Sande lowski, 1990), and the
mothe rhood mandate (Russo, 1976). The mandatory nature of pare nthood
has been extended to include the role of males as well. Miall (1986) sug-
gested that ``two traditional fertility norms continue to be widely accepted
in North America: (1) all married couples should reproduce and (2) all
married couples should want to reproduce ’’ (p. 268). These pervasive as-
sumptions about pare nthood lead to the belief that there is something
wrong with individuals who do not want to have children, who purposefully
delay having children, or who want children but are unable to have them
biologically. Even so, approximate ly 21% of women seek abortions at some
time during their lives (Adler, David, Major, Roth, Russo, & Wyatt, 1992),
10-20% of pregnancie s end in miscarriage (Reinharz, 1988), and 17% of
couples actively trying to reproduce experience infertility (Forrest & Gil-
bert, 1992). The clash between social pressures to reproduce and the experi-
ence of abortion, miscarriage , or infertility may lead to a varie ty of psycho-
logical phenomena.

Historical View of Reproducti ve Dif® culties

Feminist scholars have observe d that ``mandatory motherhood’ ’ has

been promote d and enforce d throughout western history, dating at least
from biblical times (Afek, 1990; Miall, 1986; Rhode s, 1988). There is strong
evidence that these historical and cultural beliefs have found their way
into existing psychological theories about women’ s identities, roles, and
positions in society. Classic theories of personality, such as those of Freud
and Erikson, argue d that female development is related to biological and
social functions of women as the people who bear and raise the next
generation. In Freudian theory, for instance, women only resolve their
Oedipal con¯ icts fully, and thus become true adults, when they become
pregnant and give birth, preferably to a son (Freud, 1933/1965). Erikson’ s
theory about women’ s development sugge sted that women’ s worlds are
built to re¯ ect the ``inne r space ’’ of the womb, and that preoccupations
with shelter, boundarie s, peace, and other example s of the inner space are
evident even in young girls (Erikson, 1968). Both of these theorists base d
their thinking about women on the assumption that all women share the
goal of becoming successful mothers. In fact, there is no room in these two
theories for women who choose not to, or are unable to bear children,
except as examples of pathology. The pervasiveness of the construct of the
cult of true womanhood in psychological theories for most of this century
has led to extensive pathologizing of women who are unable to become
Impact of Reproductiv e Dif® culties 769

pregnant, carry a pregnancy to term, or choose to abort. With this approach,

reproductive dif® culties have been blamed on individual women’ s internal
con¯ icts about womanhood, femininity, and motherhood that are suppos-
edly playe d out in their inability or lack of desire to have a child (Adler
et al., 1992; Forrest & Gilbert, 1992). Although there has been a recent
shift in research design and theoretical orientation, much of the existing
literature on reproductive dif® culties has been clinical case studie s that
emphasize pathology (Adler et al., 1992; Gold-Ste inberg, 1991).

Stress and Coping View of Reproductive Dif® culties

As an alternative to the psychoanalytically base d pathology model of

unde rstanding reproductive dif® culties, a stress and coping model has be-
come increasingly popular over the past twenty years. Lazarus and Folkman
(1984) discusse d psychological stress as the ``relationship between the per-
son and the environme nt that is appraise d by the person as taxing or
exceeding his or her resource s and endange ring his or her well-being’ ’ (p.
21) . Adler et al. (1992) and othe rs (e.g., Major, Cozzarelli, Sciacchitano,
Cooper, Testa, & Mueller, 1990; Major, Richards, Cooper, Cozzarelli, &
Zubek, 1998) who applied this view of stress to abortion and othe r reproduc-
tive dif® culties, argue d that multiple factors both within the person and
the environment contribute to the individual’ s perception of her level of
stress and her various mechanisms of coping. One way in which this model
differs from the historical model is in its ¯ exibility and adaptability in
different domains. Whereas the traditional psychoanalytic model predicts
a unive rsally bad outcome , both across reproductive dif® culties and among
individuals within categories of reproductive dif® culty, the stress and coping
model predicts different response s to particular reproductive dif® culties.
In addition, this model predicts different outcomes for different individuals,
base d on their coping resource s. This theory can be useful in unde rstanding
variations in individuals’ behavior across several domains and in fully devel-
oping psychological theory as well as treating individuals during and afte r
reproductive dif® culties. The three type s of reproductive experiences dis-
cussed in this paperÐ abortion, miscarriage , and infertilityÐ are viewed as
stressors; some ways that they differ are along the dimensions of time (acute
vs. chronic) and choice (planne d vs. unplanne d). For example , abortion is
both acute and planne d; miscarriage is acute and unplanne d; infertility is
chronic and unplanne d. These differences may lead to a varie ty of cognitive
appraisals and coping response s (see, e.g., Hobfoll, 1986, 1988). Although
most studie s of stress and coping examine cognitive appraisals during or
closely following a stressful event, this study is unique in that it examine s
770 Zucker

long-te rm correlates of reproductive dif® culties in women who are currently

at midlife. Speci® cally, differences in the nature of the stressors (time,
choice) are expected to relate to differences in recalled emotions about
the stressor, as well as to midlife political and pare nting behaviors.

Emotional Responses to Reproductive Dif® culties

After abortion was legalized in the United State s in 1973, it was easier
for researche rs to study diverse groups of women seeking abortions. Abor-
tion may be a successful response to the stress of an unplanne d pregnancy;
however, the abortion itself also may be stressful. As a stressor, abortion
is both acute and planne d. Because it is a planne d solution, there may be
positive emotional response s to it, such as a sense of relief or of having
made a good decision. However, because of social and moral sanctions
against abortion, there may be negative emotional response s such as regret
or shame as well.
In fact, Adler (1975) found both positive and negative emotional re-
sponse s to abortion. She aske d women retrospectively to rate how strongly
they experienced a number of emotions both during and afte r their abor-
tions. Three distinct factors emerged: positive emotions (happine ss, relief),
socially base d negative emotions (shame , guilt, fear of disapproval), and
internally based negative emotions (regret, anxie ty, depression, doubt,
ange r); furthe rmore, the positive emotions were experienced more fre-
quently than either type of negative emotion (Adler, 1975). In two more
recent studie s (including a large , prospe ctive study of women seeking abor-
tions), Major et al. (1990, 1998) found that appraisals of abortion were
in¯ uenced by an individual woman’ s circumstance s, including her level of
social support and her personality characte ristics. Appraisals and type s of
coping with abortion were in turn predictive of a varie ty of post-abortion
adjustme nt measure s. Taken toge ther, these studie s sugge st that experienc-
ing a range of positive and negative emotional responses to abortion is part
of the normal coping process, but by no means are the emotional sequelae
entirely negative , or universal. Speci® cally, I predict that women who have
had abortions will be likely to recall experiencing emotions of both relief
and regret with greater frequency than women who experienced other type s
of reproductive dif® culties.
The psychological consequences of miscarriage have been large ly ig-
nored until recently (Reinharz, 1988). Miscarriage and abortion are similar
in that they are both acute experiences. In contrast to abortion, however,
miscarriage is a reproductive dif® culty that is unplanne d. Furthe rmore,
while abortion provide s a solution to the proble m of unde sired pregnancy,
Impact of Reproductiv e Dif® culties 771

miscarriage is rarely viewed in such terms, and ofte n represents the loss of
anticipated motherhood. Miscarriage may also be painful and frighte ning.
Recent work has sugge sted that depressive symptoms and anxiety are com-
mon among some women in the days and months following miscarriage,
and that, in general, miscarriage is ofte n viewed as a traumatic event by
the women who experience it (Frost & Condon, 1996; Janssen, Cuisinier,
Hoogduin & deGraauw, 1996; Lee & Slade , 1996; Neugebaue r, Kline,
Shrout, Skodol, O’Connor, Geller, Stein, & Susser, 1997). Thus, because
of the unexpected loss and physical trauma associate d with miscarriage , I
predict that women who had miscarriage s will have higher levels of depres-
sion and intense emotional distress or trauma than women who experienced
othe r type s of reproductive dif® culties.
The experience of infertility is similar to that of miscarriage in that
both conditions are unplanned and disrupt couples’ expectations about
pare nthood. Unlike both abortion and miscarriage, however, infertility is
a chronic stressor with no clear solution and ofte n results in strong feelings
of uncertainty about the future . Forrest and Gilbert (1992) have described
a cycle associate d with infertility in which there is continue d hope by the
couple that the woman will become pregnant next month, followed by
feelings of helplessness, powerlessness, and loss of control. It is interesting
to note , though, that these negative emotions during periods of infertility
are not unive rsal in either incidence or duration. Connolly, Edelmann,
Cooke, and Robson (1992) studied 130 couples at the time of their initial
visit to an infertility clinic, and 116 of the couples again 7± 9 months later.
They found little evidence of psychopathology at either time; instead, their
participants had generally good adjustme nt and stable marital relationships,
including low depression scores. Thus, I predict that women who experi-
enced infertility will have low levels of depression generally, but because
of the chronic nature of the dif® culty, they will have highe r levels of feelings
of failure and uncertainty about the future than women who experienced
othe r type s of reproductive dif® culties.

Politicization in Response to Reproductive Dif® culties

Multiple strate gies can be employed to cope with the stress of a repro-
ductive dif® culty (Major et al., 1998). As argue d above , emotional coping
is one type of response, and speci® c emotions will vary depending on the
type of dif® culty. Similarly, a stressful reproductive experience may force
an individual to alter her cognitive frame work, and variations in the stressor
may be related to different cognitive con¯ icts and outcomes. Abortion,
miscarriage or infertility may lead an individual to question her previous
772 Zucker

assumptions about herself and the world. Janoff-B ulman (1989) has articu-
lated this cognitive process regarding trauma victims: ``the coping task
facing victims is large ly a dif® cult cognitive dilemma; they must integrate
the data of their dramatic, negative experience and their prior assumptions’ ’
(p. 121). Although a reproductive dif® culty is not always traumatic, the
experience may be suf® cient to cause a disruption in an individual’ s cogni-
tive framework. For instance , the physical, emotional and political conse-
quences of an unplanne d pregnancy and abortion may challenge previously
held beliefs, such as ``I won’t get pregnant;’ ’ ``Men and women should be
equally accountable for sexual behavior;’ ’ and ``I am moral.’ ’ The result of
integrating the new feelings with the old framework may be an altered
assumptive world. In this way, personal experiences may affe ct ideology.
The cognitive dilemmas following an abortion may lead to a shift in
ideology in a numbe r of domains. One salient domain is that of political
identity. Cole and Stewart (1996) have de® ned political identity as an
enduring commitme nt to a set of political beliefs, recognition of the social
and structural relationships that exist between self and othe rs, and the
belief that the political realm is personally meaningful. There are several
aspe cts of the experience of unplanne d pregnancy and abortion that are
likely to relate to increases in political identity.
First, the fact that women (and not their male partne rs) ultimate ly
need to make the decision about whether to have an abortion, and then
face the consequences, is likely to highlight inequities between women and
men, and this contrast may lead to a heighte ned sense of the experiences
of women as a group, rathe r than as individuals. Second, although abortion
has been legal in the United States for more than twenty-® ve years, recent
violence and continued demonstrations at abortion clinics highlight the fact
that abortion is still a highly charge d issue for many people, and that women
seeking abortions may be in pote ntially life threatening situations. Third,
because women who have abortions choose to do so, they are often stigma-
tized by many people (from members of their social network to strangers,
such as Operation Rescue members) and institutions (e.g., the church).
Stewart and Gold-Ste inberg (1996) have demonstrate d that both the
danger and the stigma associate d with choosing to have an abortion are
related to politicization. They suggeste d that although all abortions are
likely to raise a woman’ s consciousness about inequities between women
and men, illegal abortions, with their adde d cost, dange r, and stigma associ-
ated with breaking the law, are particularly likely to challenge women’ s
thinking about social structure , and, in turn, increase their political mobiliza-
tion. In this way, illegal abortion may serve as a ``catastrophic event’ ’
that requires a change in an individual’ s assumptive world. Although legal
abortion ofte n is not as catastrophic as illegal abortion, it is still a stigmatize d
Impact of Reproductiv e Dif® culties 773

event; as such, it may lead to a similar path of challenging one’s beliefs.

This example highlights the women’ s movement adage ``the personal is po-
litical.’ ’
Experiencing an abortion is expected to be more related to political
identity than experiencing miscarriage, infertility, or no reproductive dif® -
culties. The dimensions of choice, dange r and stigma are all more salient
for women who have abortions than women in any of the othe r three
categories; in this way, women who have abortions are more likely to
experience cognitive dilemmas that require an ideological shift, resulting
in increased levels of politicization around their identities as women. Thus,
I predict that women who had an abortion will have higher levels of political
identity than women who did not have an abortion.

Agentic Parenting as a Coping Response

As argue d above , emotions and cognitions are two categories of coping

or response to stressful life events. A third type of coping is behavioral;
an individual may adopt certain behaviors to cope with a particular stressor.
Both miscarriage s and periods of infertility represent times when women
are acute ly out of control of their bodies and their desired family size; thus
these events encompass a time when age ncy is severely lacking, in at least
one domain of women’ s lives. Folkman (1984) argued that a sense of
personal control is related to both the appraisal of stress and coping with
stress; such personal control will vary with the type of stressor and the
person-e nvironment relationship. A common psychological reaction to in-
fertility is a sense of not being in control of one’ s life, at least in one
important area. Stewart and Robinson (1989) sugge sted that for many
couples who have planne d their marriage s, careers, and ® nance s, childbear-
ing is the ® rst event they are not able to control. Forrest and Gilbert (1992)
argued that the inability to have children makes couples lose a sense of
being con® dent, competent, and in control of their lives. Matthews and
Matthews (1986) emphasize d that infertility treatme nt intensi® es the loss
of control over the sexual relationship, which they argued is the most private
aspe ct of the couple’ s life toge ther. Although miscarriage and infertility
differ from each othe r in terms of duration, they both represent reproductive
experiences with a profound lack of agency and control, whereas deciding
to have an abortion is itself an age ntic act.
It seems possible that this lack of age ncy may lead women who experi-
ence miscarriage or infertility to compensate by becoming more age ntic in
another way, in order to reassert their control. One possibility is that while
women experience a lack of agency in the reproductive domain, they may
774 Zucker

become more age ntic in anothe r area (e.g., work) concurre ntly. A second
possibility is that the woman will try to assert her age ncy in the reproductive
domain in a variety of ways (e.g., by seeking new treatme nts for pregnancy,
by atte mpting to adopt a child, etc.) A third possibility is that if the woman
ultimate ly has children, she may compensate for the earlier lack of age ncy
by adopting a more agentic orientation to pare nting. Although the experi-
ence of childrearing usually occurs afte r the initial reproductive dif® culty,
and the woman may have become more age ntic in anothe r area, she may
still have age ncy needs within the pare nthood domain. Even though all
three of these outcomes are likely and warrant exploration, the structure
of the data used in this study only allows the examination of the third
possibility. Thus, I predict that women who experienced either miscarriage
or infertility will expre ss a more age ntic pare nting style if and when they
become mothers than othe r women.

Hypotheses

Hypothesis 1. Midlife women who experienced abortion, miscarriage ,

or infertility earlier in life will expre ss different emotions when recalling
the experience. Speci® cally: abortion will be associate d with both relief and
regret; miscarriage will be associated with depression and intense emotional
distress; infertility will be associate d with feelings of failure and uncertainty.
Hypothesis 2. Women who had an abortion will be more politicized
at midlife than their peers who did not have an abortion.
Hypothesis 3. Women who experienced an intense lack of control in
the conte xt of reproduction (miscarriage and/or infertility) will compensate
by taking a more age ntic pare nting role than othe r women if and when
they have children.

METHOD

Participants

Participants in this study were 107 women who graduated from the
University of Michigan in 1967. These women are a sub-sample of a group of
200 women who were ® rst studie d during their senior year at the university
(Tangri & Jenkins, 1986). The sample consists almost entirely of white
women, who were approximately 47 years old at the time of the study.
They were predominantly married or living with a partne r (n 5 86), a few
were single (n 5 8), divorced or widowed (n 5 10), and almost all were
Impact of Reproductiv e Dif® culties 775

heterosexual (n 5 102). Ninety-® ve of the participants indicate d that they

thought of themselves as having a career. The women’ s personal yearly
salaries range d from not working for pay to $140,000 and above , with a
mean of $40-50,000. Their combine d household incomes were much higher,
however, ranging from $30± 40,000 to $160,000 and above , with a mean of
$100± 120,000. Thus, most of the women can be classi® ed as currently middle
to uppe r class. Eighty percent of the women were biological mothe rs, and
another 6% were adoptive or step-mothe rs. With respect to women who
had experienced reproductive dif® culties (38% of the sample; see details
below), 81% of women who had abortions were mothe rs by age 47; all of
the women who had miscarriage s were mothers by age 47; and 96% of
women who experienced infertility were either birth or adoptive mothe rs
by age 47.

Procedure

The original sample has been followed up three times since the initial
data collection in 1967. Women were contacte d by telephone and encour-
age d to participate for up to one year following the mailing. The current
sample of 107 women represents those who participate d in the most recent
wave in 1992. At this time, three women from the original sample were
deceased, and anothe r 48 women were not locatable, yielding a total re-
sponse rate of 72%.
All women in the study completed a four-part questionnaire which
included both open-and closed-ended questions concerning work, family,
health, and political involve ment and attitude s. Only some of these ques-
tions were used in the current study, and they broadly fall into the categories
of reproductive history, emotions, political involveme nt and attitudes, and
the motherhood role.

Measures

Reproductive history was assessed by a closed-ended question that

aske d participants if and at what age they had experienced any of the
following dif® culties: had an abortion, had a miscarriage , or taken more
than one year to conceive. The participants experienced abortion, miscar-
riage , and infertility at rate s quite similar to the national rate : abortion,
n 5 26 (24%); miscarriage , n 5 24 (22%); infertility, n 5 24 (22%). Age at
experience of reproductive dif® culty varied greatly across the sample . Age
at abortion ranged from 19 to 45 years, with a mean of 31.63. Age at
776 Zucker

miscarriage ranged from 23 to 41 years with a mean of 33.97. Age at

infertility range d from 22 to 46 years with a mean of 32.32.
Because this is a ``real world’ ’ sample (and not a carefully controlle d
experiment), some women experienced multiple reproductive dif® culties.
Thirty-six women experienced one type of reproductive dif® culty only
(abortion, n 5 17; miscarriage, n 5 10; infertility, n 5 9), 16 experienced
two type s (abortion and miscarriage, n 5 3; abortion and infertility, n 5
4; miscarriage and infertility, n 5 9), and two women experienced all three
types. In the following analyse s, each reproductive dif® culty is compare d
to all othe rs combine d. Thus, if a woman experienced both an abortion
and a miscarriage , she was included in the abortion group when comparing
that group to the rest of the sample , and in the miscarriage group when
comparing that group to the rest of the sample.

Emotions

Emotional response to reproductive dif® culties was assessed in an

open-ende d question that immediately followed the reproductive history
information. Women were aske d, ``If you have had any of these experiences,
please take a minute to tell us about them and how the experience affe cted
you. Be sure to indicate which experience you are telling us about.’ ’ Af-
fective response s were coded for the numbe r of mentions of relief, regret,
depression, trauma, uncertainty, and failure . See Table I for speci® c exam-
ples of these codes. Interrate r reliability was .89 for these codes. Because
this question was open-ended, and emotions were not prompte d, not all
women described emotional response s. Twenty-se ven women did not men-

Table I. Sample Codes for Emotions Following Reproductive Experiences

Emotion Coded Sample Statement
Relief/right decision ``The timing and the relationship were all
wrong, and looking back after 16 years
I still know I made the right decision.’’
Regret ``My abortion was the worst experience
of my life, my bigge st regret.’’
Depression, disappointment, sadness ``I was sad and upset.’ ’
Trauma, emotional distress ``Miscarriage was very traumatic. Lost a
child, but hard to mourn.’ ’
Failure, incompetence ``It took 18 months for me to get pregnant
the ® rst time. . . . It made me feel in-
competent.’’
Uncertainty ``It was a pretty bad time Ð to go around
not knowing if I’ d have two kids.’’
Impact of Reproductiv e Dif® culties 777

tion any emotional response, 19 mentioned one emotion, six mentione d

two emotions, and two mentione d three emotions. To test the hypothesis
regarding abortion, a new dichotomous variable was created (1 5 men-
tioned relief and/or regret, 0 5 did not mention relief or regret). Compara-
ble variables were created with depression and trauma to test the hypothesis
for miscarriage , and with uncertainty and failure to test the hypothe sis
for infertility.

Political Identity

Political identity was assessed through an index created by Cole and

Stewart (1996). Social identity theorists (e.g., Gurin, Miller & Gurin, 1980)
have argue d that connecting individual struggle s to large r social structure s
is a necessary compone nt for developing a politicized identity. Building on
this literature , and the work of Stewart and Healy (1989) on the salience
of social and historical events, this index is meant to measure a patte rn of
beliefs about the interconne ction of the individual with social groups and
issues. The index includes measures of attitude s toward past and current
political issues and represents both political ideology (e.g., collectivism)
and political salience; it was previously found to be related to active political
participation in the same sample of white women at midlife (Cole & Stewart,
1996). The index is the mean of ® ve standardize d measure s: evaluation of
system blame, collectivism vs. individualism, group vs. individual strategy
for overcoming discrimination, political salience, and political orientation.
When combine d, these scales represent a compre hensive measure of politi-
cal identity that encompasse s both the meaningfulne ss of politics and actual
political beliefs. This index had high internal consiste ncy (alpha 5 .82).
E valuation of system blame was assessed using two measures developed
by Gurin, Miller, and Gurin (1980). One set of seven items measure d
how much participants attributed social inequalitie s to social and political
systems rathe r than to individuals, with respect to gender inequities. An-
othe r set of eight items measure d the same attitude s with respect to racial
inequities. All system blame items were measured on a scale ranging from
1 (strongly disagree ) to 5 (strongly agree). Sample items are ``Many quali® ed
women can’ t get good jobs. Men with the same skills have much less
trouble;’ ’ and ``If Blacks don’ t advance in their jobs, it is because there are
barriers which keep them from getting ahead.’ ’
Collectivism vs. individualism was assessed using seven items from the
Ryan collectivism vs. individualism scale (excerpte d as in Lykes, 1985). All
items were rate d from 1 (strongly disagre e) to 7 (strongly agre e). Sample
items are ```Paddle your own canoe ’ is a good principle to live by,’ ’ and
778 Zucker

``If you want to correct problems like drug addiction or juvenile delin-
quency, you have to reform the individual addicts or delinquents because
those individuals are the ones who have proble ms.’ ’
Strategy for o vercoming discrimination was assessed with two items,
taken from the 1972 National Election Study. These items are in a forced
choice format, and the participants must endorse either collective action
or individual action as a strategy to overcome discrimination for both Black
people and women. For example , the choice regarding women is ``The best
way to handle problems of discrimination is for each woman to make sure
she gets the best training possible for what she wants to do’ ’ versus ``It is
not enough for a woman to be successful herself. Women must all work
togethe r to change laws and customs which are unfair to all women.’ ’
Political salience was assessed using a measure adapte d from Stewart
and Healy (1989) . Participants were aske d to rate how meaningful they
found each of nine historical events that occurre d in the latte r half of the
twentieth century (e.g., the Civil Rights movement, the sexual revolution,
the Reagan presidency, the Gulf war), on a scale ranging from 1 (not at
all personally meaningful) through 2 (a little personally meaningful) to 3
(very personally meaningful).
Political orientation was assessed on a 5-point scale, ranging from 1
(very conservative ) through 3 (mode rate) to 5 (radical).

Parenting Style

Orientation to the motherhood role was assessed by coding across three

open ended questions answered by the women who were mothe rs by age
47: how do you think a woman’ s life is change d by having children, what
do you like about your role in your children’ s lives, and what do you dislike
about your role in your children’ s lives. These questions were coded for
mentions of age ncy and communion. Agency was coded for mentions of
helping and teaching children, having a positive in¯ uence on children, and
setting a good example for children. Examples of agentic response s to the
question of what the respondent likes about her role include, ``Helping them
solve their proble ms± with their school work and social/pe rsonal proble ms,’ ’
and ``I am grate ful that I can provide them emotional and ® nancial security.’ ’
Communion was coded for expressions of love, joy, and happiness with
the mothe r role, feeling needed by children, and spending time toge ther.
Example s of communal responses to the question of what the responde nt
likes about her role include, ``The pleasure of being with them and doing
things with them,’’ and ``Loving them and them loving me.’ ’ Coders were
unaware of both the woman’ s reproductive status and the hypothe sis. In-
Impact of Reproductiv e Dif® culties 779

terrate r reliability was .91 across the codes for both agency and communion.
A composite variable was then created by subtracting each woman’ s com-
munion score from her age ncy score.

RESULTS

Recalled Emotions and Reproductive Dif® culties

As predicted, signi® cantly more women who had had abortions recalled
experiencing relief and /or regret than women who experienced other type s
of reproductive dif® culties (see Table II). Similarly, signi® cantly more
women who had miscarriage s recalled experiencing depression and/or
trauma than women who experienced othe r type s of reproductive dif® cult-
ies. There was a trend for women who experienced infertility to recall
emotions of failure and uncertainty more than women who experienced
othe r type s of reproductive dif® culties. In no analysis did age at particular
reproductive dif® culty relate to the dependent variable .
In addition to the chi-square analyse s presented above , a series of
logistic regressions were conducte d on the recalled emotions, with the three
types of reproductive dif® culties as independent variables. In this way, the
effects of each reproductive experience could be assesse d, controlling for
the othe r two. When relief and/or regret was regressed on the three repro-
ductive dif® culty variable s, abortion was the only signi® cant predictor

Table II. Recalled Emotions Following Reproductive Dif® culties

Reproductive Dif® culty
Emotions Group 1 Group 2
Relief and/or Regre t Abortion No Abortion
N 10 1
% 42% 4%
x 2 (1, 50) 5 10.40 c
Depression and/or Trauma Miscarriage No miscarriage
N 14 8
% 58% 31%
x 2 (1, 50) 5 3.85 b
Failure and/or Uncertainty Infertility No Infertility
N 6 3
% 29% 10%
x 2 (1, 50) 5 2.74 a
a
p , .10.
b
p , .05.
c
p , .01.
780 Zucker

(B 5 3.20, p , .05), and increased the odds by a factor of 24, x 2 (3, 50) 5
12.26, p , .01. When depression and/or trauma was regressed, none of the
factors was signi® cant, although there was a trend for miscarriage (B 5
1.16, p 5 .10), which increased the odds by a factor of 3, x 2 (3, 50) 5 4.73,
n.s. When failure and /or uncertainty was regressed, none of the factors
was signi® cant, although the betas were in the appropriate direction,
x 2 (3, 50) 5 4.48, n.s.

Politicization and Abortion

Women who had an abortion were only marginally highe r than othe r
women on the political identity index. However, when the group was re-
stricted to women who had abortions and no othe r dif® culties, it was signi® -
cantly higher than the women in the rest of the sample (see Table III).
These data sugge st that women who experienced abortion and additional
dif® culties were different from those who experienced abortion only. To
better unde rstand this ® nding, I regressed political identity on abortion,
miscarriage and infertility. In this multiple regression, the abortion predictor
droppe d in signi® cance (B 5 .19, p 5 .12), and infertility emerged as a
signi® cant negative predictor (B 5 2 .31, p , .05) ; R2 5 .08, p , .05. Thus,
with all three reproductive experiences in the model, the signi® cance of
abortion was diminished, whereas infertility was signi® cant, suggesting that
experiencing multiple dif® culties, and infertility in particular, may be depo-
liticizing. Age at reproductive dif® culty did not correlate with level of
political identity.
In a post-hoc attempt to rule out the explanation that prior levels of
political identity led to subse quent abortion, and not the reverse, I analyze d
the relationship between proxie s for political identity from the ® rst wave
of the study in 1967 (when only three women had had abortions) and
subse quent abortion and political identity. In 1967 the women were classi-
® ed into three groups base d of the traditionality of their career aspirations

Table III. Political Identity

Abortion Status
Political Identity Index Abortion Only No Abortion
N 17 79
M .31 2 .05
SD .48 .55
t (94) 5 2.48a
a
p , .05.
Impact of Reproductiv e Dif® culties 781

(traditional, moderate , and innovative ). This construct did not relate to

having an abortion or level of political identity by age 47. The participants
also rate d themselves on a variety of bipolar adjective pairs in 1967. Two of
these pairs, conve ntional-unconve ntional and intellectual-non-intellectual
were signi® cantly related to political identity at age 47 (that is, high self-
ratings of unconve ntionality and intellect at age 21 were predictive of
political identity at age 47), but did not predict subse quent abortion. Al-
though the variable s of work traditionality and self-ratings of being conve n-
tional and intellectual are not the way political identity was de® ned at
midlife, they are the closest proxie s, and sugge st that the women who
subse quently had abortions did not already have a different self-concept
from their peers at age 21. By 1970 (the next wave of data collection) when
there were more direct measure s of political identity, 35% of the abortions
in the sample had already occurred, and thus an analysis could not be
performe d with these data.

Orientation to Motherhood

Except for one woman, all of the women who had had a miscarriage
or period of infertility went on to become mothe rs, either biologically or
through adoption. As predicted, women who experienced miscarriage and/
or infertility scored higher than women who did not have these experiences
on the agency-minus-communion scale (see Table IV). When the orienta-
tion to mothe rhood variable was regressed on abortion and the combined
miscarriage and/or infertility variable, miscarriage and/or infertility was
the only signi® cant predictor (B 5 .43, p , .05), R2 5 .08, p , .05. Age at
reproductive dif® culty did not correlate with score on the age ncy-minus-
communion variable .

Table IV. Parenting Style

Reproductive Category
Agency minus Communion Miscarriage or Infertility No Miscarriage or Infertility
N 27 57
M .26 2 .16
SD .71 .77
t (82) 5 2.36 a
p ,
a
.05.
782 Zucker

DISCUSSION

The data described in this pape r allow us to examine correlates of

reproductive dif® culties in a numbe r of domains, many years after the
dif® culties occurre d. This is a unique contribution to the literature , which
instead ofte n focuse s on outcome s immediate ly or shortly afte r the repro-
ductive dif® culty (see Russo & Zierk, 1992, for an exception). The stress
and coping model predicts that there will be variance in both stress and
coping depending on the nature of the person-e nvironme nt relationship.
In line with this theory, and the varying nature of reproductive dif® culties,
I found differences in the frequency of recollection of different emotions
following reproductive dif® culties.
Women who had abortions recalled feeling relief and regret more than
othe r women. This was expected in light of the fact that abortion represents
a solution to the proble m of an unwante d pregnancy. In most cases of
miscarriage and infertility, a pregnancy is desired, and choices are not
involved. Thus, emotions of relief and regretÐ both of which are relevant
to the experience of making a choice, were expected and found much more
frequently for women who had abortions.
Women who experienced miscarriage s recalled the emotions of depres-
sion and trauma more frequently than othe r women. Miscarriage is primar-
ily an experience of loss (both physical and emotional), and depression
and emotional distress are common emotional reactions to loss. Even
though women who have abortions may experience feelings of loss, it is
less likely that they will because they made a conscious decision to abort.
Women who experience periods of infertility may feel a general sense of
loss relating to their inability to have children, but it is not as focuse d as
in the case where there was an actual pregnancy lost. An example of
recalling emotional distress afte r experiencing reproductive dif® culty is
offere d by one woman recalling her miscarriage: ``I had a miscarriage in
my fourth month. It was traumatic because the fetus came out at home,
and I could see some human shape . . . . Because I lost so much blood and
almost died, the experience staye d with me for a while.’’ Another woman
who had a miscarriage wrote, ``My husband and I had already bonded with
our unborn child and the miscarriage was extremely depressing for both
of us.’ ’
There was a trend for women who experienced infertility to recall the
emotions of failure and uncertainty more freque ntly than othe r women
when the two groups were compare d; however, when all reproductive
experiences were included in a regression, there were no signi® cant pre-
dictors. Although not hypothesize d, it seems reasonable that women who
experienced abortion or miscarriage would also describe such emotions.
Impact of Reproductiv e Dif® culties 783

Women who become pregnant unintentionally may experience feelings of

failure at controlling their reproductive lives; in this case, although abortion
would be associate d with feelings of failure , the abortion itself might not
be the cause of the emotions. Miscarriage can leave some women feeling
uncertain about their ability to have children in the future , and indeed,
some women in the sample described this experience.
It is important to remember that in all instance s women were recalling
(often many years later) their reactions to the reproductive dif® culty. In
one way, this is a limitation of the study, because we do not know the
actual duration or intensity of the emotions at the time. However, the fact
that the question did not speci® cally prompt for emotions, but simply for
a description of how the experience affe cted the participant, sugge sts that
the emotions they did recall and report were of signi® cance to them, and
remained salient over a number of years.
Women who had abortions and no othe r type of dif® culty were more
politicized at midlife than their peers who did not have abortions. Although
all three experiences of abortion, miscarriage, and infertility have negative
connotations in this reproduction-orie nted society, these ® ndings indicate d
that abortion is the one that is most related to political mobilization. The
stigma attache d to abortion, and its legal status, have ¯ uctuate d during the
years these women had abortions (1964± 1990); however, the stigma was, at
all times, greate r than that for miscarriage and infertility. These data support
Stewart and Gold-Ste inberg’ s (1996) ® nding that abortion, both illegal and
legal, has political implications in a woman’ s own life. It was interesting that
abortion, when experienced along with miscarriage and/or infertility, was not
related to political identity in the same way. Perhaps women who had these
multiple reproductive dif® culties viewed them more in terms of medical expe-
riences (and thus as less politicizing) than as gendered, political experiences.
There is some support for this hypothe sis from the unpre dicted ® nding that,
in a multiple regression, infertility emerged as a signi® cant negati ve predictor
of political identity. This ® nding suggests that a protracte d negative reproduc-
tive dif® culty that is often medicalized is related to a focus on individuals
instead of groups, and a fairly depoliticized identity.
The relationship of abortion to political identity also sugge sts that
there are consequences of abortion that are not negative . One woman who
had an illegal abortion while she was a University stude nt wrote:
It cost $200, a vast sum, borrowed in $10 and $20 bits from friendsÐ all women.
Before and after my own abortion I lent money to other women {for abortions}. .
. . I think it was a pivotal experience. It was the ® rst time I took control, made a
decision, followed through, and cared for myself. I began to realize that my choices
could make a difference.

Although this woman does not say explicitly that her abortion was politiciz-
784 Zucker

ing, she does offe r evidence that the process of deciding and making the
arrange ments to have an abortion had a profound effect on her. This kind
of cognitive awakening is a way of altering one’s assumptive world (Janoff-
Bulman, 1989) and may lead to a more developed political identity. Furthe r-
more, this woman’ s example of lending and borrowing money with othe r
women in her social circle in order to provide for abortions sugge sts a
tendency toward group consciousne ss and collective action, example s of a
politicized identity.
As predicted, women who experienced a lack of control around repro-
ductive issues in their lives (those who had miscarriage s and/or infertility)
described a more agentic than communal parenting style than women in
othe r groups when and if they did have children. This ® nding offers an
example of the mechanism for how the expression of age ncy is crucial for
women’ s well-being. If one area of an individual’ s life is a place where she
struggle s to be age ntic and fails (e.g., reproduction), she may compensate
by becoming especially age ntic in a related area (e.g., pare nting), if given
an opportunity. The age ntic parenting style is exempli® ed by two women
who experienced both miscarriage and periods of infertility, in response to
the question ``What do you like about your role in your children’ s lives? ’’
One woman wrote, ``I can guide her and provide her with the environme nt
to nourish all of her interests so that she will have more ways to enjoy
life.’’ Anothe r woman wrote, ``Assisting in forming a human who will be
an asset to society.’ ’ Both of these responses show the importance of the
pare nting role to these women; however, these women describe their rela-
tionships with children in active terms, rather than in terms of their close,
loving conne ctions. This ® nding shows that instead of retaining a sense of
being out-of-control of their lives, women who were not in charge of their
fertility were more age ntic in the parenting domain, possibly compensating
for those earlier feelings. The fact that these data are retrospe ctive is an
asset rathe r than a limitation. Because the data were collected so long afte r
the reproductive dif® culties, most of these women had a chance to become
mothe rs (either biological or adoptive); thus explorations in this domain
were possible . Although data on othe r possible avenues of agency at the
time were not available (and would be important to examine in future
explorations) , these data do show a long-te rm relationship between repro-
ductive dif® culties and parenting style.
Taken togethe r, these results shed light on the long-te rm implications
of reproductive experiences for women’ s lives. The stress and coping model
was useful in predicting and unde rstanding women’ s outcome s in a variety
of areas. Each reproductive dif® culty represents a different type of stressor
and multiple type s of coping are possible. Women with educational and
othe r resource s are able to cope with the experiences in a varie ty of ways,
Impact of Reproductiv e Dif® culties 785

often transforming negative experiences (shame, lack of control) into posi-

tive ones (political action, age ntic pare nting styles). Although these data
cannot tell us about the nature of these experiences for women from othe r
educational backgrounds or for women of color, they form a useful knowl-
edge base for future research. In addition, it is important to remember that
the data are correlational, and no causal links should be drawn. The issue
of multicollinearity among the predictors is also an interesting one. Many
of the women who experienced reproductive dif® culties experienced more
than one; it would be useful in other studie s to furthe r explore the impact
of multiple dif® culties versus single dif® culties.
In future studies it will be important to continue to move away from
a pathology-based explanation of reproductive experiences, and explore a
varie ty of both positive and negative outcome s. One could expand on the
work in the current pape r by examining pote ntial mechanisms by which
negative emotions or experiences may be transformed into positive out-
comes such as political identity. In addition, examining these relationships
among more diverse sample s will provide a richer picture of the psychologi-
cal implications of these experiences. Finally, including a comparison group
of women who make a conscious decision not to have children could expand
our knowledge base in new and useful directions.

REFERENCES

Adler, N. E. (1975). Emotional responses of women following therapeutic abortion. American

Journal of Orthopsychiatry, 45, 446± 454.
Adler, N. E., David, H. P., Major, B. N., Roth, S. H., Russo, N. F., & Wyatt, G. E. (1992).
Psychological factors in abortion. American Psychologist, 47, 1194± 1204.
Afek, D. (1990). Sarah and the women’s movement: The experience of infertility. Wom en
and Therapy, 10, 195± 203.
Cole, E. R., & Stewart, A. J. (1996). Meanings of political participation among black and
white women: Political identity and social responsibility. Journal of Personality and Social
Psychology, 71, 130± 140.
Collins, P. H. (1987). The meaning of motherhood in black culture and black mother/daughter
relationships. In J. Wetzel, M. L. Espenlaub, M. A. Hagen, A. B. McElhiney, & C. B.
Williams (Eds.), Wom en’s studies: Thinking women. Dubuque, IA: Kendall/Hunt.
Connolly, K. J., Edelmann, R. J., Cooke, I. D., & Robson, J. (1992). The impact of infertility
on psychological functioning. Journal of Psychosomatic Research, 36, 459± 468.
Erikson, E. H. (1968). Womanhood and the inner space. In J. Strouse (Ed.), Wom en &
analysis. New York: Grossman Publishers.
Folkman, S. (1984). Personal control and stress and coping processes: A theoretical analysis.
Journal of Personality and Social Psychology, 46, 839± 852.
Forrest, L., & Gilbert, M. S. (1992). Infertility: An unanticipated and prolonged life crisis.
Journal of Mental Health Counseling, 14, 42± 58.
Freud, S. (1933/1965). Femininity. In New introductory lectures on psychoanalysis . New York:
W. W. Norton.
Frost, M., & Condon, J. T. (1996). The psychological sequelae of miscarriage : A critical review
of the literature. Australian and New Zealand Journal of Psychiatry, 30, 54± 62.
786 Zucker

Gold-Steinberg, S. E. (1991). Legal and illegal abortion: Coping with the impact of social
policies on women’s li ves. Unpublished doctoral dissertation, University of Michigan,
Ann Arbor.
Gurin, P., Miller, A., & Gurin, G. (1980). Stratum identi® cation and consciousness. Social
Psychology Quarterly, 43, 30± 47.
Hare-Mustin, R. T., & Broderick, P. C. (1979). The myth of motherhood: A study of attitudes
toward motherhood. Psychology of Women Quarterly, 4, 114± 128.
Hobfoll, S. E., & Lerman, M. (1988). Personal relationships, personal attributes, and stress
resistance: Mothers’ reactions to their child’s illness. American Journal of Community
Psychology, 16, 565± 589.
Hobfoll, S. E., Nadler, A., & Leiberman, J. (1986). Satisfaction with social support during
crisis: Intimacy and self-esteem as critical determinants. Journal of Personality and Social
Psychology, 51, 296± 304.
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications
of the schema construct. Social Cognition, 7, 113± 136.
Janssen, H. J. E. M., Cuisinier, M. C. J., Hoogduin, K. A. L., & deGraauw, K. P. H. M. (1996).
Controlled prospective study on the mental health of women following pregnancy loss.
American Journal of Psychiatry, 153, 226± 230.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer
Publishing Company.
Lee, C., & Slade, P. (1996). Miscarriage as a traumatic event: A review of the literature
and new implications for intervention. Journal of Psychosom atic Research, 40, 235±
244.
Lykes, M. B. (1985). Gender and individualistic vs. collectivist bases for notions about the
self. Journal of Personality, 53, 356± 383.
Major, B., Cozzarelli, C., Sciacchitano, A. M., Cooper, M. L., Testa, M., & Mueller, P. (1990).
Perceived social support, self-ef® cacy, and adjustment to abortion. Journal of Personality
and Social Psychology, 59, 452± 463.
Major, B., Richards, C., Cooper, M. L., Cozzarelli, C., & Zubek, J. (1998). Personal resilience,
cognitive appraisals, and coping: An integrative model of adjustment to abortion. Journal
of Personality and Social Psychology, 74, 735± 752.
Matthe ws, R., & Matthe ws, A. M. (1986). Infertility and involuntary childlessness: The transi-
tion to nonparenthood. Journal of Marriage and the Family, 48, 641± 649.
Miall, C. E. (1986). The stigma of involuntary childlessness. Social Problems, 33, 268±
282.
Neugebauer, R., Kline, J., Shrout, P., Skodol, A., O’Connor, P., Geller, P. A., Stein, Z., &
Susser, M. (1997). Major depressive disorder in the six months after miscarriage. Journal
of the American Medical Association, 277, 383± 388.
Reinharz, S. (1988). What’ s missing in miscarriage ? Journal of Community Psychology, 16,
84± 103.
Rhodes, R. (1988). Women, motherhood, and infertility: The social and historical context.
Journal of Social Work and Human Sexuality, 6, 5± 20.
Russo, N. F. (1976). The motherhood mandate. Journal of Social Issues, 32, 143± 153.
Russo, N. F., & Zierk, K. L. (1992). Abortion, childbearing, and women’ s well-being. Profes-
sional Psychology, 23, 269± 280.
Sandelowski, M. J. (1990). Failures of volition: Female age ncy and infertility in historical
perspective. Signs: Journal of Wom en in Culture and Society, 15, 475± 499.
Stewart, A. J., & Gold-Steinberg, S. (1996). Women’s abortion experiences as sources of
political mobilization. In M. B. Lykes, A. Banuazizi, R. Liem, & M. Morris (Eds.), Myths
about the powerless: Contesting social inequalities (pp. 275± 295). Philadelphia, PA: Temple
University Press.
Stewart, A. J., & Healy, J. M. (1989). Linking individual development and social changes.
American Psychologist, 44, 30± 42.
Stewart, D. E., & Robinson, G. E. (1989). Infertility by choice or by nature. Canadian Journal
of Psychiatry, 34, 866± 871.
Tangri, S. S., & Jenkins, S. R. (1986). Stability and change in role innovation and life plans.
Sex Roles, 14, 647± 662.