title: Moderators and mediators of the relationship between receiving versus being denied a pregnancy termination and subsequent binge drinking.
abstract: BACKGROUND
  Women who terminate pregnancies drink more subsequent to the pregnancy than women who give birth, including women who give birth after seeking to terminate a pregnancy.
  
  
  METHODS
  Data are from the Turnaway Study, a prospective, longitudinal study of 956 women who sought to terminate pregnancies at 30 U.S. facilities. This paper focuses on the 452 women who received terminations just below facility gestational limits and 231 who were denied terminations because they presented just beyond facility gestational limits. This study examined whether baseline characteristics moderate the relationship between termination and subsequent binge drinking and whether stress, feelings about the pregnancy, and number of social roles mediate the relationship.
  
  
  RESULTS
  Only having had a previous live birth modified the termination-binge drinking relationship. Among women with previous live births, binge drinking was reduced among women carrying to term compared to terminating the pregnancy. Among women who had not had a previous live birth, however, the reduction in binge drinking among those denied termination was not sustained over time, and binge drinking of those who had and had not had terminations converged by 2.5 years. Neither stress, negative emotions, nor social roles mediated effects on binge drinking. Positive emotions at one week mediated effects on binge drinking at six months, although positive emotions at two years did not mediate effects on binge drinking at 2.5 years.
  
  
  CONCLUSIONS
  Higher levels of binge drinking among those who terminate pregnancies do not appear due to stress or to negative emotions. Only parous women - and not nulliparous women - denied terminations experienced sustained reductions in binge drinking over time.
authors.affiliation: Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94706, USA. Electronic address: sarah.roberts@ucsf.edu.
authors.forename: S C M
authors.initials: SC
authors.lastname: Roberts
authors.affiliation: Alcohol Research Group, Public Health Institute, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA. Electronic address: msubbaraman@arg.org.
authors.forename: M S
authors.initials: MS
authors.lastname: Subbaraman
authors.affiliation: Department of Psychiatry, University of California, San Francisco, Box 0984 TRC, 401 Parnassus Avenue, Langley Porter Room 379, San Francisco, CA 94143, USA. Electronic address: kevin.delucchi@ucsf.edu.
authors.forename: K L
authors.initials: KL
authors.lastname: Delucchi
authors.affiliation: Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine & Health Sciences, 501 North Columbia Road Stop 9037, Grand Forks, ND 58202-9037, USA. Electronic address: sharon.wilsnack@med.und.edu.
authors.forename: S C
authors.initials: SC
authors.lastname: Wilsnack
authors.affiliation: Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94706, USA. Electronic address: diana.greenefoster@ucsf.edu.
authors.forename: D G
authors.initials: DG
authors.lastname: Foster
mesh_terms: D000029:Abortion, Legal / Q000331:legislation & jurisprudence* / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D063425:Binge Drinking / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States; D055815:Young Adult
keywords: Alcohol; Parenting; Pregnancy; Pregnancy termination