Dimensions of Abortion Decision Difficulty (DADD) Scale

The Dimensions of Abortion Decision Difficulty (DADD) Scale is a 12-item measure that captures the ease or difficulty with which women decide to have an abortion. The DADD scale includes these four dimensions: (1) unrealistic fears about the abortion and fantasies about the pregnancy; (2) decision conflict; (3) negative abortion attitudes; and (4) general indecisiveness.


Geographies Tested: Netherlands

Populations Included: Female

Age Range: Adults


Please indicate to what extent the following statements about the abortion decision process 2 to 3 years ago are true for you.

1. Even though the pregnancy was unintended, I had positive feelings about being pregnant (like joy, feeling proud, or maternal feelings).
2. I was afraid I would have severe regrets after the abortion.
3. I thought the abortion procedure could induce infertility.
4. I was anxious about having the abortion procedure itself.
5. I was afraid I would develop mental health problems after the abortion.
6. I felt that abortion was in general not justified (save exceptional circumstances).
7. I felt that many women take the choice for abortion too lightly.
8. I fantasized about my life with a child.
9. It was completely my own decision to have an abortion.*
10. I felt pressured (by others) to have the abortion.
11. I have difficulty with decision making in general.
12. I think I am an indecisive person.

*Item(s) reverse coded during scoring

Response Options:
Not at all - 1
A little - 2
Somewhatmoderately - 3
To a high degree - 4
To a very high degree - 5

Scoring Procedures

Items are averaged to create a scale. A higher score on the scale indicates women who experience high decision conflict (score 4 or 5), and low score indicates low decision difficulty (score 1 or 2). Item 9 is reverse coded.

Original Citation

van Ditzhuijzen, J., Brauer, M., Boeije, H., & van Nijnatten, C. (2019). Dimensions of decision difficulty in women's decision-making about abortion: A mixed methods longitudinal study. PLoS ONE, 14(2), e0212611.

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Formative Research

Qualitative Research

Existing Literature/Theoretical Framework

Field Expert Input

Cognitive Interviews / Pilot Testing








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