Beyond Abortion History: The Decision Environment and Reproductive Vulnerability in Women’s Contraceptive Quality of Life—A Cross-Sectional Study

When women choose a contraceptive method, the decision depends not only on what they prefer but also on the quality of the information they encounter online and on how confident they feel about using a method. We examined how exposure to inaccurate online contraceptive information (“digital misinformation”) and uncertainty about contraceptive decisions (“decisional conflict”) related to mental health and quality of life in women with and without a history of abortion. This was a cross-sectional study of 134 women aged 18–42 years attending obstetrics–gynecology or family-planning services at one Romanian tertiary center. Women were grouped as having no prior abortion (n = 41), one prior abortion (n = 53), or repeat abortion (n = 40). We measured a study-specific digital misinformation index, an access barrier index, contraceptive self-efficacy, reproductive autonomy, depression (PHQ-9), anxiety (GAD-7), well-being (WHO-5), quality of life (WHOQOL-BREF), and current use of highly effective contraception. We compared groups and used regression, mediation, and exploratory profiling. Women with repeat abortion reported the most online misinformation (10.0 ± 2.0), the most decisional conflict (43.9 ± 9.3), the lowest quality of life (61.3 ± 5.6), and the lowest use of highly effective contraception (45.0%). More misinformation and more access barriers were each associated with greater decisional conflict, while higher self-efficacy was associated with less. In this cross-sectional sample, online misinformation and decisional uncertainty were associated with reproductive vulnerability more closely than abortion count alone. Findings are associational and require prospective confirmation.