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Psychological Responses of Women After First-Trimester Abortion
Brenda Major, PhD;
Catherine Cozzarelli, PhD;
M. Lynne Cooper, PhD;
Josephine Zubek, PhD;
Caroline Richards, PhD;
Michael Wilhite, PhD;
Richard H. Gramzow, PhD
Arch Gen Psychiatry. 2000;57:777-784.
Background Controversy exists over psychological risks associated with abortion. The objectives of this study were to examine women's emotions, evaluations, and mental health after an abortion, as well as changes over time in these responses and their predictors.
Methods Women arriving at 1 of 3 sites for an abortion of a first-trimester unintended pregnancy were randomly approached to participate in a longitudinal study with 4 assessments—1 hour before the abortion, and 1 hour, 1 month, and 2 years after the abortion. Eight hundred eighty-two (85%) of 1043 eligible women approached agreed; 442 (50%) of 882 were followed for 2 years. Preabortion and postabortion depression and self-esteem, postabortion emotions, decision satisfaction, perceived harm and benefit, and posttraumatic stress disorder were assessed. Demographic variables and prior mental health were examined as predictors of postabortion psychological responses.
Results Two years postabortion, 301 (72%) of 418 women were satisfied with their decision; 306 (69%) of 441 said they would have the abortion again; 315 (72%) of 440 reported more benefit than harm from their abortion; and 308 (80%) of 386 were not depressed. Six (1%) of 442 reported posttraumatic stress disorder. Depression decreased and self-esteem increased from preabortion to postabortion, but negative emotions increased and decision satisfaction decreased over time. Prepregnancy history of depression was a risk factor for depression, lower self-esteem, and more negative abortion-specific outcomes 2 years postabortion. Younger age and having more children preabortion also predicted more negative abortion evaluations.
Conclusions Most women do not experience psychological problems or regret their abortion 2 years postabortion, but some do. Those who do tend to be women with a prior history of depression.
From the Department of Psychology, University of California, Santa Barbara (Drs Major, Richards, and Wilhite), Kansas State University, Manhattan (Dr Cozzarelli), and University of Missouri, Columbia (Dr Cooper) Department of Organization and Human Resources, School of Management, State University of New York at Buffalo (Dr Zubek); and the Department of Psychology, University of Southampton, Southampton, England (Dr Gramzow).
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