Abortion in young women and subsequent mental health

Fergusson, David M.; Horwood, L. John; Ridder, Elizabeth M.

doi:10.1111/j.1469-7610.2005.01538.x

Cited by 169 publications

(185 citation statements)

References 19 publications

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“…em estudo realizado na Nova Zelândia, o abortamento é relatado por 15% das mulheres que engravidaram pelo menos uma vez antes dos 25 anos, e as que praticaram o abortamento apresentam elevadas taxas de subsequentes problemas de depressão, ansiedade, pensamentos suicidas e droga adicção 12 .…”

Section: Introductionunclassified

Abortamento espontâneo e provocado: ansiedade, depressão e culpa

Benute¹,

Nomura²,

Pereira³

et al. 2009

Rev. Assoc. Med. Bras.

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ResumoObjetivOs. Caracterizar a população que sofreu abortamento; investigar a existência de ansiedade e depressão; verificar se existe ou não sentimento de culpa após o abortamento e comparar os resultados entre mulheres que sofreram abortamento espontâneo e as que provocaram-no. MétOdOs. 50 mulheres com abortamento espontâneo e 50 com provocado foram entrevistadas 30 dias após o abortamento. Foi realizada entrevista com questões abertas e fechadas e aplicada a escala Hospital Anxiety and depression. intROduçãOA gravidez tem um significado simbólico particular para cada mulher. Varia de acordo com a estrutura de personalidade, associada à história de vida pregressa e o momento atual de cada uma. Quando não desejada, a maternidade pode ser opressiva, já que a gestação altera o senso físico da mulher e convida-a a reorganizar vários aspectos de sua identidade, como a relação com o seu corpo, com o pai da criança e seus planos para a vida. Quando a gestação conscientemente desejada é perdida, também ocorre uma alteração na identidade, levando à sensação de fracasso pessoal.Culpa é emoção experimentada pela mulher quando há um desvio da sua condição de totalidade, é sentida em função dos desvios havidos dos padrões estabelecidos para o comportamento 1 . "A culpa manifesta-se com especial agudeza quando nos sentimos inaceitáveis perante nós mesmos, emaranhados em conflitos de dever que nos dividem(...)" 2 .No Brasil, onde a legislação só permite o aborto intencional em poucas exceções -acaba sendo um conflito de dever estabelecido moralmente, pois o significado particular de cada gestação faz parte do contexto individual, no qual, por vezes, a expectativa social da maternidade é vista como vivência maravilhosa, ideal, e a mãe deve desempenhar seu papel com perfeição 3 . A transgressão das leis morais desencadeia conflitos nos quais uma das saídas é a culpa, pois o conflito moral exige despertar e reorganizar a consciência 4 . No aborto por anomalia fetal letal, a autorização judicial ameniza o sentimento de culpa, conferindo ao casal o sentimento de adequação social 4 . O abortamento pode ser provocado quando a interrupção da gravidez é decisão transformada em alguma ação com essa finalidade, ou espontâneo, quando a perda do feto não é consequência de manipulação voluntária. diagnosticar o abortamento como provocado tampouco é fácil. Em geral, só pode ser feito pela informação da própria paciente, de familiares ou daquele que o realizou. Sem esse depoimento pessoal, raramente se pode distinguir pelo exame clínico a natureza do evento 5 .Os motivos que levam a mulher a interromper a gravidez envolvem aspectos particulares e individuais, de modo geral fundamentadas em questões sociais, econômicas e emocionais, por vezes permeada pela violência doméstica ou sexual 6,7,8 .No Brasil, o Código Penal de 1940 permite o abortamento nos casos de estupro e na existência de risco de morte materna. Para as situações de diagnóstico de anomalia fetal letal é necessária a autorização judicial para a interrupção da gestação por ano...

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Section: Introductionunclassified

Abortamento espontâneo e provocado: ansiedade, depressão e culpa

Benute¹,

Nomura²,

Pereira³

et al. 2009

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

show abstract

“…A further problem in interpreting the data rests with the variable quality and methodology of the studies For example some use clinical diagnosis obtained from general practitioners' records [1] while others are based on diagnosis derived from structured interviews conducted in the general population [2]. Some are cohort studies which identify women seeking abortion and carry out evaluations after a set period thereafter [3] while others use a nested case-control design [2].…”

Section: Presenting and Interpreting The Datamentioning

confidence: 99%

“…Some are cohort studies which identify women seeking abortion and carry out evaluations after a set period thereafter [3] while others use a nested case-control design [2]. Sourcing the data varies also with some using public databases such as the National Longitudinal Survey of Youth [4] or record linkage methods e.g.…”

Section: Presenting and Interpreting The Datamentioning

confidence: 99%

“…Controlling for these possible confounders and sources of bias is thus essential. Most of the large scale studies for over two decade have controlled for socio-demographic variables and some personal variables such as prior mental health history [1,7] but a recent crop of studies has also begun to control for variables connected to the decision to abort such as partner violence [8] and childhood abuse [2] and even more recently for the wantedness of the pregnancy [9] resulting in controls for over 30 variables in the latter, the largest number ever.…”

Section: Presenting and Interpreting The Datamentioning

confidence: 99%

“…IN a series of studies one [2] reported lower risks of depression among women who were not pregnant (65% lower risk) or who were pregnant but not having an abortion (52% lower risk) in comparison to women having abortions. although this was less powerful in a later study [9] Another long-term study [26] followed young women from the age of 12 for 27 years.…”

Section: Suicidal Behaviourmentioning

confidence: 99%

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Abortion among young women and subsequent life outcomes

Casey¹

2010

Best Practice & Research Clinical Obstetrics & Gynaecol

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Publication informationBest Practice and Research: Clinical Obstetrics and Gynaecology, 24 (4): 491-502Publisher Elsevier Item record/more information http://hdl.handle.net/10197/5799 Publisher's statementThis is the author's version of a work that was accepted for publication in Best Practice and Research: Clinical Obstetrics and Gynaecology. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Best Practice and Research: Clinical Obstetrics and Gynaecology (VOL 24, ISSUE 4, (2010) AbstractThis paper will discuss the nature of the association between abortion and mental health problems. Studies arguing that both side of the debate as to whether abortion per se is responsible will be presented. The prevalence of various psychiatric disorders will be outlined and where there is dispute between studies these will be highlighted. The impact of abortion on other areas such as education, partner relationships and sexual function will also be considered and the question as to whether abortion helps women's mental health will be addressed. Suggestions for early identification of illness will be made. The absence of specific interventions will be highlighted Word count: 7225 including practice points, research agenda, multiple choice questions and references 3 Abortion among young women and subsequent life outcomesInduced abortion is the most common surgical procedure in the Western World with an estimated 42 million pregnancy terminations taking place worldwide each year according to The Alan Guttmacher Institute. The relationship between abortion and subsequent life outcomes, particularly those relating to mental health outcomes, is one that has been discussed, often acrimoniously, in peer reviewed journals for several decades although this was hampered by significant methodological flaws in the earlier studies. It is an important question to resolve since an increase in the incidence of mental health problems post abortion would impact significantly on resources as well as on personal wellbeing.A number of questions present themselves in relation to the subsequent life outcome for women who terminate their pregnancies. These are:1. What is the usual emotional reaction to abortion? 2. Is there a specific psychiatric disorder associated abortion? 3. Is abortion associated with an increase in mental health problems and if so is the relationship a causal one? 4. What psychiatric disorders are associated with abortion? 5. Does abortion impact on social outcomes such as education, employment and relationships? 6. Does terminating an unwanted pregnancy help women's mental health? 7. What therapeutic interventions are available when a woman has an adverse reaction and do these have impact on subsequent life outcomes?Each of these questions will be considered in...

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Adverse Pregnancy Outcomes and Subsequent First-Time Use of Psychiatric Treatment Among Fathers in Denmark

Christiansen,

Petersen,

Thorius

et al. 2024

JAMA Netw Open

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ImportanceBecoming a first-time parent is a major life-changing event and can be challenging regardless of the pregnancy outcome. However, little is known how different adverse pregnancy outcomes affect the father’s risk of psychiatric treatment post partum.ObjectiveTo examine the associations of adverse pregnancy outcomes with first-time psychiatric treatment in first-time fathers.Design, Setting, and ParticipantsThis nationwide cohort study covered January 1, 2008, to December 31, 2017, with a 1-year follow-up completed December 31, 2018. Data were gathered from Danish, nationwide registers. Participants included first-time fathers with no history of psychiatric treatment. Data were analyzed from August 1, 2022, to February 20, 2024.ExposuresAdverse pregnancy outcomes including induced abortion, spontaneous abortion, stillbirth, small for gestational age (SGA) and not preterm, preterm with or without SGA, minor congenital malformation, major congenital malformation, and congenital malformation combined with SGA or preterm compared with a full-term healthy offspring.Main Outcomes and MeasuresPrescription of psychotropic drugs, nonpharmacological psychiatric treatment, or having a psychiatric hospital contact up to 1 year after the end of the pregnancy.ResultsOf the 192 455 fathers included (median age, 30.0 [IQR, 27.0-34.0] years), 31.1% experienced an adverse pregnancy outcome. Most of the fathers in the study had a vocational educational level (37.1%). Fathers experiencing a stillbirth had a significantly increased risk of initiating nonpharmacological psychiatric treatment (adjusted hazard ratio [AHR], 23.10 [95% CI, 18.30-29.20]) and treatment with hypnotics (AHR, 9.08 [95% CI, 5.52-14.90]). Moreover, fathers experiencing an early induced abortion (≤12 wk) had an increased risk of initiating treatment with hypnotics (AHR, 1.74 [95% CI, 1.33-2.29]) and anxiolytics (AHR, 1.79 [95% CI, 1.18-2.73]). Additionally, late induced abortion (&gt;12 wk) (AHR, 4.46 [95% CI, 3.13-6.38]) and major congenital malformation (AHR, 1.36 [95% CI, 1.05-1.74]) were associated with increased risk of nonpharmacological treatment. In contrast, fathers having an offspring being born preterm, SGA, or with a minor congenital malformation did not have a significantly increased risk of any of the outcomes.Conclusions and RelevanceThe findings of this Danish cohort study suggest that first-time fathers who experience stillbirths or induced abortions or having an offspring with major congenital malformation had an increased risk of initiating pharmacological or nonpharmacological psychiatric treatment. These findings further suggest a need for increased awareness around the psychological state of fathers following the experience of adverse pregnancy outcomes.

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Abortion in young women and subsequent mental health

Abstract: The findings suggest that abortion in young women may be associated with increased risks of mental health problems.

Cited by 169 publications

References 19 publications

Abortamento espontâneo e provocado: ansiedade, depressão e culpa

Abortamento espontâneo e provocado: ansiedade, depressão e culpa

Abortion among young women and subsequent life outcomes

Adverse Pregnancy Outcomes and Subsequent First-Time Use of Psychiatric Treatment Among Fathers in Denmark

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