Psychological distress symptoms in women undergoing medical vs. surgical termination of pregnancy

Löwenstein, Lior; Deutcsh, Michael; Gruberg, Rakefet; Solt, Ido; Yagil, Yaron; Nevo, Ori; Bloch, Miki

doi:10.1016/j.genhosppsych.2005.07.006

Cited by 20 publications

(27 citation statements)

References 6 publications

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“…Findings of these studies are consistent with several others based on non-U.S. samples in suggesting that method of termination does not affect emotional adjustment or psychological experiences after the procedure among women given a choice of procedure (Ashok et al, 2005;Howie, Henshaw, Naji, Russell, & Templeton, 1997;Lowenstein et al, 2006).…”

Section: Prospective Studiessupporting

confidence: 86%

Abortion and Mental Health: Evaluating the Evidence

2010

PsycEXTRA Dataset

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Section: Prospective Studiessupporting

confidence: 86%

Abortion and Mental Health: Evaluating the Evidence

2010

PsycEXTRA Dataset

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“…We focused on pre-abortion psychological health for two main reasons. First, psychological distress before an abortion is higher compared to any time afterwards (Bradshaw & Slade, 2003; Major et al, 2000; Lowenstein et al, 2006) and compared to other samples as described just above (Antony et al, 1998; Lee et al, 2005; Miller et al, 2006; Thomas et al, 2001); and second, pre-abortion psychological health has consistently been shown to be a strong predictor of post-abortion psychological health (Major et al, 2000; Steinberg et al, 2014). Therefore, helping women reduce pre-abortion psychological distress is warranted and to do that, we need to understand what predicts pre-abortion psychological health.…”

Section: Discussionmentioning

confidence: 80%

“…Most research in the area of abortion and mental health has focused on the mental health of women after an abortion, partly because of policies in many U.S. states requiring women be warned of the negative psychological effects of having an abortion. However, research consistently finds that depressive, anxiety, and stress symptoms are higher just before an abortion compared to anytime afterwards (Bradshaw & Slade, 2003; Major et al, 2000; Lowenstein et al, 2006), so understanding what contributes to pre-abortion psychological health is warranted. Pre-abortion mental health influences coping with the abortion experience (Cozzarelli, 1993), and it is the strongest predictor of post-abortion mental health (Major et al, 2009; Major et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Psychosocial factors and pre-abortion psychological health: The significance of stigma

Steinberg

Tschann

Furgerson

et al. 2016

Social Science & Medicine

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Rationale Most research in mental health and abortion has examined factors associated with post-abortion psychological health. However, research that follows women from before to after their abortion consistently finds that depressive, anxiety, and stress symptoms are highest just before an abortion compared to any time afterwards. Objective This finding suggests that studies investigating psychosocial factors related to pre-abortion mental health are warranted. Methods The current study uses data from 353 women seeking abortions at three community reproductive health clinics to examine predictors of pre-abortion psychological health. Drawing from three perspectives in the abortion and mental health literature, common risks, stress and coping, and sociocultural context, we conducted multivariable analyses to examine the contribution of important factors on depressive, anxiety, and stress symptoms just before an abortion, including sociodemographics, abortion characteristics, childhood adversities, recent adversities with an intimate partner, relationship context, future pregnancy desires, and perceived abortion stigma. Results Childhood and partner adversities, including reproductive coercion, were associated with negative mental health symptoms, as was perceived abortion stigma. Before perceived abortion stigma was entered into the model, 18.6 %, 20.7 %, and 16.8% of the variance in depressive, anxiety, and stress symptoms respectively, was explained. Perceived abortion stigma explained an additional 13.2 %, 9.7 %, and 10.7 % of the variance in depressive, anxiety, and stress symptoms pre-abortion. Conclusion This study, one of the first to focus on pre-abortion mental health as an outcome, suggests that addressing stigma among women seeking abortions may significantly lower their psychological distress.

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“…Previous research may have found that more distress was associated with use of less effective methods because the distress was not as transient as it may have been in the current study. Indeed, other research has found that among women having abortions, psychological distress declines dramatically from just before to just after the abortion [20,40,41]. Therefore, future research could tease out the effects of chronic versus acute stress on contraceptive behaviors.…”

Section: Discussionmentioning

confidence: 97%

Psychological distress and post-abortion contraceptive method effectiveness level chosen at an urban clinic

et al. 2013

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Objective We investigated whether more psychological distress before an abortion is associated with the effectiveness of contraception selected (low, moderate, or high effectiveness) at an abortion clinic visit. Method Using data from 253 women attending an urban abortion clinic that primarily serves low-income women, we tested the association between pre-abortion psychological distress and the effectiveness level of post-abortion contraceptive choice. Based on typical use failure rates, we classified effectiveness of contraceptive choice into three levels—low, moderate, and high effectiveness. We measured psychological distress with four validated measures of depressive, anxious, and stress symptoms, and negative affect, as well as with a global measure comprised of these four measures. We used multivariable ordinal logistic regression to measure the association of each psychological distress measure with post-abortion contraceptive method effectiveness level, adjusting for sociodemographic factors, pregnancy history, trimester of abortion, and importance of avoiding pregnancy in the next year. Results We found that compared to women experiencing less stress symptoms, negative affect, and global psychological distress, women experiencing more stress symptoms [AOR = 1.028, 95% CI: 1.001-1.050], negative affect [AOR = 1.05, 95% CI: 1.01-1.09], and global psychological distress [AOR = 1.46, 95% CI: 1.09-1.95] were more likely to choose more effective versus less effective methods, ps < .05, in adjusted models. Using dichotomous psychological measures we found similar results. Conclusions Women experiencing more psychological distress before an abortion selected more effective contraceptive methods after their abortions. Future research should examine whether this distress is associated with subsequent contraceptive use or continuation. Implications The current study suggests that contraceptive providers should not assume that women experiencing more psychological distress prefer to use less effective contraceptive methods.

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Psychological distress symptoms in women undergoing medical vs. surgical termination of pregnancy

Cited by 20 publications

References 6 publications

Abortion and Mental Health: Evaluating the Evidence

Abortion and Mental Health: Evaluating the Evidence

Psychosocial factors and pre-abortion psychological health: The significance of stigma

Psychological distress and post-abortion contraceptive method effectiveness level chosen at an urban clinic

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