The abortion and mental health controversy: A comprehensive literature review of common ground agreements, disagreements, actionable recommendations, and research opportunities

Reardon, David C.

doi:10.1177/2050312118807624

Cited by 82 publications

(91 citation statements)

References 233 publications

(738 reference statements)

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“…For example, a study that investigated the association between abortion and risk of subsequent depression in pregnant women showed that women with a history of abortion were more likely to have depression (AOR = 3.5; 95% CI 2.06.1) [47]. In a comprehensive literature review of 2018, abortion has been associated with higher rates of mental health problems when compared to women without a history of abortion [48,49]. Further, evidence from a prospective cohort study also showed a 30% relative increase in the rate of depression among women who reported a history of abortion when compared to those who did not [50].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with depression among pregnant mothers in the West Shoa zone, Ethiopia: a community-based cross-sectional study

Tiki¹,

Taye²,

Duko³

2020

Ann Gen Psychiatry

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Background: Depression during pregnancy, the most prevalent mental health problem, can alter fetal development and has important consequences on the offspring's physical and mental health. Evidence suggests increasing rates of prevalence of depression in low-income settings such as Ethiopia. However, there are a few studies on the topic with inconsistent results. Therefore, the aim of this study was to investigate the prevalence of antenatal depression and its correlates among pregnant women in Ethiopia. Methods: A community-based cross-sectional study was conducted in the West Shoa zone, Oromia regional state, Ethiopia, from February 20, 2018, to March 20, 2018. Pregnant women were recruited by using cluster sampling techniques. Data on socio-demographic, obstetric, and psychosocial characteristics were collected by intervieweradministered questionnaire. Patient Health Questionnaire (PHQ-9) was used to assess depression during pregnancy. Bivariable and multivariable logistic regression analyses were fitted to identify correlates of depression. The level of statistical significance was declared at p value < 0.05. Results: The mean age (± SD) of the pregnant women was 28.41 ± 5.9 years. The prevalence of depression during pregnancy was 32.3%. When we adjusted for possible confounding variables in the final model; those pregnant mothers with an average monthly income of less than 500 (18 USD) Ethiopian birr [AOR = 3.19, 95% CI (1.47, 6.96)], unplanned pregnancy [AOR = 1.52, 95% CI (1.04, 2.21)] and having history of abortion [AOR = 5.13, 95% CI (2.42, 10.85)] have higher odds of depression when compared to their counterparts. Conclusion: The prevalence of depression during pregnancy was high. Strengthening the counseling service as well as increasing access and availability of modern contraceptive methods may reduce the rates of unplanned pregnancy in Ethiopia and this, in turn, plays a significant role in alleviating a resultant depression. Further, the integration of mental health services with existing maternal health care as well as strengthening the referral system among public health centers was warranted to minimize antenatal depression in the West Shoa zone health facilities.

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Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with depression among pregnant mothers in the West Shoa zone, Ethiopia: a community-based cross-sectional study

Tiki¹,

Taye²,

Duko³

2020

Ann Gen Psychiatry

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“…[10][11][12] These findings demonstrating that low-income women who have abortions are more likely to have more overall pregnancies, including more subsequent abortions, would tend to support the body of evidence indicating that abortion is associated with greater subsequent reproductive health risks. 13,14 Abortion decreases the likelihood of a birth in any subsequent pregnancy. More than 60% of surveyed women seeking an abortion indicate that they had not completed their childbearing.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Outcome Patterns of Medicaid-Eligible Women, 1999-2014: A National Prospective Longitudinal Study

Studnicki¹,

Fisher²,

Reardon³

et al. 2020

Health Services Research and Managerial Epidemiology

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Introduction: The number and outcomes of pregnancies experienced by a woman are consequential determinants of her health status. However, there is no published research comparing the patterns of subsequent pregnancy outcomes following a live birth, natural fetal loss, or induced abortion. Objectives: The objective of this study was to describe the characteristic patterns of subsequent pregnancy outcomes evolving from each of three initiating outcome events (birth, induced abortion, natural fetal loss) occurring in a Medicaid population fully insured for all reproductive health services. Methods: We identified 7,388,842 pregnancy outcomes occurring to Medicaid-eligible women in the 17 states which paid for abortion services between 1999-2014. The first known pregnancy outcome for each woman was marked as the index outcome which assigned each woman to one of three cohorts. All subsequent outcomes occurring up to the fifth known pregnancy were identified. Analyses of the three index outcome cohorts were conducted separately for all pregnancy outcomes, three age bands (<17, 17-35, 36+), and three race/ethnicity groups (Hispanic, Black, White). Results: Women with index abortions experienced more lifetime pregnancies than women with index births or natural fetal losses and were increasingly more likely to experience another pregnancy with each subsequent pregnancy. Women whose index pregnancy ended in abortion were also increasingly more likely to experience another abortion at each subsequent pregnancy. Both births and natural fetal losses were likely to result in a subsequent birth, rather than abortion. Women with natural losses were increasingly more likely to have a subsequent birth than women with an index birth. All age and racial/ethnic groups exhibited the characteristic pattern we have described for all pregnancy outcomes: abortion is associated with more subsequent pregnancies and abortions; births and fetal losses are associated with subsequent births. Other differences between groups are, however, apparent. Age is positively associated with the likelihood of a birth following an index birth, but negatively associated with the likelihood of a birth following an index abortion. Hispanic women are always more likely to have a birth and less likely to have an abortion than Black or White women, for all combinations of index outcome and the number of subsequent pregnancies. Similarly, Black women are always more likely to have an abortion and less likely to experience a birth than Hispanic or White women. Conclusion: Women experiencing repeated pregnancies and subsequent abortions following an index abortion are subjected to an increased exposure to hemorrhage and infection, the major causes of maternal mortality, and other adverse consequences resulting from multiple separation events.

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“…18 Guidelines in other jurisdictions state that women should have access to objective information and counselling about their pregnancy options in the case of unwanted pregnancy. 26 While some studies show that women may experience mental health problems following abortion, [27][28][29][30] others have challenged this. 31,32 In any case, support techniques for a more informed choice are needed.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Knowledge and attitudes of Irish GPs towards abortion following its legalisation: a cross-sectional study

et al. 2019

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BackgroundIn May 2018, the Irish Constitution was changed following a referendum allowing termination of pregnancy by abortion. It is envisaged that the majority of terminations will be by medical abortion and will take place in general practice before 12 weeks gestation.AimTo elicit attitudes and level of preparedness of Irish GPs to provide medical abortion services.Design & settingCross-sectional study of 222 GPs who were associated with the University of Limerick Graduate Entry Medical School (GEMS) and GP training programme.MethodAn anonymous online questionnaire was distributed via email. Reminders were sent 2 and 4 weeks later.ResultsThe response rate was 57.2% (n = 127/222). Of the responders, 105 (82.7%) had no training in this area, with only 4 (3.1%) indicating that they had sufficient training. Nearly all responders (n = 119, 93.7%) were willing to share abortion information with patients. Just under half of responders (n = 61, 48.0%) would be willing to prescribe abortion pills, with 47 (37.0%) unwilling to do so. Only 53 (41.7%) responders believed that provision of abortion services should be part of general practice, with 52 (40.9%) saying that it should not. As to whether doctors should be entitled to a conscientious objection but should also be obliged to refer the patient, 92 (72.4%) responders agreed. Over two-thirds of responders (n = 89, 70.1%) felt that necessary patient support services are not currently available.ConclusionThere is a lack of training and a considerable level of unwillingness to participate in this process among Irish GPs. There is also a perceived lack of patient support services for women experiencing unwanted pregnancy. It is incumbent upon state and professional bodies to address these issues.

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The abortion and mental health controversy: A comprehensive literature review of common ground agreements, disagreements, actionable recommendations, and research opportunities

Cited by 82 publications

References 233 publications

Prevalence and factors associated with depression among pregnant mothers in the West Shoa zone, Ethiopia: a community-based cross-sectional study

Prevalence and factors associated with depression among pregnant mothers in the West Shoa zone, Ethiopia: a community-based cross-sectional study

Pregnancy Outcome Patterns of Medicaid-Eligible Women, 1999-2014: A National Prospective Longitudinal Study

Knowledge and attitudes of Irish GPs towards abortion following its legalisation: a cross-sectional study

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