Hostname: page-component-5d84bcc8dc-9cbtj Total loading time: 0 Render date: 2026-09-09T04:05:43.359Z Has data issue: false hasContentIssue false
  • English
  • Français

A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one

Published online by Cambridge University Press:  28 January 2015

D. G. Foster ,
J. R. Steinberg ,
S. C. M. Roberts ,
J. Neuhaus  and
M. A. Biggs
D. G. Foster
Affiliation:
Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, CA, USA
J. R. Steinberg
Affiliation:
Department of Psychiatry, University of California, San Francisco, CA, USA
S. C. M. Roberts
Affiliation:
Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, CA, USA
J. Neuhaus
Affiliation:
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
M. A. Biggs*
Affiliation:
Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, CA, USA
*
* Address for correspondence: M. A. Biggs, Ph.D., Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, 1330 Broadway, Suite 1100, Oakland, CA 94612, USA. (Email: Antonia.biggs@ucsf.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

This study prospectively assesses the mental health outcomes among women seeking abortions, by comparing women having later abortions with women denied abortions, up to 2 years post-abortion seeking.

Method

We present the first 2 years of a 5-year telephone interview study that is following 956 women who sought an abortion from 30 facilities throughout the USA. We use adjusted linear mixed-effects regression analyses to assess whether symptoms of depression and anxiety, as measured by the Brief Symptom Inventory-short form and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire, differ over time among women denied an abortion due to advanced gestational age, compared with women who received abortions.

Results

Baseline predicted mean depressive symptom scores for women denied abortion (3.07) were similar to women receiving an abortion just below the gestational limit (2.86). Depressive symptoms declined over time, with no difference between groups. Initial predicted mean anxiety symptoms were higher among women denied care (2.59) than among women who had an abortion just below the gestational limit (1.91). Anxiety levels in the two groups declined and converged after 1 year.

Conclusions

Women who received an abortion had similar or lower levels of depression and anxiety than women denied an abortion. Our findings do not support the notion that abortion is a cause of mental health problems.

Keywords

Abortionanxietydepression

Information

Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 10 , July 2015 , pp. 2073 - 2082
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Adler, NE, David, HP, Major, B, Roth, SH, Russo, NF, Wyatt, GE (1992). Psychological factors in abortion: a review. American Psychologist 47, 1194–1204.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Text Revision. American Psychological Association: Washington, DC.Google Scholar
American Psychological Association Task Force on Mental Health and Abortion (2008). Report of the APA Task Force on Mental Health and Abortion. The American Psychological Association: Washington, DC.Google Scholar
Biggs, MA, Gould, H, Foster, DG (2013). Understanding why women seek abortions in the US. BMC Women's Health 13, 29.Google Scholar
Charles, VE, Polis, CB, Sridhara, SK, Blum, RW (2008). Abortion and long-term mental health outcomes: a systematic review of the evidence. Contraception 78, 436–450.Google Scholar
Coleman, PK, Coyle, CT, Shuping, M, Rue, VM (2009). Induced abortion and anxiety, mood, and substance abuse disorders: isolating the effects of abortion in the National Comorbidity Survey. Journal of Psychiatric Research 43, 770–776.Google Scholar
Cougle, JR, Reardon, DC, Coleman, PK (2003). Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Medical Science Monitor 9, CR105–CR112.Google ScholarPubMed
Cozzarelli, C, Major, B, Karrasch, A, Fuegen, K (2000). Women's experiences of and reactions to antiabortion picketing. Basic and Applied Social Psychology 22, 265–275.Google Scholar
Derogatis, LR (2001). Brief Symptom Inventory 18: Administration, Scoring, and Procedures Manual. NCS Pearson, Inc.: Minneapolis, MN.Google Scholar
Dingle, K, Alati, R, Clavarino, A, Najman, JM, Williams, GM (2008). Pregnancy loss and psychiatric disorders in young women: an Australian birth cohort study. British Journal of Psychiatry 193, 455–460.Google Scholar
Galea, S, Tracy, M (2007). Participation rates in epidemiologic studies. Annals of Epidemiology 17, 643–653.Google Scholar
Gilchrist, AC, Hannaford, PC, Frank, P, Kay, CR (1995). Termination of pregnancy and psychiatric morbidity. British Journal of Psychiatry 167, 243–248.Google Scholar
Gould, H, Perrucci, A, Barar, R, Sinkford, D, Foster, DG (2012). Patient education and emotional support practices in abortion care facilities in the United States. Women's Health Issues 22, 359–364.Google Scholar
Jones, RK, Finer, LB (2012). Who has second-trimester abortions in the United States? Contraception 85, 544–551.Google Scholar
Jones, RK, Kavanaugh, ML (2011). Changes in abortion rates between 2000 and 2008 and lifetime incidence of abortion. Obstetrics and Gynecology 117, 1358–1366.Google Scholar
Kessler, RC, Ustun, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.Google Scholar
Major, B, Cozzarelli, C, Cooper, ML, Zubek, J, Richards, C, Wilhite, M, Gramzow, RH (2000). Psychological responses of women after first-trimester abortion. Archives of General Psychiatry 57, 777–784.CrossRefGoogle ScholarPubMed
Major, B, Gramzow, RH (1999). Abortion as stigma: cognitive and emotional implications of concealment. Journal of Personality and Social Psychology 77, 735–745.Google Scholar
McCulloch, CE, Searle, SR, Neuhaus, JM (2008). Generalized, Linear, and Mixed Models, 2nd edn. John Wiley & Sons: Hoboken.Google Scholar
Morton, LM, Cahill, J, Hartge, P (2006). Reporting participation in epidemiologic studies: a survey of practice. American Journal of Epidemiology 163, 197–203.Google Scholar
Mota, NP, Burnett, M, Sareen, J (2010). Associations between abortion, mental disorders, and suicidal behaviour in a nationally representative sample. Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie 55, 239–247.Google Scholar
National Collaborating Centre for Mental Health at the Royal College of Psychiatrists (2011). Induced Abortion and Mental Health: A Systematic Review of the Mental Health Outcomes of Induced Abortion, Including their Prevalence and Associated Factors. Royal College of Psychiatrists: London.Google Scholar
Pazol, K, Zane, S, Parker, WY, Hall, LR, Gamble, SB, Hamdan, S, Berg, C, Cook, DA (2011). Abortion surveillance – United States, 2007. MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance Summaries/CDC 60, 1–42.Google Scholar
Rocca, CH, Kimport, K, Gould, H, Foster, DG (2013). Women's emotions one week after receiving or being denied an abortion in the United States. Perspectives on Sexual and Reproductive Health 45, 122–131.CrossRefGoogle ScholarPubMed
Spitzer, RL, Kroenke, K, Williams, JBW (1999). Validation and utility of a self-report version of PRIMEMD – The PHQ primary care study. JAMA 282, 1737–1744.Google Scholar
Steinberg, JR, Becker, D, Henderson, JT (2011). Does the outcome of a first pregnancy predict depression, suicidal ideation, or lower self-esteem? Data from the National Comorbidity Survey. American Journal of Orthopsychiatry 81, 193–201.Google Scholar
Steinberg, JR, Finer, LB (2012). Coleman, Coyle, Shuping, and Rue make false statements and draw erroneous conclusions in analyses of abortion and mental health using the National Comorbidity Survey. Journal of Psychiatric Research 46, 407–408; discussion 408–411.Google Scholar
Steinberg, JR, McCulloch, CE, Adler, NE (2014). Abortion and mental health: findings from The National Comorbidity Survey-Replication. Obstetrics and Gynecology 123, 263–270.CrossRefGoogle ScholarPubMed
Steinberg, JR, Russo, NF (2008). Abortion and anxiety: what's the relationship? Social Science and Medicine 67, 238–252.Google Scholar
Upadhyay, UD, Weitz, TA, Jones, RK, Barar, RE, Foster, DG (2013). Denial of abortion because of provider gestational age limits in the United States. American Journal of Public Health 104, 1687–1694.Google Scholar