Outcome following therapeutic abortion

Abstract

Psychological outcome of abortion was studied in 102 patients, measuring multiple variables over four time intervals. Five measured affects--anxiety, depression, anger, guilt, and shame-were significantly lower six months after the preabortion period. The following variables describe subgroups of patients with significant variations in patterns of responses as indicated by changes in affects: marital status, personality diagnosis, character of object relations, past psychopathologic factors, relationship to husband or lover, relationship to mother, ambivalence about abortion, religion, and previous parity. A complex multivariate model, based on conflict and conflict resolution, is appropriate to conceptualize, the unwanted pregnancy and abortion experience. Data suggest that women most vulnerable to conflict are those who are single and nulliparous, those with previous history of serious emotional problems, conflictual relationships to lovers, past negative relationships to mother, strong ambivalence toward abortion, or negative religious or cultural attitudes about abortion.

PIP: Anxiety, depression, anger, quilt, and shame following induced abortion were studied in 102 patients over 4 time intervals. The study was made before the Supreme Court decision liberalizing abortion when the major therapeutic indication was that the pregnancy would be emotionally damaging to the health of the mother. Minnesota Multiphasic Personality Inventory (MMPI), Profile of Mood States (POMS), and Symptom Rating Scale (SRS) tests were given at the preabortion interview, the POMS and SRS were given in the hospital within 24 hours and at 6 weeks, and all 3 tests were given at 6 months. Levels of all 5 variables dropped immediately after abortion, then rose slightly at 6 weeks, remaining constant at 6 months. Anger, depression, and anxiety generally rose to higher levels at 6 weeks than did quilt and shame. At 6 months, levels for all of these feelings are significantly lower than preabortion (p less than .001). Comparable affects measured by the psychological tests showed a sharp decrease postabortion (p less than .001). Further study was done of 24 subgroups of variables characterized by the headings: demographic factors; mental health and diagnosis; personal relationships; and current pregnancy. Anxiety was the only affect that differed with race or previous illegitimate pregnancy. Black women and those who have had previous illegitimate children show less anziety. White women show a higher level of guilt, but this does not reach significance. Women in low-status employment show the highest levels of housewives and high-status working women were in the middle range. Housewives and low-status working women had the highest levels of anger. Students scored lowest on all variables. Previous mental health was directly related to depression, anxiety, and anger but not guilt or shame. Those who had negative relationships with either her mother or the father of the child had the greatest levels of anger and depression. Those with negative or ambivalent relationships with their children experienced significantly greater depression and shame. Those who had the most ambivilent feelings toward abortion also had the greatest number of negative feelings. A religions or cultural background strongly negative toward abortion and sexuality also led to greater conflict. This information can be used to identify those individuals most likely to benefit from additional support and from brief selective psychotherapy modeled on crisis-intervention techniques.