Short-term grief after an elective abortion

Conflicts Between Women's Religiosity and Sense of Free Will in the Context of Elective Abortion: A Qualitative Study in the Worst Period of Italy's COVID-19 Crisis

This qualitative study considers the relationship between abortion, bereavement, and the effects of the COVID-19 lockdown nine women who had undergone an elective abortion, which is voluntarily termination of a pregnancy at the woman's request. These women were interviewed in three time points (1 month, 6 months, and 1 year after the event) to consider the possible evolution of their experience. The third phase was concurrent with the COVID-19 pandemic and particularly with Pope Francis's Easter declaration against abortion. All the interviews were conducted and analysed through qualitative research in psychology. Results showed that the abortion experience led to physical, relational, and psychological suffering, similar to perinatal grief. Participants were non-practising Catholics and religiosity did not help them to overcome their sorrow. Though religiosity is a possible resilience factor in other stressful conditions, in this case it is a factor that aggravated suffering. Finally, we discuss the difficulties experienced by Catholic women who choose to have an abortion and assert the necessity of psychological and spiritual interventions to support these women.

Public Health Impact of Legal Termination of Pregnancy in the US: 40 Years Later

During the 40 years since the US Supreme Court decision in Doe versus Wade and Doe versus Bolton, restrictions on termination of pregnancy (TOP) were overturned nationwide. The use of TOP was much wider than predicted and a substantial fraction of reproductive age women in the U.S. have had one or more TOPs and that widespread uptake makes the downstream impact of any possible harms have broad public health implications. While short-term harms do not appear to be excessive, from a public perspective longer term harm is conceiving, and clearly more study of particular relevance concerns the associations of TOP with subsequent preterm birth and mental health problems. Clearly more research is needed to quantify the magnitude of risk and accurately inform women with the crisis of unintended pregnancy considering TOP. The current US data-gathering mechanisms are inadequate for this important task.

Existential experiences and needs related to induced abortion in a group of Swedish women: a quantitative investigation

OBJECTIVE

To investigate the prevalence of existential experiences and needs among women who have requested an induced abortion.

METHODS

A questionnaire was used to collect information from 499 women who had requested an induced abortion. A principle component analysis resulted in three components of existential experiences and needs: existential thoughts, existential practices, and humanisation of the foetus. These components were analysed in relation to background data and other data from the questionnaire.

RESULTS

Existential experiences and needs were common. For 61% of women existential thoughts about life and death, meaning and morality were related to the abortion experience. Almost 50% of women reported a need for special acts in relation to the abortion; 67% of women thought of the pregnancy in terms of a child. A higher presence of existential components correlated to difficulty in making the abortion decision and poor psychological wellbeing after the abortion.

CONCLUSION

Women's experiences of abortion can include existential thoughts about life, death, meaning and morality, feelings of attachment to the foetus, and the need for symbolic expression. This presents a challenge for abortion personnel, as the situation involves complex aspects over and above medical procedures and routines.

Women's experiences after an induced second trimester abortion

OBJECTIVE

to describe women's experiences of an abortion in the second trimester.

DESIGN

qualitative design using semi-structured interviews.

SETTING/PARTICIPANTS

six women were interviewed after a second trimester abortion.

METHODS

the women were interviewed in person after they were discharged from the hospital. Interviews were recorded, transcribed, and then analysed using qualitative content analysis.

FINDINGS

four categories were identified: to consider and accept the decision; to lack understanding about the abortion procedure; to be in need of support and information; to have memories for life. Findings show that information and support during the whole abortion process is important. Women found it difficult to make the decision and going through abortion left memories for life.

CONCLUSION

information and support is of great importance for women in this vulnerable situation. The need for further support points out the need to have follow-up contacts with women after an induced second trimester abortion.

Is there an "abortion trauma syndrome"? Critiquing the evidence

The objective of this review is to identify and illustrate methodological issues in studies used to support claims that induced abortion results in an "abortion trauma syndrome" or a psychiatric disorder. After identifying key methodological issues to consider when evaluating such research, we illustrate these issues by critically examining recent empirical studies that are widely cited in legislative and judicial testimony in support of the existence of adverse psychiatric sequelae of induced abortion. Recent studies that have been used to assert a causal connection between abortion and subsequent mental disorders are marked by methodological problems that include, but not limited to: poor sample and comparison group selection; inadequate conceptualization and control of relevant variables; poor quality and lack of clinical significance of outcome measures; inappropriateness of statistical analyses; and errors of interpretation, including misattribution of causal effects. By way of contrast, we review some recent major studies that avoid these methodological errors. The most consistent predictor of mental disorders after abortion remains preexisting disorders, which, in turn, are strongly associated with exposure to sexual abuse and intimate violence. Educating researchers, clinicians, and policymakers how to appropriately assess the methodological quality of research about abortion outcomes is crucial. Further, methodologically sound research is needed to evaluate not only psychological outcomes of abortion, but also the impact of existing legislation and the effects of social attitudes and behaviors on women who have abortions.

Intimate partner violence, pregnancy and the decision for abortion

Pregnant women whose lives are affected by intimate partner violence and unintended pregnancy are often faced with the decision for abortion. In this qualitative research, the authors explored women's experiences of unintended pregnancy and intimate partner violence (IPV) from the perspective of adult pregnant women seeking abortion. Women were assessed for intimate partner violence and study inclusion by means of two IPV screening tools. The authors collected data during one-to two-hour semi-structured interviews with eight pregnant women. At the completion of the interviews, all women were assessed for safety using an assessment of danger tool. Safety planning and referrals were provided for all women. Qualitative data collection and data analysis were guided by naturalistic inquiry to identify prevalent themes. Three major themes emerged from the data: (1) It Wasn't That Bad, (2) Then It Got Worse, and (3) If I Have the Baby He'll Come Back. Descriptive statistics were used to tabulate and describe the women's responses to the three tools.

Depression among Nigerian women following pregnancy loss

OBJECTIVE

To determine the level of depression in Nigerian women following spontaneous pregnancy loss and the coping strategies used.

METHODS

A questionnaire survey of 202 Nigerian women who had involuntary pregnancy loss over a 1-year period. The Zung Self-Rating Depression Scale was used to assess the women.

RESULTS

Two-thirds of the pregnancy losses occurred before 20 weeks of gestation and one-third occurred after 20 weeks. The majority of respondents (74.3%) had minimal depressive symptoms (scoring 50-59 on the depression scale), 3% had moderate symptoms (scoring 60-69), and 13.9% had severe symptoms (scoring 70-80). Risk factors for moderate to severe depression included being married, previous pregnancy loss, loss of a male fetus, childlessness, and losses after 20 weeks (P<0.05). Presence of a woman's husband, children, parents and relatives, friends, and religious observance were identified as positive coping strategies.

CONCLUSION

Most Nigerian women suffer some level of depression following pregnancy loss, with no living children and losses after 20 weeks being the most significant risk factors.

The language of loss when a baby dies prior to birth: cocreating human experience

When a baby dies prior to birth, a woman and her family begin a life long journey of living and transforming with loss. The language used with families during times of devastating loss is important to reflect upon since, language has the potential to either intensify suffering or enhance the family's experience of grieving. Words that affirm the meaning the baby holds for the family can provide comfort as families engage with the reality of lost hopes and dreams. Recognizing that healthcare professionals do not intend to harm families whose babies die prior to birth, the current authors offer this column as a vehicle for reflecting on the meanings of words used during this particular time of loss and grief. The authors further explore the role that the arts have to play in expressing loss and in helping others to understand.

Adolescent Postabortion Groups: Risk Reduction in a School-Based Health Clinic

A short-term postabortion group for adolescents was developed. Three groups were conducted in an adolescent mental health clinic within an urban high school-based health clinic. The clinical group experiences offered the adolescents an opportunity to integrate the experience of pregnancy and the abortion decision into their lives. At follow up, adolescents who participated in th postabortion counseling group indicated that they chose and used a method of birth control, did not repeat an unplanned pregnancy, and remained in high school.