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==Feelings experienced after a miscarriage or abortion== ==Feelings experienced after a miscarriage or abortion==
Various studies suggest that women may experience stress after a miscarriage or abortion. The kind of stress and the amount of stress women experience varies from culture to culture. Studies also suggest that an individual woman's stress level is influenced by her economic status, family situation and the status of her mental health before the pregnancy. Women who experience a life-stress often feel some of the following: Various studies suggest that women may experience stress after a miscarriage or abortion. The kind of stress and the amount of stress women experience varies from culture to culture. Studies also suggest that an individual woman's stress level is influenced by her economic status, family situation and the status of her mental health before the pregnancy. Again, no studies have been able to conclude definitively that there is a causal relationship between abortion and depression or stress. Many studies cite the pre-existence of depression and stress in many women who seek abortions. Women who experience any life-stress often feel some of the following:
<ul> <ul>
<li>Guilt<ref name=Broen/><ref name=Gomez/><ref name=Bianchi-Demicheli></ref><ref name=Kero></ref><ref>, France</ref><ref name=Casey> Portugal</ref> <li>Guilt<ref name=Broen/><ref name=Gomez/><ref name=Bianchi-Demicheli></ref><ref name=Kero></ref><ref>, France</ref><ref name=Casey> Portugal</ref>

Revision as of 19:40, 21 August 2007

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Post-abortion syndrome (PAS), post-traumatic abortion syndrome and abortion trauma syndrome, are terms primarily used by opponents of abortion and a minority of health care professionals to describe a proposed diagnosis of psychopathological characteristics which may be observed in some women following a medically induced abortion.

The term was coined by psychotherapist Vincent Rue in 1981, when it was described as a variant of post traumatic stress syndrome. At that time, PTSD had only been accepted as an official diagnosis by the American Psychiatric Association in 1980.

American Psychological Association and the American Psychiatric Association do not recognize PAS. PAS is not included in Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR or ICD-10 list of psychiatric conditions. Prior to 1994 the DSM III-R listed abortion as a "psychosocial stressor." Specifically, in Chapter Two, page 20 of that edition, a psychosocial stressor was described to include a "physical illness or injury: e.g., illness, accident, surgery, abortion." Abortion in this context is pregnancy loss before 20 weeks that can be spontaneous or medically induced. Opponents of PAS have alleged that abortion is a benign experience and that PAS is a myth created by opponents of abortion for political purposes.

Academic research

Academic research on abortion is not typically specific to the study of Post-Abortion Syndrome. Rather, academic studies are usually concerned with the statistical incidence of stress or depression among women who have sought an abortion. No academic study to-date has been able to establish a causal relationship between abortion and depression. In 1989, the American Psychological Association (APA) convened a panel of psychologists with extensive experience in this field to review the data available to determine the existence of "post-abortion syndrome". The panel concluded that "research with diverse samples, different measures of response, and different times of assessment have come to similar conclusions. The time of greatest distress is likely to be before the abortion. Severe negative reactions after abortions are rare and can best be understood in the framework of coping with normal life stress."

Vincent Rue, who proposed the term Post-abortion Syndrome in 1981, believed that many of the women he was treating for post-abortion reactions were experiencing a constellation of symptoms similar to that of many Viet Nam veterans under his care. In 1994, the word abortion was excised from the description of psychosocial stressors included in the APA's diagnostic manual.

Europe

Norwegian Study

A study in Norway compared the mental distress of women experienced a spontaneous abortion (miscarriage) and those who chose a voluntary abortion. The conclusion of the study states, "Women who had experienced a miscarriage had more mental distress at 10 days and six months after the pregnancy termination than women who had undergone an abortion." and "The responses of women in the miscarriage group were similar to those expected after a traumatic and sad life event. However, the women in the induced abortion group had more atypical responses. This may be because the mental health of the aborting women was somewhat poorer than that of the miscarrying women before the pregnancy termination event. The more complex nature of the induced abortion event may also account for differences in the course of psychological responses between the two groups. Women in both groups should be given information about common psychological responses to pregnancy termination, and follow-up talks with health personnel should be offered to women most affected by the event."

Danish study

The conclusion of this study done at the University of Copenhagen, Denmark, legal abortion is associated with few adverse effects on sexual function. The study was conducted among 941 women who chose elective abortion. At 8 weeks follow-up, coitus was reported by 86.9% of women who sought an abortion, ranging from 65.8% of women not in a steady relationship to 93.7% of women in a relationship.

Finnish study

"A Finnish study has shown a link between miscarriage or abortion with depression and suicide. The study found that suicide is slightly more common in women who have experienced miscarriage and especially after induced abortion, than in the general population. However, the study was unable to establish a causal link between abortion and suicide because it was not clear if abortion causes depression and suicide, or if women who are depressed and suicidal are more likely to elect to have an an abortion. The article goes on to say, "Another explanation for the higher suicide rate after an abortion could be low social class, low social support, and previous life events or that abortion is chosen by women who are at higher risk for suicide because of other reasons."

PAS Specific Report in Spain

According to a third study conducted by Spanish social work researchers Gomez, Lavin C., & Zapata, symptoms attributed to PAS are "dreams and nightmares related with the abortion," and "feelings of guilt". Gomez, Lavin C., & Zapata examined ways to categorize PAS under the assumption that it exists and is related to Post Traumatic Stress Disorder. Abortion is illegal in Spain except in cases of rape or incest.

New Zealand

A study from New Zealand completed in 2006 which used gathered data about children and young adults (ages 15-25) who sought abortions over a 25-year period, found an increased occurrence of clinical depression, anxiety, suicidal behavior, and substance abuse among women who had previously had an abortion compared to women who have not sought an elective abortion. However, no causal link was established. It was not clear if abortion causes depression and suicide, or if women who are depressed or suicidal are more likely to elect to have an abortion.

United States

University of Chicago Medical Center

Researchers at the Department of Psychiatry at the University of Chicago Medical Center in the United States conducted a study and have concluded that PAS is a myth. PAS is listed in neither the DSM-IV-TR nor the ICD-10, and not considered a medical condition by the American Psychiatric Association.

Surgeon General

The former U.S. Surgeon General, C Everett Koop, an abortion opponent, conducted a review in 1989 of over 250 studies pertaining to the psychological impact of abortion, but wrote that it was not possible to reach any conclusions, and recommended setting up a five-year longitudinal study, tracking thousands of women, which would cost $100 million. The study was never funded, however, so most studies on psychological reactions to abortion rely on relatively small samples.

Feelings experienced after a miscarriage or abortion

Various studies suggest that women may experience stress after a miscarriage or abortion. The kind of stress and the amount of stress women experience varies from culture to culture. Studies also suggest that an individual woman's stress level is influenced by her economic status, family situation and the status of her mental health before the pregnancy. Again, no studies have been able to conclude definitively that there is a causal relationship between abortion and depression or stress. Many studies cite the pre-existence of depression and stress in many women who seek abortions. Women who experience any life-stress often feel some of the following:

  • Guilt
  • Anxiety
  • Depression
  • Anniversary syndrome

Some empirical research suggests that some women are more likely than others to develop stress after a after a miscarriage or abortion. The risk factors found in some clinical studies include:

  • Low self-efficacy for coping with the abortion
  • Low self-esteem
  • External locus of control
  • Difficulty with the decision to have an abortion
  • When there is emotional investment in the pregnancy
  • Perceptions of one's partner, family members, or friends as non-supportive
  • Timing during adolescence, being unmarried, or poor
  • A poor or insecure attachment relationship with one's mother or a childhood history of separation from one's mother for a year or more before age 16
  • Involvement in violent relationships
  • Traditional sex-role orientations
  • Conservative views of abortion and/or religious affiliation
  • When a pregnancy is initially intended
  • Abortion during the second trimester
  • When the woman is in an unstable partner relationship
  • Being forced into abortion by one's partner, others, or by life circumstances

Recent research and APA's Response

Fergusson, a self-described "pro-choice atheist", criticized the American Psychological Association (APA) for publishing reports that he says indicate little or no psychological harm associated with abortion while omitting references to studies which contradicted their official position in favor of abortion. In responding to this charge, Dr. Nancy Russo, who was referred to a Washington Time's reporter by the APA, explained that the APA's official position on abortion developed from the viewpoint that abortion is a civil right. According to the article, Russo states that "pre-existing mental health problems, relationship quality, and whether the pregnancy was wanted or unwanted are key factors determining postabortion mental distress, not the abortion itself".

References

  1. http://www.afterabortion.info/mainpol.html
  2. Bazelon, Emily. The New York Times. Is There a Post-Abortion Syndrome?
  3. ^ Gomez, Lavin C & Zapata, Garcia R. "Diagnostic categorization of post-abortion syndrome", Actas Esp Psiquiatr. 2005 Jul-Aug;33(4):267-72.
  4. Stotland NL. The myth of the abortion trauma syndrome. JAMA. 1992 Oct 21;268(15):2078-9. PMID 1404747.
  5. Cooper, Cynthia L. Abortion Under Attack
  6. American Psychological Association. "APA research review finds no evidence of 'post-abortion syndrome' but research studies on psychological effects of abortion inconclusive." Press release, January 18, 1989.
  7. Adler NE, et al. "Psychological responses after abortion." Science, April 1990, 248: 41-44.
  8. Vincent Rue, “Abortion and Family Relations,” testimony before the Subcommittee on the Constitution of the US Senate Judiciary Committee, U.S. Senate, 97th Congress, Washington, DC (1981).
  9. ^ The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study - Norway
  10. Sexual behavior during the first eight weeks after legal termination of pregnancy
  11. http://www.bmj.com/cgi/content/full/313/7070/1431
  12. Gomez, Lavin C., & Zapata, Garcia R. (2005). - "Diagnostic categorization of post-abortion syndrome". Actas Esp Psiquiatr, 33 (4), 267-72. Retrieved Setepmber 8, 2006
  13. Abortion in young women and subsequent mental health.
  14. University of Chicago Study: The myth of the abortion trauma syndrome
  15. Koop CE. Post abortion syndrome: myth or reality? Health Matrix. 1989 Summer;7(2):42-4. PMID 10294679.
  16. ^ Sexual behavior during the first eight weeks after legal termination of pregnancy
  17. ^ Legal abortion: a painful necessity - Sweden
  18. Abortion and guilt, France
  19. ^ Psychological effects of abortion Portugal
  20. Predictors of anxiety and depression following pregnancy termination: a longitudinal five-year follow-up study, Norway
  21. Anniversary reactions and due date responses following abortion.
  22. Major, B., Cozzarelli, C., Sciacchitano, A.M., Cooper, M.L., Testa, M., & Mueller, P.M. (1990). Perceived social support, self-efficacy, and adjustment to abortion. Journal of Personality and Social Psychology, 59, 186-197.
  23. Cozzarelli, C., Karrasch, A., Sumer, N., & Major, B. (1994). The meaning and impact of partner's accompaniment on women's adjustment to abortion. Journal of Applied Social Psychology, 24, 2028-2056.
  24. Cozzarelli, C. (1993). Personality and self-efficacy as predictors of coping with abortion. Journal of Personality and Social Psychology, 65, 1224-1236.
  25. Bracken, M.B. (1978). A causal model of psychosomatic reactions to vacuum aspiration abortion. Social Psychiatry, 13, 135-145.
  26. Osofsky, J.D., & Osofsky, H.J. (1972). The psychological reaction of patients to legalized abortion. American Journal of Orthopsychiatry, 42, 48-60.
  27. Lyndon, J., Dunkel-Schetter, C., Cohan, C.L., & Pierce, T. (1996). Pregnancy decision making as a significant life event: A commitment approach. Journal of Personality and Social Psychology, 71, 141-151.
  28. Remennick, L.I., & Segal, R. (2001). Sociocultural context and women's experiences of abortion: Israeli women and Russian immigrants compared. Culture, Health, and Sexuality, 3, 49-66.
  29. Major et al. (1990).
  30. Major, B., & Cozzarelli, C. (1992). Psychological predictors of adjustment to abortion. Journal of Social Issues, 48, 121-142.
  31. Adler, N.E. (1975). Emotional responses of women following therapeutic abortion: How great a problem? Journal of Applied Social Psychology, 6, 240-259.
  32. Bracken, M.B., Hachamovitch, M., & Grossman, G. (1974). The decision to abort and psychological sequelae. Journal of Nervous and Mental Disease, 158, 155-161.
  33. Campbell, N., Franco, K., & Jurs, S. (1988). Abortion in adolescence. Adolescence, 23, 813-823.
  34. Cozzarelli, C., Sumer, N., & Major, B. (1998). Mental models of attachment and coping with abortion. Journal of Personality and Social Psychology, 74, 453-467.
  35. Kitamura, T., Toda, M.A., Shima, S., & Sugawara, M. (1998). Single and repeated elective abortions in Japan: A psychosocial study. Psychosomatic Obstetrics and Gynecology, 19, 126-134.
  36. Payne, E., Kravitz, A., Notman, M., & Anderson, J. (1976). Outcome following therapeutic abortion. Archives of General Psychiatry, 33, 725-733.
  37. Allanson, S., & Astbury, J. (2001). Attachment style and broken attachments: Violence, pregnancy, and abortion. Australian Journal of Psychology, 53, 146-151.
  38. Russo, N., & Denious, J.E. (2001). Violence in the lives of women having abortions: Implications for policy and practice. Professional Psychology Research and Practice, 32, 142-150.
  39. Gold, D., Berger, C., & Andres, D. (1979). The abortion choice: Psychological determinants and consequences. Concordia University, Department of Psychology, Montreal.
  40. Bogen, I. (1974). Attitudes of women who have had abortions. Journal of Sex Research, 10, 97-109.
  41. Osofsky & Osofsky (1972)
  42. Soderberg, H., Janzon, L., & Slosberg, N.-O. (1998). Emotional distress following induced abortion: A study of its incidence and determinants among adoptees in Malmo, Sweden. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 79, 173-178.
  43. Ashton, J. (1980). The psychosocial outcome of induced abortion. British Journal of Obstetrics and Gynecology, 87, 1115-1122.
  44. Friedman, C., Greenspan, R., & Mittleman, F. (1974). The decision-making process and the outcome of therapeutic abortion. American Journal of Psychiatry, 131, 1332-1337.
  45. Lazarus, A. (1985). Psychiatric sequelae of legalized first trimester abortion. Journal of Psychosomatic Obstetrics and Gynecology, 4, 141-150.
  46. Major, B., Mueller, P., & Hildebrandt, K. (1985). Attributions, expectations, and coping with abortion. Journal of Personality and Social Psychology, 48, 585-599.
  47. Miller, W.B. (1992). An empirical study of the psychological antecedents and consequenes of induced abortion. Journal of Social Issues, 48, 67-93.
  48. Anthanasiou, R., Oppel, W., Michelson, L., Unger, T., & Yager, M. (1973). Psychiatric sequelae to term birth and induced early and late abortion: A longitudinal study. Family Planning Perspectives, 5, 227-231.
  49. Llewellyn, S.P., & Pytches, R. (1988). An investigation of anxiety following termination of pregnancy. Journal of Advanced Nursing, 51, 468-471.
  50. Soderberg, H., Andersson, C., Janzon, L., & Slosberg, N.-O. (1997). Continued pregnancy among abortion applicants. A study of women having a change of mind. Act Obstetrica Gynecologica Scandinavia, 76, 942-947.
  51. Friedman, et. al (1974)
  52. Cite error: The named reference Fergusson was invoked but never defined (see the help page).
  53. Warren Throckmorton. "Abortion and mental health." Washington Times. January 21, 2005.

External links

Articles from non-aligned sites

Articles from pro-choice sites

Articles from pro-life sites

Post-abortion support sites & organizations

  • Backline toll free, national talk line to women and men wanting to discuss feelings both before and after abortion.
  • Abortion Conversation Project handouts and training materials on Healthy Coping After an Abortion.
  • Exhale: U.S. post-abortion counselling hotline.
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