Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Medicine
Published in: BMC Medicine 1/2005

Open Access 01-12-2005 | Research article

The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study

Authors: Anne Nordal Broen, Torbjørn Moum, Anne Sejersted Bødtker, Øivind Ekeberg

Published in: BMC Medicine | Issue 1/2005

Login to get access

Abstract

Background

Miscarriage and induced abortion are life events that can potentially cause mental distress. The objective of this study was to determine whether there are differences in the patterns of normalization of mental health scores after these two pregnancy termination events.

Methods

Forty women who experienced miscarriages and 80 women who underwent abortions at the main hospital of Buskerud County in Norway were interviewed. All subjects completed the following questionnaires 10 days (T1), six months (T2), two years (T3) and five years (T4) after the pregnancy termination: Impact of Event Scale (IES), Quality of Life, Hospital Anxiety and Depression Scale (HADS), and another addressing their feelings about the pregnancy termination. Differential changes in mean scores were determined by analysis of covariance (ANCOVA) and inter-group differences were assessed by ordinary least squares methods.

Results

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. However, women who had had a miscarriage exhibited significantly quicker improvement on IES scores for avoidance, grief, loss, guilt and anger throughout the observation period. Women who experienced induced abortion had significantly greater IES scores for avoidance and for the feelings of guilt, shame and relief than the miscarriage group at two and five years after the pregnancy termination (IES avoidance means: 3.2 vs 9.3 at T3, respectively, p < 0.001; 1.5 vs 8.3 at T4, respectively, p < 0.001). Compared with the general population, women who had undergone induced abortion had significantly higher HADS anxiety scores at all four interviews (p < 0.01 to p < 0.001), while women who had had a miscarriage had significantly higher anxiety scores only at T1 (p < 0.01).

Conclusion

The course of psychological responses to miscarriage and abortion differed during the five-year period after the event. Women who had undergone an abortion exhibited higher scores during the follow-up period for some outcomes. The difference in the courses of responses may partly result from the different characteristics of the two pregnancy termination events.
Appendix
Available only for authorised users
Literature
1.
Frost M, Condon JT: The psychological sequelae of miscarriage: a critical review of the literature. Aust NZ J Psychiatry. 1996, 30: 54-62.CrossRef
2.
Klier CM, Geller PA, Ritsher JB: Affective disorders in the aftermath of miscarriage: a comprehensive review. Arch Women Ment Health. 2002, 5: 129-149. 10.1007/s00737-002-0146-2.CrossRef
3.
Thapar AK, Thapar A: Psychological sequelae of miscarriage: a controlled study using the general health questionnaire and the hospital anxiety and depression scale. Br J Gen Pract. 1992, 42: 94-96.PubMedPubMedCentral
4.
Brier N: Anxiety after miscarriage: a review of the empirical literature and implications for clinical practice. Birth. 2004, 31: 138-142. 10.1111/j.0730-7659.2004.00292.x.CrossRefPubMed
5.
Geller PA, Klier CM, Neugebauer R: Anxiety disorders following miscarriage. J Clin Psychiatry. 2001, 62: 432-438.CrossRefPubMed
6.
Klier CM, Geller PA, Neugebauer R: Minor depressive disorder in the context of miscarriage. J Affect Disord. 2000, 59: 13-21. 10.1016/S0165-0327(99)00126-3.CrossRefPubMed
7.
Bowles SV, James LC, Solursh DS, Yancey MK, Epperly TD, Folen RA, Masone M: Acute and post-traumatic stress disorder after spontaneous abortion. Am Fam Physician. 2000, 61: 1689-1696.PubMed
8.
Engelhard IM, van den Hout MA, Arntz A: Posttraumatic stress disorder after pregnancy loss. Gen Hosp Psychiatry. 2001, 23: 62-66. 10.1016/S0163-8343(01)00124-4.CrossRefPubMed
9.
Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE: Psychological factors in abortion. A review. Am Psychol. 1992, 47: 1194-1204. 10.1037/0003-066X.47.10.1194.CrossRefPubMed
10.
11.
Kero A, Hogberg U, Lalos A: Wellbeing and mental growth – long-term effects of legal abortion. Soc Sci Med. 2004, 58: 2559-2569. 10.1016/j.socscimed.2003.09.004.CrossRefPubMed
12.
Major B, Cozzarelli C, Cooper ML, Zubek J, Richards C, Wilhite M, Gramzow RH: Psychological responses of women after first-trimester abortion. Arch Gen Psychiatry. 2000, 57: 777-784. 10.1001/archpsyc.57.8.777.CrossRefPubMed
13.
Bradshaw Z, Slade P: The effects of induced abortion on emotional experiences and relationships: a critical review of the literature. Clin Psychol Rev. 2003, 23: 929-958. 10.1016/j.cpr.2003.09.001.CrossRefPubMed
14.
Perrin E, Bianchi-Demicheli F: [Sexual life, future of the couple, and contraception after voluntary pregnancy termination. Prospective study in Geneva (Switzerland) with 103 women].[French]. Rev Med Suisse Romande. 2002, 122: 257-260.PubMed
15.
Broen AN, Moum T, Bodtker AS, Ekeberg O: Psychological impact on women of miscarriage versus induced abortion: A 2-year follow-up study. Psychosom Med. 2004, 66: 265-271. 10.1097/01.psy.0000118028.32507.9d.CrossRefPubMed
16.
Broen AN, Moum T, Bodtker AS, Ekeberg O: Reasons for induced abortion and their relation to women's emotional distress: a prospective, two-year follow-up study. Gen Hosp Psychiatry. 2005, 27: 36-43. 10.1016/j.genhosppsych.2004.09.009.CrossRefPubMed
17.
Horowitz M, Wilner N, Alvarez W: Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979, 41: 209-218.CrossRefPubMed
18.
Sundin EC, Horowitz MJ: Horowitz's Impact of Event Scale evaluation of 20 years of use. Psychosom Med. 2003, 65: 870-876. 10.1097/01.PSY.0000084835.46074.F0.CrossRefPubMed
19.
Joseph S: Psychometric evaluation of Horowitz's Impact of Event Scale: a review. J Trauma Stress. 2000, 13: 101-113. 10.1023/A:1007777032063.CrossRefPubMed
20.
Salvesen KA, Oyen L, Schmidt N, Malt UF, Eik-Nes SH: Comparison of long-term psychological responses of women after pregnancy termination due to fetal anomalies and after perinatal loss. Ultrasound Obstet Gynecol. 1997, 9: 80-85. 10.1046/j.1469-0705.1997.09020080.x.CrossRefPubMed
21.
Winje D: Long-term outcome of trauma in adults: the psychological impact of a fatal bus accident. J Consult Clin Psychol. 1996, 64: 1037-1043. 10.1037/0022-006X.64.5.1037.CrossRefPubMed
22.
Moum T, Naess S, Sorensen T, Tambs K, Holmen J: Hypertension labelling, life events and psychological well-being. Psychol Med. 1990, 20: 635-646.CrossRefPubMed
23.
Roysamb E, Harris JR, Magnus P, Vitterso J, Tambs K: Subjective well-being. Sex-specific effects of genetic and environmental factors. Pers Individ Dif. 2002, 32: 211-213. 10.1016/S0191-8869(01)00019-8.CrossRef
24.
Roysamb E, Tambs K, Reichborn-Kjennerud T, Neale MC, Harris JR: Happiness and health: environmental and genetic contributions to the relationship between subjective well-being, perceived health, and somatic illness. J Pers Soc Psychol. 2003, 85: 1136-1146. 10.1037/0022-3514.85.6.1136.CrossRefPubMed
25.
Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983, 67: 361-370.CrossRefPubMed
26.
Herrmann C: International experiences with the Hospital Anxiety and Depression Scale – a review of validation data and clinical results. J Psychosom Res. 1997, 42: 17-41. 10.1016/S0022-3999(96)00216-4.CrossRefPubMed
27.
Stordal E, Bjelland I, Dahl AA, Mykletun A: Anxiety and depression in individuals with somatic health problems. The Nord-Trondelag Health Study (HUNT). Scand J Prim Health Care. 2003, 21: 136-141. 10.1080/02813430310002030.CrossRefPubMed
28.
Adler NE: Emotional responses of women following therapeutic abortion. Am J Orthopsychiatry. 1975, 45: 446-454.CrossRefPubMed
29.
Cohen J: Statistical power analysis for the behavioral sciences. 1988, Hillsdale, NJ: Lawrence Erlbaum Associates, 2
30.
Cougle JR, Reardon DC, Coleman PK: Generalized anxiety following unintended pregnancies resolved through childbirth and abortion: a cohort study of the 1995 National Survey of Family Growth. J Anxiety Disord. 2005, 19: 137-142. 10.1016/j.janxdis.2003.12.003.CrossRefPubMed
31.
Moseley DT, Follingstad DR, Harley H, Heckel RV: Psychological factors that predict reaction to abortion. J Clin Psychol. 1981, 37: 276-279.CrossRefPubMed
32.
Rue VM, Coleman PK, Rue JJ, Reardon DC: Induced abortion and traumatic stress: a preliminary comparison of American and Russian women. Med Sci Monit. 2004, 10: SR5-SR16.PubMed
33.
Leskela J, Dieperink M, Thuras P: Shame and posttraumatic stress disorder. J Trauma Stress. 2002, 15: 223-226. 10.1023/A:1015255311837.CrossRefPubMed
34.
Stone AM: The role of shame in post-traumatic stress disorder. Am J Orthopsychiatry. 1992, 62: 131-136.CrossRefPubMed
35.
Street AE, Arias I: Psychological abuse and posttraumatic stress disorder in battered women: examining the roles of shame and guilt. Violence Vict. 2001, 16: 65-78.PubMed
36.
Lee DA, Scragg P, Turner S: The role of shame and guilt in traumatic events: a clinical model of shame-based and guilt-based PTSD. Br J Med Psychol. 2001, 74: 451-466. 10.1348/000711201161109.CrossRefPubMed
37.
Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE: Psychological responses after abortion. Science. 1990, 248: 41-44.CrossRefPubMed
38.
Weisaeth L: Importance of high response rates in traumatic stress research. Acta Psychiatr Scand Suppl. 1989, 355: 131-137.CrossRefPubMed
39.
Soderberg H, Andersson C, Janzon L, Sjoberg NO: Selection bias in a study on how women experienced induced abortion. Eur J Obstet Gynecol Reprod Biol. 1998, 77: 67-70. 10.1016/S0301-2115(97)00223-6.CrossRefPubMed
Metadata
Title
The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study
Authors
Anne Nordal Broen
Torbjørn Moum
Anne Sejersted Bødtker
Øivind Ekeberg
Publication date
01-12-2005
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2005
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/1741-7015-3-18

Other articles of this Issue 1/2005

BMC Medicine 1/2005 Go to the issue

Research article

Chronic Fatigue Syndrome – A clinically empirical approach to its definition and study

Research article

Suicide attempts in clinical trials with paroxetine randomised against placebo

Research article

Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan

Research article

The impact of glucose-insulin-potassium infusion in acute myocardial infarction on infarct size and left ventricular ejection fraction [ISRCTN56720616]

Research article

Long-term use of non-steroidal anti-inflammatory drugs and the risk of myocardial infarction in the general population

Research article

Sudden Infant Death Syndrome and prenatal maternal smoking: rising attributed risk in the Back to Sleepera