Validity of Studies - Revision history

Barb: /* Research Validating Abortion Associated PTSD */

2026-08-05T16:00:25Z

Research Validating Abortion Associated PTSD

← Older revision		Revision as of 11:00, 5 August 2026
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	===Research Validating Abortion Associated PTSD===		===Research Validating Abortion Associated PTSD===
			'''[https://pubmed.ncbi.nlm.nih.gov/42536018/ Mental Health Among Asian and Latina Survivors of International Criminal Sex Trafficking in New York City.] Cao J, Forbes N, Cohen L, Chin JJ, Lim S. Violence Against Women. 2026 Jul 31:10778012261471528. doi: 10.1177/10778012261471528. Epub ahead of print. PMID: 42536018.'''<blockquote>Asian and Latina survivors of international criminal sex trafficking often face profound mental health challenges, yet research on this group remains limited. This study examines mental health outcomes and correlates among 94 survivors in New York City using a Community-Based Participatory Research approach. Multivariable logistic regression identified factors associated with depression, posttraumatic stress disorder (PTSD), and comorbid symptoms. Survivors reported high rates of depression (41.9%), PTSD (41.3%), and co-occurring symptoms (26.6%). '''Pain and forced abortion were significantly associated with PTSD and comorbidity'''. Findings highlight the need for trauma-informed, culturally appropriate mental health interventions addressing pain and reproductive coercion to support survivor recovery.</blockquote>


	'''[https://pubmed.ncbi.nlm.nih.gov/41724312/ Posttraumatic stress disorder after second trimester medical termination of pregnancy]. Anselem O, et al.Am J Obstet Gynecol. 2026 Feb 20:S0002-9378(26)00085-2. doi: 10.1016/j.ajog.2026.02.021. Epub ahead of print. PMID: 41724312.'''<blockquote>'''Objectives:''' To evaluate the risk of posttraumatic stress disorder (PTSD) after indicated second-trimester termination of pregnancy (TOP) and to identify factors associated with a probable diagnosis of severe PTSD.		'''[https://pubmed.ncbi.nlm.nih.gov/41724312/ Posttraumatic stress disorder after second trimester medical termination of pregnancy]. Anselem O, et al.Am J Obstet Gynecol. 2026 Feb 20:S0002-9378(26)00085-2. doi: 10.1016/j.ajog.2026.02.021. Epub ahead of print. PMID: 41724312.'''<blockquote>'''Objectives:''' To evaluate the risk of posttraumatic stress disorder (PTSD) after indicated second-trimester termination of pregnancy (TOP) and to identify factors associated with a probable diagnosis of severe PTSD.

Barb: /* Older Studies - Pre-1970 */

2026-07-10T00:02:13Z

Older Studies - Pre-1970

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 == Older Studies - Pre-1970 ==
-Arén, P., & C. Amark (1957): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Prognosen vid beviljad men icke utförd legal abort.] (The prognosis when legal abortion is granted but not performed). ''Svenska Läk.-Tidn.'' 54, 3709–3784.<blockquote>In a study of women granted permission to abort, 35 to 50% of women had unfavorable reactions to legal abortion, though few resulted to an incapacity to work.  Among 142 granted permission who instead subsequently chose to carry to term, 89% were satisfied that they did not have the abortion.  "The post-course seems, if anything, to have been more favorouable for these women than is generally the case after a legal abortion."</blockquote>Ekblad, M. (1955): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Induced Abortion on Psychiatric Grounds. A Follow-up Study of 479 Women.] ''Acta psychiat. neurol. scand.'' Suppl. 99.<blockquote>Of 479 women who had abortions approved for psychiatric grounds, 75% were content with the operation, 14% reported mild self reproach and 11% serious self reproach. Only in 1% of cases was the woman's working capacity noticeably diminished. </blockquote>SIM M. [https://pmc.ncbi.nlm.nih.gov/articles/PMC1872282/ Abortion and the psychiatrist.] Br Med J. 1963 Jul 20;2(5350):145-8. doi: 10.1136/bmj.2.5350.145
+Arén, P., & C. Amark (1957): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Prognosen vid beviljad men icke utförd legal abort.] (The prognosis when legal abortion is granted but not performed). ''Svenska Läk.-Tidn.'' 54, 3709–3784.<blockquote>In a study of women granted permission to abort, 35 to 50% of women had unfavorable reactions to legal abortion, though few resulted to an incapacity to work.  Among 142 granted permission who instead subsequently chose to carry to term, 89% were satisfied that they did not have the abortion.  "The post-course seems, if anything, to have been more favorouable for these women than is generally the case after a legal abortion."</blockquote>Ekblad, M. (1955): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Induced Abortion on Psychiatric Grounds. A Follow-up Study of 479 Women.] ''Acta psychiat. neurol. scand.'' Suppl. 99.<blockquote>Of 479 women who had abortions approved for psychiatric grounds, 75% were content with the operation, 14% reported mild self reproach and 11% serious self reproach. Only in 1% of cases was the woman's working capacity noticeably diminished. </blockquote>SIM M. [https://pmc.ncbi.nlm.nih.gov/articles/PMC1872282/ Abortion and the psychiatrist.] Br Med J. 1963 Jul 20;2(5350):145-8. doi: 10.1136/bmj.2.5350.145<blockquote>Argues there is no evidence of benefit from abortion, and it is likely more harmful than helpful.  (See also Sim & Neisser in ''New Perspective on Human Abortion)''
 == Qualitative Studies==

Barb: /* Older Studies - Pre-1970 */

2026-07-09T23:51:50Z

Older Studies - Pre-1970

← Older revision		Revision as of 18:51, 9 July 2026
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	== Older Studies - Pre-1970 ==		== Older Studies - Pre-1970 ==
	Arén, P., & C. Amark (1957): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Prognosen vid beviljad men icke utförd legal abort.] (The prognosis when legal abortion is granted but not performed). ''Svenska Läk.-Tidn.'' 54, 3709–3784.<blockquote>In a study of women granted permission to abort, 35 to 50% of women had unfavorable reactions to legal abortion, though few resulted to an incapacity to work. Among 142 granted permission who instead subsequently chose to carry to term, 89% were satisfied that they did not have the abortion. "The post-course seems, if anything, to have been more favorouable for these women than is generally the case after a legal abortion."</blockquote>Ekblad, M. (1955): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Induced Abortion on Psychiatric Grounds. A Follow-up Study of 479 Women.] ''Acta psychiat. neurol. scand.'' Suppl. 99.<blockquote>Of 479 women who had abortions approved for psychiatric grounds, 75% were content with the operation, 14% reported mild self reproach and 11% serious self reproach. Only in 1% of cases was the woman's working capacity noticeably diminished. </blockquote>		Arén, P., & C. Amark (1957): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Prognosen vid beviljad men icke utförd legal abort.] (The prognosis when legal abortion is granted but not performed). ''Svenska Läk.-Tidn.'' 54, 3709–3784.<blockquote>In a study of women granted permission to abort, 35 to 50% of women had unfavorable reactions to legal abortion, though few resulted to an incapacity to work. Among 142 granted permission who instead subsequently chose to carry to term, 89% were satisfied that they did not have the abortion. "The post-course seems, if anything, to have been more favorouable for these women than is generally the case after a legal abortion."</blockquote>Ekblad, M. (1955): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Induced Abortion on Psychiatric Grounds. A Follow-up Study of 479 Women.] ''Acta psychiat. neurol. scand.'' Suppl. 99.<blockquote>Of 479 women who had abortions approved for psychiatric grounds, 75% were content with the operation, 14% reported mild self reproach and 11% serious self reproach. Only in 1% of cases was the woman's working capacity noticeably diminished. </blockquote>SIM M. [https://pmc.ncbi.nlm.nih.gov/articles/PMC1872282/ Abortion and the psychiatrist.] Br Med J. 1963 Jul 20;2(5350):145-8. doi: 10.1136/bmj.2.5350.145

	== Qualitative Studies==		== Qualitative Studies==

Barb: /* Qualitative Studies */

2026-07-09T23:41:42Z

Qualitative Studies

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	''"Psychiatric Sequelae of Induced Abortion," Mary Gibbons, Journal of the Royal College of General Practitioners 34:146-150(1984) ''		''"Psychiatric Sequelae of Induced Abortion," Mary Gibbons, Journal of the Royal College of General Practitioners 34:146-150(1984) ''
	:Observes that many studies concluding that few psychiatric problems follow induced abortion were deficient in methodology, material or length of follow-up. It concludes that a large amount of the previously reported research on the psychiatric indications of abortion may be unreliable.		:Observes that many studies concluding that few psychiatric problems follow induced abortion were deficient in methodology, material or length of follow-up. It concludes that a large amount of the previously reported research on the psychiatric indications of abortion may be unreliable.

			== Older Studies - Pre-1970 ==
			Arén, P., & C. Amark (1957): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Prognosen vid beviljad men icke utförd legal abort.] (The prognosis when legal abortion is granted but not performed). ''Svenska Läk.-Tidn.'' 54, 3709–3784.<blockquote>In a study of women granted permission to abort, 35 to 50% of women had unfavorable reactions to legal abortion, though few resulted to an incapacity to work. Among 142 granted permission who instead subsequently chose to carry to term, 89% were satisfied that they did not have the abortion. "The post-course seems, if anything, to have been more favorouable for these women than is generally the case after a legal abortion."</blockquote>Ekblad, M. (1955): [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0447.1965.tb04971.x Induced Abortion on Psychiatric Grounds. A Follow-up Study of 479 Women.] ''Acta psychiat. neurol. scand.'' Suppl. 99.<blockquote>Of 479 women who had abortions approved for psychiatric grounds, 75% were content with the operation, 14% reported mild self reproach and 11% serious self reproach. Only in 1% of cases was the woman's working capacity noticeably diminished. </blockquote>

	== Qualitative Studies==		== Qualitative Studies==

Barb: /* Research Validating Abortion Associated PTSD */

2026-03-02T14:54:32Z

Research Validating Abortion Associated PTSD

← Older revision		Revision as of 09:54, 2 March 2026
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	===Research Validating Abortion Associated PTSD===		===Research Validating Abortion Associated PTSD===
			'''[https://pubmed.ncbi.nlm.nih.gov/41724312/ Posttraumatic stress disorder after second trimester medical termination of pregnancy]. Anselem O, et al.Am J Obstet Gynecol. 2026 Feb 20:S0002-9378(26)00085-2. doi: 10.1016/j.ajog.2026.02.021. Epub ahead of print. PMID: 41724312.'''<blockquote>'''Objectives:''' To evaluate the risk of posttraumatic stress disorder (PTSD) after indicated second-trimester termination of pregnancy (TOP) and to identify factors associated with a probable diagnosis of severe PTSD.

	'''[https://pubmed.ncbi.nlm.nih.gov/31956603/ The Severity of Post-abortion Stress in Spontaneous, Induced and Forensic Medical Center Permitted Abortion in Shiraz, Iran, in 2018.] Alipanahpour S, Zarshenas M, Ghodrati F, Akbarzadeh M. Iran J Nurs Midwifery Res. 2019 Dec 27;25(1):84-90. doi: 10.4103/ijnmr.IJNMR_36_19. PMID: 31956603; PMCID: PMC6952917.'''<blockquote>'''Background:''' Abortion and loss of pregnancy in the first trimester may affect maternal mortality and morbidity. This study aimed to determine the severity of post-abortion stress in spontaneous abortion, induced abortion, and Forensic Medical Center (FMC) referral abortions immediately after abortion and after 1 month of follow-up in Shiraz, Iran, in 2018.		'''Study design:''' Secondary analysis of a multicenter randomized controlled trial comparing the efficacy of cervical dilators inserted concurrently with misoprostol with that of misoprostol alone for women undergoing TOP between 150/7 and 276/7 weeks of gestation. PTSD was evaluated by the Impact of Event Scale-Revised (IES-R) questionnaire, self-administered 1-4 months after TOP. This 22-item scale is designed to assess subjective distress caused by traumatic events and has been validated in perinatal care. The literature suggests that a score ≥33 indicates a probable diagnosis of PTSD and a score ≥37 a probable diagnosis of severe PTSD. Maternal and obstetric characteristics associated with a score ≥37 were studied with mixed models. We present results after multiple imputation to take selective dropouts and missing information at follow-up into account and for complete cases.

			'''Results:''' Among the 347 women enrolled, 247 (71.2%) IES-R questionnaires were available. Median time between TOP and completion of the questionnaire was 7 weeks (IQR, 4.9-13.3). The mean IES-R score was 32.1 (SD 15.4) The IES-R score was ≥33 for 44.9% (95%CI, 38.4-51.4) of women and ≥37 for 35.8% (95%CI, 29.7-41.8). After multivariate analysis, obstetric or labor-related characteristics such as parity, gestational age over 22 weeks, use of cervical dilators, labor > 12 h, and pain or complications during delivery or postpartum were not associated with an IES-R ≥37. The results were similar in complete cases.

			'''Conclusion:''' Nearly half of women undergoing medically indicated second-trimester TOP were at risk of PTSD and more than one-third of severe PTSD. The absence of risk factors underlines the potential benefits of systematic psychological evaluation after TOP for all women.

			'''Keywords:''' Termination of pregnancy (TOP); mental health; post-traumatic stress disorder (PTSD).</blockquote>



			'''[https://pubmed.ncbi.nlm.nih.gov/31956603/ The Severity of Post-abortion Stress in Spontaneous, Induced and Forensic Medical Center Permitted Abortion in Shiraz, Iran, in 2018.] Alipanahpour S, Zarshenas M, Ghodrati F, Akbarzadeh M. Iran J Nurs Midwifery Res. 2019 Dec 27;25(1):84-90. doi: 10.4103/ijnmr.IJNMR_36_19. PMID: 31956603; PMCID: PMC6952917.'''<blockquote>'''Background:''' Abortion and loss of pregnancy in the first trimester may affect maternal mortality and morbidity. This study aimed to determine the severity of post-abortion stress in spontaneous abortion, induced abortion, and Forensic Medical Center (FMC) referral abortions immediately after abortion and after 1 month of follow-up in Shiraz, Iran, in 2018.

	'''Materials and methods:''' This cross-sectional study was conducted on 104 mothers selected through convenience sampling method in 2018. The data collection tools included a demographic characteristics questionnaire and the Mississippi Post-Traumatic Stress Disorder (M-PTSD) Scale that were filled out by mothers immediately and 1 month after the abortion. Data were analyzed using one-way ANOVA and post-hoc LSD test in SPSS software. Moreover, ''p'' < 0.05 was considered as statistically significant.		'''Materials and methods:''' This cross-sectional study was conducted on 104 mothers selected through convenience sampling method in 2018. The data collection tools included a demographic characteristics questionnaire and the Mississippi Post-Traumatic Stress Disorder (M-PTSD) Scale that were filled out by mothers immediately and 1 month after the abortion. Data were analyzed using one-way ANOVA and post-hoc LSD test in SPSS software. Moreover, ''p'' < 0.05 was considered as statistically significant.

Barb: /* Sleep Disorders */

2025-12-08T18:48:42Z

Sleep Disorders

← Older revision		Revision as of 13:48, 8 December 2025
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	:CONCLUSIONS: This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.		:CONCLUSIONS: This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.

			== Moral Injury ==
			[https://pubmed.ncbi.nlm.nih.gov/41208181/ Is termination of a desired pregnancy due to possible fetal abnormalities a case of moral injury? A preliminary report.] Sartel-Raviv S, Levi-Belz Y, Bar V, Zerach G. Death Stud. 2025 Nov 9:1-11. doi: 10.1080/07481187.2025.2585935. Epub ahead of print. PMID: 41208181.

			<blockquote>Abstract

			Termination of pregnancy (TOP) due to possible fetal abnormalities is known to be associated with various mental health problems. This study examines associations between potentially morally injurious events (PMIEs), moral injury outcomes (MI), posttraumatic stress disorder (PTSD), and prolonged grief (PG) among treatment-seeking women following late pregnancy loss. A volunteer sample of (''n'' = 132) Israeli women who attended a reproductive psychiatry clinic following TOP (''n'' = 99) or pregnancy loss due to intrauterine fetal demise (IUFD; ''n'' = 33), responded to self-report questionnaires in a cross-sectional, comparative study. Results show that among participants in the TOP group, PMIEs-self predicted MI outcomes of shame, and PMIEs-betrayal predicted MI outcomes of trust violation. Importantly, following exposure to PMIE-self, MI outcomes of trust violation significantly predicted both PTSD and PG symptoms. This study emphasized that TOP due to possible fetal abnormalities, may constitute a morally injurious experience, highlighting the need for clinical interventions addressing MI.</blockquote>

	==Sleep Disorders==		==Sleep Disorders==

	Sleep disorders are associated with PTSD and increased risk of suicide See [[Sleep Disorders]]		Sleep disorders are associated with PTSD and increased risk of suicide See [[Sleep Disorders]]

Barb: /* Research Validating Abortion Associated PTSD */

2025-09-08T18:56:13Z

Research Validating Abortion Associated PTSD

← Older revision		Revision as of 13:56, 8 September 2025
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	===Research Validating Abortion Associated PTSD===		===Research Validating Abortion Associated PTSD===

	'''[https://pmc.ncbi.nlm.nih.gov/articles/PMC12357282/ A multi-component psychosocial intervention programme to reduce psychological distress and enhance social support for women undergoing termination of pregnancy for foetal anomaly in China: A randomised controlled trial.] Qin C, Li Y, Wang Y, Huang C, Xiao G, Zeng L, He Y, Jiang W, Xie J Int J Nurs Stud Adv. 2025 Jul 29;9:100389. doi: 10.1016/j.ijnsa.2025.100389. PMID: 40822251; PMCID: PMC12357282.'''<blockquote>Background		'''[https://pubmed.ncbi.nlm.nih.gov/31956603/ The Severity of Post-abortion Stress in Spontaneous, Induced and Forensic Medical Center Permitted Abortion in Shiraz, Iran, in 2018.] Alipanahpour S, Zarshenas M, Ghodrati F, Akbarzadeh M. Iran J Nurs Midwifery Res. 2019 Dec 27;25(1):84-90. doi: 10.4103/ijnmr.IJNMR_36_19. PMID: 31956603; PMCID: PMC6952917.'''<blockquote>'''Background:''' Abortion and loss of pregnancy in the first trimester may affect maternal mortality and morbidity. This study aimed to determine the severity of post-abortion stress in spontaneous abortion, induced abortion, and Forensic Medical Center (FMC) referral abortions immediately after abortion and after 1 month of follow-up in Shiraz, Iran, in 2018.

			'''Materials and methods:''' This cross-sectional study was conducted on 104 mothers selected through convenience sampling method in 2018. The data collection tools included a demographic characteristics questionnaire and the Mississippi Post-Traumatic Stress Disorder (M-PTSD) Scale that were filled out by mothers immediately and 1 month after the abortion. Data were analyzed using one-way ANOVA and post-hoc LSD test in SPSS software. Moreover, ''p'' < 0.05 was considered as statistically significant.

			'''Results:''' The mean (SD) of post-traumatic stress scores was 83.87 (18.35) and 77.40 (9.88) in spontaneous abortion, 82.28 (13.27) and 75.71 (14.73) in FMC permitted abortions, and 86.66 (10.10) and 74.98 (12.99) in induced abortions immediately and 1 month after abortion, respectively. Stress was reduced in the three groups of mothers, after one month of severe value. The score for frequency of stress was 3.10% in FMC-permitted abortions and 5.10% in induced abortions; moreover, no stress was observed in the spontaneous abortion cases.

			'''Conclusions:''' Stress was gradually reduced over time. The level of PTSD was lower after 1 month in women who had experienced spontaneous abortion. Given that 1 month after abortion, women are still often moderately stressed, follow-up care, and appropriate counseling for these women are necessary.</blockquote>


			'''[https://pmc.ncbi.nlm.nih.gov/articles/PMC12357282/ A multi-component psychosocial intervention programme to reduce psychological distress and enhance social support for women undergoing termination of pregnancy for foetal anomaly in China: A randomised controlled trial.] Qin C, Li Y, Wang Y, Huang C, Xiao G, Zeng L, He Y, Jiang W, Xie J Int J Nurs Stud Adv. 2025 Jul 29;9:100389. doi: 10.1016/j.ijnsa.2025.100389. PMID: 40822251; PMCID: PMC12357282.'''<blockquote>Background
	Termination of pregnancy for foetal anomaly causes significant psychological distress, yet evidence-based psychosocial interventions tailored to the needs of women experiencing termination of pregnancy for foetal anomaly remain limited.		Termination of pregnancy for foetal anomaly causes significant psychological distress, yet evidence-based psychosocial interventions tailored to the needs of women experiencing termination of pregnancy for foetal anomaly remain limited.
	Objective		Objective

Barb: /* Research Validating Abortion Associated PTSD */

2025-09-08T17:33:15Z

Research Validating Abortion Associated PTSD

← Older revision		Revision as of 12:33, 8 September 2025
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	===Research Validating Abortion Associated PTSD===		===Research Validating Abortion Associated PTSD===

	[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952917/ The Severity of Post-abortion Stress in Spontaneous, Induced and Forensic Medical Center Permitted Abortion in Shiraz, Iran, in 2018.] Alipanahpour S, Zarshenas M, Ghodrati F, Akbarzadeh M. Iran J Nurs Midwifery Res. 2019 Dec 27;25(1):84-90.		'''[https://pmc.ncbi.nlm.nih.gov/articles/PMC12357282/ A multi-component psychosocial intervention programme to reduce psychological distress and enhance social support for women undergoing termination of pregnancy for foetal anomaly in China: A randomised controlled trial.] Qin C, Li Y, Wang Y, Huang C, Xiao G, Zeng L, He Y, Jiang W, Xie J Int J Nurs Stud Adv. 2025 Jul 29;9:100389. doi: 10.1016/j.ijnsa.2025.100389. PMID: 40822251; PMCID: PMC12357282.'''<blockquote>Background
			Termination of pregnancy for foetal anomaly causes significant psychological distress, yet evidence-based psychosocial interventions tailored to the needs of women experiencing termination of pregnancy for foetal anomaly remain limited.
			Objective
			To evaluate the effectiveness of a multi-component psychosocial intervention designed to reduce depression and post-traumatic stress disorder (PTSD) and enhance psychological flexibility and social support among women following termination of pregnancy for foetal anomaly.
			Methods
			A single-blinded, two-arm randomised controlled trial was conducted in two maternity hospitals in Hunan Province, China. Eighty-six participants were randomly allocated to the multi-component psychosocial intervention group (''n'' = 41) or the control group (''n'' = 45). The multi-component psychosocial intervention included informational support, Acceptance and Commitment Therapy, and social support involving an online peer support group and family engagement. Depression, PTSD, psychological flexibility and social support were assessed at baseline, immediately (T1), one-month (T2) and three-months (T3) post-intervention.
			Results
			Although the intervention group showed greater reductions in depressive symptoms (EPDS: ''β'' = 0.92, 95 % CI: –1.38 to 3.21, ''p'' = 0.435) and post-traumatic stress symptoms (IES-R: ''β'' = 5.31, 95 % CI: –1.25 to 11.86, ''p'' = 0.113) compared to the control group, these differences did not reach statistical significance. Significant group-by-time effects emerged for PTSD-related avoidance symptoms (''β'' = 2.98, 95 % CI: 0.27 to 5.70, ''p'' = 0.031; ''d'' = 0.49), perceived social support (''β'' = –1.56, 95 % CI: –3.10 to –0.02, ''p'' = 0.047; ''d'' = 0.38) and utilisation of social support (-0.83, 95 % CI: -1.48 to -0.18, ''p'' = 0.013; ''d'' = 0.55) at T3. Participants with baseline EPDS > 9 (''n'' = 54) showed stronger effects, with significant improvements in depression (''β'' = 2.02, 95 % CI: 0.38 to 3.66, ''p'' = 0.016) and experiential avoidance (''β'' = 2.54, 95 % CI: 0.30 to 4.78; ''p'' = 0.026) at T1, PTSD (''β'' = 11.75, 95 % CI: 2.39 to 21.12, ''p'' = 0.014; ''d'' = 0.61) and utilisation of social support (''β'' = -0.95, 95 % CI: -1.85 to -0.04; ''p'' = 0.040, ''d'' = 0.65) at T3. No adverse events occurred.
			Conclusions
			The multi-component psychosocial intervention programme reduced PTSD-related avoidance symptoms and enhanced social support. Participants with depressive symptoms experienced immediate improvements in depression and psychological flexibility, with sustained benefits in PTSD and utilisation of social support over three months. Tailoring the intervention components to individual needs may benefit women undergoing termination of pregnancy for foetal anomaly. Further research should compare women with and without baseline psychological distress to determine who benefits most from this intervention.</blockquote>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952917/ The Severity of Post-abortion Stress in Spontaneous, Induced and Forensic Medical Center Permitted Abortion in Shiraz, Iran, in 2018.] Alipanahpour S, Zarshenas M, Ghodrati F, Akbarzadeh M. Iran J Nurs Midwifery Res. 2019 Dec 27;25(1):84-90.

	:Background: Abortion and loss of pregnancy in the first trimester may affect maternal mortality and morbidity. This study aimed to determine the severity of post-abortion stress in spontaneous abortion, induced abortion, and Forensic Medical Center (FMC) referral abortions immediately after abortion and after 1 month of follow-up in Shiraz, Iran, in 2018.		:Background: Abortion and loss of pregnancy in the first trimester may affect maternal mortality and morbidity. This study aimed to determine the severity of post-abortion stress in spontaneous abortion, induced abortion, and Forensic Medical Center (FMC) referral abortions immediately after abortion and after 1 month of follow-up in Shiraz, Iran, in 2018.

WikiSysop: /* Post-Traumatic Stress Disorder / Post-Abortion Syndrome / PTSD */

2024-02-23T21:00:17Z

Post-Traumatic Stress Disorder / Post-Abortion Syndrome / PTSD

← Older revision		Revision as of 16:00, 23 February 2024
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	A history of abortion was associated with a six fold increased risk of subsequent postpartum PTSD.		A history of abortion was associated with a six fold increased risk of subsequent postpartum PTSD.

			'''''[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939862 Previous experience of spontaneous or elective abortion and risk for posttraumatic stress and depression during subsequent pregnancy].''''' Hamama L, Rauch SA, Sperlich M, Defever E, Seng JS. Depress Anxiety. 2010 Jun 23.

	'''~~[http~~://~~www.ncbi~~.~~nlm.nih.gov~~/~~pubmed/22840934 Psychological problems sequalae~~ in ~~adolescents after artificial abortion~~.]''' ~~Zulčić-Nakić V~~, ~~Pajević I~~, ~~Hasanović M~~, ~~Pavlović S~~, ~~Ljuca D~~. ~~J Pediatr Adolesc Gynecol~~. ~~2012 Aug;25~~(4)~~:241-7~~. ~~doi: 10~~.~~1016/j~~.~~jpag~~.~~2011~~.12.~~072~~.		: Abstract
			: '''Background''': Few studies have considered whether elective and/or spontaneous abortion (EAB/SAB) may be risk factors for mental health sequelae in subsequent pregnancy. This paper examines the impact of EAB/SAB on mental health during subsequent pregnancy in a sample of women involved in a larger prospective study of posttraumatic stress disorder (PTSD) across the childbearing year (n=1,581). '''Methods''': Women expecting their first baby completed standardized telephone assessments including demographics, trauma history, PTSD, depression, and pregnancy wantedness, and religiosity. '''Results''': Fourteen percent (n=221) experienced a prior elective abortion (EAB), 13.1% (n=206) experienced a prior spontaneous abortion (SAB), and 1.4% (n=22) experienced both. Of those women who experienced either an EAB or SAB, 13.9% (n=220) appraised the EAB or SAB experience as having been "a hard time" (i.e., potentially traumatic) and 32.6% (n=132) rated it as their index trauma (i.e., their worst or second worst lifetime exposure). Among the subset of 405 women with prior EAB or SAB, the rate of PTSD during the subsequent pregnancy was 12.6% (n-51), the rate of depression was 16.8% (n=68), and 5.4% (n-22) met criteria for both disorders. '''Conclusions''': History of sexual trauma predicted appraising the experience of EAB or SAB as "a hard time." Wanting to be pregnant sooner was predictive of appraising the experience of EAB or SAB as the worst or second worst (index) trauma. EAB or SAB was appraised as less traumatic than sexual or medical trauma exposures and conveyed relatively lower risk for PTSD. The patterns of predictors for depression were similar

	:STUDY AND OBJECTIVES: Controversy exists over psychological risks associated with unwanted pregnancy and consecutive abortion. The aim of this study was to assess the psychological health of female adolescents following artificial abortion up to 12(th) week of pregnancy.

	:~~DESIGN~~: ~~The control case study~~.		'''[http://www.ncbi.nlm.nih.gov/pubmed/22840934 Psychological problems sequalae in adolescents after artificial abortion.]''' Zulčić-Nakić V, Pajević I, Hasanović M, Pavlović S, Ljuca D. J Pediatr Adolesc Gynecol. 2012 Aug;25(4):241-7. doi: 10.1016/j.jpag.2011.12.072.

	:SETTING: The study was carried out in the Department of Gynecology and Obstetrics, University Clinical Center Tuzla, in Bosnia-Herzegovina.		:STUDY AND OBJECTIVES: Controversy exists over psychological risks associated with unwanted pregnancy and consecutive abortion. The aim of this study was to assess the psychological health of female adolescents following artificial abortion up to 12(th) week of pregnancy. DESIGN: The control case study. SETTING: The study was carried out in the Department of Gynecology and Obstetrics, University Clinical Center Tuzla, in Bosnia-Herzegovina.
			:PARTICIPANTS: We assessed 120 female adolescents. The mean (SD) age of the patients was 17.7 (1.5) years experiencing sexual intercourse in the age of 14-19 years for trauma experiences, presence of posttraumatic stress symptoms, depression and anxiety as state, and anxiety as trait. Sixty adolescents had intentional artificial abortion and 60 had sexual intercourse but did not become pregnant. MAIN OUTCOME MEASURES: We used the PTSD Questionnaire, the Beck Depression Inventory, and the Spielberger State Trait Anxiety Inventory (Form Y) for assessment of anxiety in adolescents. Basic socio-demographic data were also collected. RESULTS: PTSD presented significantly more often in adolescents who aborted pregnancy (30%), than in adolescents who did not abort (13.3%) (odds ratio = 4.91 (95%CI 0.142-0.907) P = 0.03). Anxiety as state and as trait were significantly higher in the abortion group, as the mean (SD) anxiety score of patients was 59.8 (8.9), 57.9 (9.7) respectively, than in non-abortion group 49.5 (8.8), 47.3 (9.9) respectively (t = 6.392, P < 0.001; t = 5.914, P < 0.001, respectively). Adolescents who aborted pregnancy had significantly higher depression symptoms severity 29.2 (5.6) than controls 15.2 (3.3) (t = 8.322, P < 0.001), and they presented significantly more often depression (75%), than adolescents who did not abort (10%) (χ(2) = 53.279, P < 0.001). Logistic regression showed that only experience of life threatening(s) and injury of other person(s) reliably predicted PTSD, whereas abortion and experience of life threatening(s) reliably predicted depression. CONCLUSION: Adolescents who aborted pregnancy presented significantly greater prevalence of PTSD and depression, and significantly greater depression severity and anxiety as state and trait than those who did not abort. Abortion predicted depression only, and did not predict PTSD.
	:PARTICIPANTS: We assessed 120 female adolescents. The mean (SD) age of the patients was 17.7 (1.5) years experiencing sexual intercourse in the age of 14-19 years for trauma experiences, presence of posttraumatic stress symptoms, depression and anxiety as state, and anxiety as trait. Sixty adolescents had intentional artificial abortion and 60 had sexual intercourse but did not become pregnant.

	:MAIN OUTCOME MEASURES: We used the PTSD Questionnaire, the Beck Depression Inventory, and the Spielberger State Trait Anxiety Inventory (Form Y) for assessment of anxiety in adolescents. Basic socio-demographic data were also collected.

	:RESULTS: PTSD presented significantly more often in adolescents who aborted pregnancy (30%), than in adolescents who did not abort (13.3%) (odds ratio = 4.91 (95%CI 0.142-0.907) P = 0.03). Anxiety as state and as trait were significantly higher in the abortion group, as the mean (SD) anxiety score of patients was 59.8 (8.9), 57.9 (9.7) respectively, than in non-abortion group 49.5 (8.8), 47.3 (9.9) respectively (t = 6.392, P < 0.001; t = 5.914, P < 0.001, respectively). Adolescents who aborted pregnancy had significantly higher depression symptoms severity 29.2 (5.6) than controls 15.2 (3.3) (t = 8.322, P < 0.001), and they presented significantly more often depression (75%), than adolescents who did not abort (10%) (χ(2) = 53.279, P < 0.001). Logistic regression showed that only experience of life threatening(s) and injury of other person(s) reliably predicted PTSD, whereas abortion and experience of life threatening(s) reliably predicted depression.

	:CONCLUSION: Adolescents who aborted pregnancy presented significantly greater prevalence of PTSD and depression, and significantly greater depression severity and anxiety as state and trait than those who did not abort. Abortion predicted depression only, and did not predict PTSD.


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	::4. “Thus it would follow that screening women pre-termination for PTSD and disability and post-termination for high levels of dissociation is important in order to help identify women at risk of PTSD and to provide follow-up care.” p. 6		::4. “Thus it would follow that screening women pre-termination for PTSD and disability and post-termination for high levels of dissociation is important in order to help identify women at risk of PTSD and to provide follow-up care.” p. 6
	::5. "[t]here was a high rate of attrition over the course of the study leaving a small final sample (37% of the original sample). It might be that participants who were lost to follow-up were lost because of their higher levels of postabortion distress (i.e. PTSD and other psychopathology)."		::5. "[t]here was a high rate of attrition over the course of the study leaving a small final sample (37% of the original sample). It might be that participants who were lost to follow-up were lost because of their higher levels of postabortion distress (i.e. PTSD and other psychopathology)."
	::6. The rates of depression and anxiety were high both pre-abortion and at three months post-abortion, but were not significantly higher. Regarding depression, at pre-termination 21.9% of the sample had high depression scores compared to 20% at 1 and 3 months. 'High' state anxiety (STAI) at pre-abortion was reported by 63.9%, and this dropped to 56.3% of women at both 1 and 3 months. Note: Pre-depresssion and anxiety scores are measured at the height of the crisis when the woman is about to have an abortion. It does not reflect pre-pregnancy scores. In addition, the high attrition rate and short time frame (3 months) must also be considered in properly interpreting this data.		::6. The rates of depression and anxiety were high both pre-abortion and at three months post-abortion, but were not significantly higher. Regarding depression, at pre-termination 21.9% of the sample had high depression scores compared to 20% at 1 and 3 months. 'High' state anxiety (STAI) at pre-abortion was reported by 63.9%, and this dropped to 56.3% of women at both 1 and 3 months. Note: Pre-depresssion and anxiety scores are measured at the height of the crisis when the woman is about to have an abortion. It does not reflect pre-pregnancy scores. In addition, the high attrition rate and short time frame (3 months) must also be considered in properly interpreting this data. 7. "[W]omen with PTSD 3 months after termination were further along in their pregnancy than those without PTSD (gestational age: With PTSD: 13.2 ± 3.3; Without PTSD: 9.7 ± 4.2; p = 0.023)."

	::7. "[W]omen with PTSD 3 months after termination were further along in their pregnancy than those without PTSD (gestational age: With PTSD: 13.2 ± 3.3; Without PTSD: 9.7 ± 4.2; p = 0.023)."


	'''''[http://www.tandfonline.com/doi/abs/10.1080/02646838.2012.654489 Posttraumatic Stress Disorder and psychological distress following medical and surgical abortion.]''''' C. Rousset, C. Brulfert, N. Séjourné, N. Goutaudier & H. Chabrol Journal of Reproductive and Infant Psychology, (2011) Volume 29(5), 506-517.		'''''[http://www.tandfonline.com/doi/abs/10.1080/02646838.2012.654489 Posttraumatic Stress Disorder and psychological distress following medical and surgical abortion.]''''' C. Rousset, C. Brulfert, N. Séjourné, N. Goutaudier & H. Chabrol Journal of Reproductive and Infant Psychology, (2011) Volume 29(5), 506-517.

	:Method: Eighty-six women were approached a few hours after the abortion and then 6 weeks later. Several questionnaires were completed: the Impact of Event Scale Revised (IES-R), the Multidimensional Scale of Social Support (MSPSS), the Peritraumatic Dissociative Experience Questionnaire (PDEQ), the Peritraumatic Emotions List (PEL), the Hospital Anxiety and Depression Scale (HADS), the Perinatal Grief Scale (PGS) and the Texas Grief Inventory (TGI).		:Method: Eighty-six women were approached a few hours after the abortion and then 6 weeks later. Several questionnaires were completed: the Impact of Event Scale Revised (IES-R), the Multidimensional Scale of Social Support (MSPSS), the Peritraumatic Dissociative Experience Questionnaire (PDEQ), the Peritraumatic Emotions List (PEL), the Hospital Anxiety and Depression Scale (HADS), the Perinatal Grief Scale (PGS) and the Texas Grief Inventory (TGI). Results: Six weeks after the abortion, 38% of women reported a potential PTSD and a significant decrease of the anxious symptomatology was also highlighted. Peritraumatic dissociation and peritraumatic emotions were the main predictors of the intensity of post-abortum PTSD symptoms. Compared to surgical abortion, medical abortion was associated with increasing the risk of developing a possible PTSD. Conclusion: By providing evidence on some of the main risk factors, this study highlights the need for psychological support for women and strategies of prevention to be developed.

	:Results: Six weeks after the abortion, 38% of women reported a potential PTSD and a significant decrease of the anxious symptomatology was also highlighted. Peritraumatic dissociation and peritraumatic emotions were the main predictors of the intensity of post-abortum PTSD symptoms. Compared to surgical abortion, medical abortion was associated with increasing the risk of developing a possible PTSD.

	:Conclusion: By providing evidence on some of the main risk factors, this study highlights the need for psychological support for women and strategies of prevention to be developed.

	[http://www.ajol.info/index.php/safp/article/viewFile/13106/15689 The prevalence of post-abortion syndrome in patients presenting at Kalafong hospital's family medicine clinic after having a termination of pregnancy.] van Rooyen M, Smith S. South African Family Practice (2004) 46 (5), pp 21-24.		[http://www.ajol.info/index.php/safp/article/viewFile/13106/15689 The prevalence of post-abortion syndrome in patients presenting at Kalafong hospital's family medicine clinic after having a termination of pregnancy.] van Rooyen M, Smith S. South African Family Practice (2004) 46 (5), pp 21-24.

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Research Validating Abortion Associated PTSD

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	===Research Validating Abortion Associated PTSD===		===Research Validating Abortion Associated PTSD===

			[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952917/ The Severity of Post-abortion Stress in Spontaneous, Induced and Forensic Medical Center Permitted Abortion in Shiraz, Iran, in 2018.] Alipanahpour S, Zarshenas M, Ghodrati F, Akbarzadeh M. Iran J Nurs Midwifery Res. 2019 Dec 27;25(1):84-90.

			:Background: Abortion and loss of pregnancy in the first trimester may affect maternal mortality and morbidity. This study aimed to determine the severity of post-abortion stress in spontaneous abortion, induced abortion, and Forensic Medical Center (FMC) referral abortions immediately after abortion and after 1 month of follow-up in Shiraz, Iran, in 2018.

			:Materials and methods: This cross-sectional study was conducted on 104 mothers selected through convenience sampling method in 2018. The data collection tools included a demographic characteristics questionnaire and the Mississippi Post-Traumatic Stress Disorder (M-PTSD) Scale that were filled out by mothers immediately and 1 month after the abortion. Data were analyzed using one-way ANOVA and post-hoc LSD test in SPSS software. Moreover, p < 0.05 was considered as statistically significant.

			:Results: The mean (SD) of post-traumatic stress scores was 83.87 (18.35) and 77.40 (9.88) in spontaneous abortion, 82.28 (13.27) and 75.71 (14.73) in FMC permitted abortions, and 86.66 (10.10) and 74.98 (12.99) in induced abortions immediately and 1 month after abortion, respectively. Stress was reduced in the three groups of mothers, after one month of severe value. The score for frequency of stress was 3.10% in FMC-permitted abortions and 5.10% in induced abortions; moreover, no stress was observed in the spontaneous abortion cases.

			:Conclusions: Stress was gradually reduced over time. The level of PTSD was lower after 1 month in women who had experienced spontaneous abortion. Given that 1 month after abortion, women are still often moderately stressed, follow-up care, and appropriate counseling for these women are necessary.



	'''[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746441/ Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study.] Biggs MA, Rowland B, McCulloch CE, Foster DG. BMJ Open. 2016;6(2)'''		'''[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746441/ Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study.] Biggs MA, Rowland B, McCulloch CE, Foster DG. BMJ Open. 2016;6(2)'''