Controversy over abortion inhibits recognition and treatment for women who experience psychological distress after abortion (PAD). This study identified the characteristics, severity, and treatment preferences of university students who experienced PAD. Of 151 females, 89 experienced an abortion. Psychological outcomes were compared among those who preferred or did not prefer psychological services after abortion to those who were never pregnant. All who had abortions reported symptoms of post-traumatic stress disorder (PTSD) and grief lasting on average 3 years. Yet, those who preferred services experienced heightened psychological trauma indicative of partial or full PTSD (Impact of Event Scale, M = 26.86 versus 16.84, p < .05), perinatal grief (Perinatal Grief Scale, M 62.54 versus 50.89, p < 0.05), dysthymia (BDI M = 11.01 versus 9.28, p < 0.05), (M = 41.86 versus 39.36, p < 0.05), and co-existing mental health problems. PAD appeared multi-factorial, associated with the abortion and overall emotional health. Thus, psychological interventions for PAD need to be developed as a public health priority.

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Background: Emerging data report 30% of women worldwide who obtain elective abortion experience negative and persistent psychological distress afterward. Studies find higher rates of psychological stress, depressive, substance, and anxiety disorders as well as suicidal behaviors, among some populations after abortion as compared to other reproductive events. Of concern, is that current theory and practice which promote abortion to relieve the stress of an unwanted pregnancy do not reflect new evidence. Moreover, the controversy on abortion inhibits research and treatment on its impact on women's mental health. Thus, clinicians do not identify adverse psychological outcomes to abortion leaving many women untreated. Indeed, this knowledge-practice gap among healthcare providers may be the major reason that the incidence of adverse psychological outcomes after abortion continues to rise. Method: This paper proposes a theoretical understanding of psychological distress after abortion based on new data. A bio-psychosocial framework, including a psychological and biological theory, as well as a conceptual model is presented to explain the development of psychological distress after abortion. A comparison of risk factors between postpartum and post-abortion disorders is presented. Conclusion: A new theoretical model of psychological distress after abortion deepens understanding of the range of women's responses to abortion and promotes evidence based practice.A scientific framework provides a much needed understanding of abortion aftermath as opposed to a political one. By providing assistance to clinicians in the identification, screening, and treatment of psychological disorders after abortion, this thesis aims to close the practice gap, and increase services after abortion to women who need them.