Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study

Biggs, M. Antonia; Rowland, Brenly; McCulloch, Charles E.; Foster, Diana Greene

doi:10.1136/bmjopen-2015-009698

Cited by 44 publications

(35 citation statements)

References 36 publications

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“…Consistent with the published literature, we found that people's social and cultural contexts, including race/ethnicity, age, religion, and where they lived, were significantly associated with perceived abortion stigma [3,29,36]. One of the strengths of our study design lies that we collected data from people seeking abortions in 21 states, representing every region of the United States, which allowed us to capture the experience of a diverse range of individuals.…”

Section: Discussionsupporting

confidence: 64%

“…In this study, we use all 11 semi-annual interview waves from the Turnaway Study, a longitudinal study designed to look at the effects of receiving versus being denied an abortion on socioeconomic status, mental health, and emotional well-being. Study details have been reported elsewhere [28][29][30][31]. From January 2008 to December 2010, we recruited people seeking an abortion at 30 facilities in 21 U.S. states.…”

Section: Methodsmentioning

confidence: 99%

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Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion

2020

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Objective To prospectively assess perceptions of abortion stigma after receiving or being denied an abortion over 5 years, the factors associated with perceived abortion stigma, and the effects of perceived abortion stigma on psychological well-being. Methods We recruited people seeking abortion from 30 facilities across the US, and interviewed them by phone one week post-abortion seeking, then semiannually for 5 years. We used adjusted mixed effects regression analyses to examine the abortion stigma trajectories of those who obtained an abortion near a facility's gestational age limit (Near-limits) compared to those denied an abortion because they were just over the limit and carried their pregnancies to term (Turnaway-births). Results Of the 956 people recruited, we removed 28 due to ineligibility or missing data, leaving a final sample of 928. In unadjusted analyses, at one-week post-abortion seeking, over half of those seeking abortion perceived that if others knew they had sought an abortion, they would be looked down upon at least "a little bit" by people close to them (60%) or by people in their community (56%). In longitudinal adjusted analyses, people denied an abortion and who carried their pregnancies to term (Turnaway-birth group) reported significantly lower baseline perceived abortion stigma from people close to them (-0.38; 95% CI,-0.59,-0.16) and from people in their community (0.30; 95% CI,-0.52,-0.08), than Near-limits, differences that remained statistically significant for 1.5 years. Overall perceived abortion stigma declined significantly (p < .001) for both study groups. High perceived abortion stigma at baseline was associated with higher odds of experiencing psychological distress years later (adjusted Odds Ratio, 3.98; 95% CI, 1.39, 11.37).

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Section: Discussionsupporting

confidence: 64%

Section: Methodsmentioning

confidence: 99%

Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion

2020

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“…Numerous factors make the participation in an induced abortion a traumatic experience. Studies show that participation in multiple pregnancy termination procedures increased the probability of developing posttraumatic stress disorder [10].…”

Section: Introductionmentioning

confidence: 99%

Emotional Complications in Midwives Participating in Pregnancy Termination Procedures—Polish Experience

Zaręba

Banasiewicz

Rozenek

et al. 2020

IJERPH

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Background: Ethically controversial medical procedures, such as the termination of pregnancy, are frequently associated with a discrepancy between personal attitude and values versus requirements related to a professional situation. The study aimed to assess emotional complications in midwives participating in pregnancy termination procedures. Methods: The study included 181 midwives working in state-governed healthcare facilities in central and eastern Poland. The Oldenburg Burnout Inventory (OLBI) and the present authors’ own questionnaire were used in the study. The results indicating the level of occupational burnout were presented in two scales: the exhaustion scale and the disengagement scale. Results: The study revealed that 48% of midwives had never participated in pregnancy termination procedures due to fetal defects. The level of occupational burnout described with the exhaustion factor (t = 2.06; p < 0.041) and disengagement factor (t = 2.96; p < 0.003) was significantly higher in the group of midwives participating in pregnancy termination procedures due to fetal defects than in the group of midwives who did not participate in pregnancy terminations. The most common factors contributing to burnout reported by midwives who participated in pregnancy terminations were: moral dilemmas (68%), seeing the aborted fetus (65%), anticipating the child’s death in case it was born with signs of life (59%) and the lack of professional psychological support for medical personnel (56%). Conclusions: Importantly, pregnancy termination should be performed by persons who find such procedures acceptable from the viewpoint of their value system. It is a protective factor in regards to work with women who undergo terminations. Moreover, developing a system of informational and psychological support for midwives participating in pregnancy termination procedures is also a significant aspect.

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“…Using a cutoff score of 3 the PC‐PTSD scale had a sensitivity rate of 0.78, a specificity rate of 0.87, a positive predictive value of 0.65, a negative predictive value of 0.92 (Prins & Ouimette, ), and good test–retest reliability ( r = 0.84; Kimerling, Trafton, & Nguyen, ). The PC‐PTSD is sensitive to change over time and has been assessed as an outcome in a number of longitudinal studies (Biggs, Rowland, McCulloch, & Foster, , Milliken, Auchterlonie, & Hoge, ; Warren et al, ).…”

Section: Methodsmentioning

confidence: 99%

“…outcome in a number of longitudinal studies (Biggs, Rowland, McCulloch, & Foster, 2016, Milliken, Auchterlonie, & Hoge, 2007Warren et al, 2014).…”

mentioning

confidence: 99%

Mental health change in the transition to permanent supportive housing: The role of housing and social networks

Harris

Rhoades

Duan

et al. 2019

Journal Community Psychology

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Aims: Permanent Supportive Housing (PSH) may improve homeless adults’ mental health via housing stabilization and/or improved relational factors, however, the role of housing and social networks on PSH residents' mental health change is minimally understood. Methods: Interviews were conducted with a baseline sample of adults experiencing homelessness ( N = 421), across their initial year in PSH (3‐months, 6‐months, and 12‐months). Generalized linear mixed models assessed changes in positive past‐month psychiatric disability screenings (Modified‐Colorado Symptom Index [MCSI]) and probable posttraumatic stress disorder (PC‐PTSD) in controlled models, and between and within‐subject effects of time‐varying social network correlates on mental health changes. Results: Compared with baseline, positive MCSI screens continuously decreased over time (56%, 54%, and 50%) while PC‐PTSD screens declined initially (40%) with marginal decreases at remaining follow‐ups (39% and 38%). These differences remained significant in controlled models. Gaining a romantic partner was associated with a longitudinal increase in a positive MCSI screening. Between subjects, emotional health counselors and conflicting network members were associated with an increased likelihood in positive screenings, while doctors and case managers were protective. Conclusion: Housing may facilitate positive changes in PSH residents' mental health, yet positive screenings remain high. Social network interventions that increase residents’ positive interpersonal exchanges and prosocial relationships are warranted.

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Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study

Cited by 44 publications

References 36 publications

Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion

Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion

Emotional Complications in Midwives Participating in Pregnancy Termination Procedures—Polish Experience

Mental health change in the transition to permanent supportive housing: The role of housing and social networks

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