Catégorie : Chiffres et études

Women’s Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion
A Prospective, Longitudinal Cohort Study
M. Antonia Biggs, PhD1; Ushma D. Upadhyay, PhD, MPH1; Charles E. McCulloch, PhD2; et Diana G. Foster, PhD1

JAMA Psychiatry. Published online December 14, 2016. doi:10.1001/jamapsychiatry.2016.3478

Source : JAMA Psychiatry

Key Points
Question Are there associations between having or being denied an abortion with women’s mental health and well-being?

Findings This longitudinal cohort study observed 956 women semiannually for 5 years. Eight days after seeking an abortion, women who were denied an abortion reported significantly more anxiety symptoms and lower self-esteem and life satisfaction, but similar levels of depression, as women receiving abortions; outcomes improved or remained steady over time.

Meaning Abortion denial may be initially associated with psychological harm to women and findings do not support restricting abortion on the basis that abortion harms women’s mental health.

Abstract
Importance The idea that abortion leads to adverse psychological outcomes has been the basis for legislation mandating counseling before obtaining an abortion and other policies to restrict access to abortion.

Objective To assess women’s psychological well-being 5 years after receiving or being denied an abortion.

Design, Setting, and Participants This study presents data from the Turnaway Study, a prospective longitudinal study with a quasi-experimental design. Women were recruited from January 1, 2008, to December 31, 2010, from 30 abortion facilities in 21 states throughout the United States, interviewed via telephone 1 week after seeking an abortion, and then interviewed semiannually for 5 years, totaling 11 interview waves. Interviews were completed January 31, 2016. We examined the psychological trajectories of women who received abortions just under the facility’s gestational limit (near-limit group) and compared them with women who sought but were denied an abortion because they were just beyond the facility gestational limit (turnaway group, which includes the turnaway-birth and turnaway-no-birth groups). We used mixed effects linear and logistic regression analyses to assess whether psychological trajectories differed by study group.

Main Outcomes and Measures We included 6 measures of mental health and well-being: 2 measures of depression and 2 measures of anxiety assessed using the Brief Symptom Inventory, as well as self-esteem, and life satisfaction.

Results Of the 956 women (mean [SD] age, 24.9 [5.8] years) in the study, at 1 week after seeking an abortion, compared with the near-limit group, women denied an abortion reported more anxiety symptoms (turnaway-births, 0.57; 95% CI, 0.01 to 1.13; turnaway-no-births, 2.29; 95% CI, 1.39 to 3.18), lower self-esteem (turnaway-births, –0.33; 95% CI, –0.56 to –0.09; turnaway-no-births, –0.40; 95% CI, –0.78 to –0.02), lower life satisfaction (turnaway-births, –0.16; 95% CI, –0.38 to 0.06; turnaway-no-births, –0.41; 95% CI, –0.77 to –0.06), and similar levels of depression (turnaway-births, 0.13; 95% CI, –0.46 to 0.72; turnaway-no-births, 0.44; 95% CI, –0.50 to 1.39).

Conclusions and Relevance In this study, compared with having an abortion, being denied an abortion may be associated with greater risk of initially experiencing adverse psychological outcomes. Psychological well-being improved over time so that both groups of women eventually converged. These findings do not support policies that restrict women’s access to abortion on the basis that abortion harms women’s mental health.

A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one
D. G. Foster, J. R. Steinberg, S. C. M. Roberts, J. Neuhaus, M. A. Biggs
Journal: Psychological Medicine / Volume 45 / Issue 10 / July 2015
DOI: https://doi.org/10.1017/S0033291714003213
Published online: 28 January 2015, pp. 2073-2082
Source: NCBI

Background

This study prospectively assesses the mental health outcomes among women seeking abortions, by comparing women having later abortions to women denied abortions, up to two years post-abortion seeking.

Methods

We present the first two years of a 5-year telephone interview study that is following 956 women who sought an abortion from 30 facilities throughout the U.S. We use adjusted linear mixed effects regression analyses to assess whether symptoms of depression and anxiety, as measured by the BSI-short form and Prime-MD, differ over time among women denied an abortion due to advanced gestational age, compared to women who received abortions.

Results

Baseline predicted mean depressive symptom scores for women denied abortion (3.07) were similar to women receiving an abortion just below the gestational limit (2.86). Depressive symptoms declined over time with no difference between groups. Initial predicted mean anxiety symptoms were higher among women denied care (2.59) than among women who had an abortion just below the gestational limit (1.91). Anxiety levels in the two groups declined and converged after one year.

Conclusions

Women who received an abortion had similar or lower levels of depression and anxiety than women denied an abortion. Our findings do not support the notion that abortion is a cause of mental health problems

Source: Journal PLOS One

Abstract

Background

Arguments that abortion causes women emotional harm are used to regulate abortion, particularly later procedures, in the United States. However, existing research is inconclusive. We examined women’s emotions and reports of whether the abortion decision was the right one for them over the three years after having an induced abortion.

Methods

We recruited a cohort of women seeking abortions between 2008-2010 at 30 facilities across the United States, selected based on having the latest gestational age limit within 150 miles. Two groups of women (n=667) were followed prospectively for three years: women having first-trimester procedures and women terminating pregnancies within two weeks under facilities’ gestational age limits at the same facilities. Participants completed semiannual phone surveys to assess whether they felt that having the abortion was the right decision for them; negative emotions (regret, anger, guilt, sadness) about the abortion; and positive emotions (relief, happiness). Multivariable mixed-effects models were used to examine changes in each outcome over time, to compare the two groups, and to identify associated factors.

Results

The predicted probability of reporting that abortion was the right decision was over 99% at all time points over three years. Women with more planned pregnancies and who had more difficulty deciding to terminate the pregnancy had lower odds of reporting the abortion was the right decision (aOR=0.71 [0.60, 0.85] and 0.46 [0.36, 0.64], respectively). Both negative and positive emotions declined over time, with no differences between women having procedures near gestational age limits versus first-trimester abortions. Higher perceived community abortion stigma and lower social support were associated with more negative emotions (b=0.45 [0.31, 0.58] and b=-0.61 [-0.93, -0.29], respectively).

Conclusions

Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding.

Source: tandfonline.com

The European Journal of Contraception & Reproductive Health Care
Volume 16, Issue 4, 2011
DOI:10.3109/13625187.2011.570883
Sam Rowlands*a
pages 233-240

Résumé de l’article de Sam Rowland : Misinformation on abortion, Eur J Contracept Reprod Health Care. 2011;16(4):233-40

Une revue de la littérature a été réalisée pour étudier cinq aspects de l’interruption volontaire de grossesse (IVG): risque pour la vie, risque de cancer du sein, risque pour la santé mentale, risque pour la fertilité future, et douleur fœtale.
Résultats : L’IVG est clairement plus sûre que l’accouchement. Il n’y a aucune preuve d’une association entre avortement et cancer du sein. Les femmes qui ont une IVG ne sont pas exposées à un risque accru de problèmes de santé mentale par rapport aux femmes qui poursuivent une grossesse non désirée. Il n’y a pas d’effet négatif de l’IVG sur la fertilité ultérieure de la femme. Il est impossible pour un fœtus de percevoir la douleur avant 24 semaines de gestation.
La désinformation sur l’IVG est largement répandue. De la littérature et des sites Web sont explorés pour démontrer comment les données ont été manipulées et mal citées ou tout simplement ignorées. Les citations d’articles qui n’ont pas été évalués par des experts sont également courantes. La fourniture d’informations inexactes dans certaines lois des états des États-Unis est présentée. L’attention est attirée sur la façon dont les femmes peuvent être induites en erreur par les Crisis Pregnancy centres.
Conclusion : La désinformation sur l’IVG est largement promulguée par ceux qui
s’opposent à l’avortement. Cette désinformation est fréquemment basée sur l’interprétation erronée de la littérature scientifique

Traduction de Laurence Esterle

ABSTRACT
Objective To find the latest and most accurate information on aspects of induced abortion.

Methods A literature survey was carried out in which five aspects of abortion were scrutinised: risk to life, risk of breast cancer, risk to mental health, risk to future fertility, and fetal pain.

Findings Abortion is clearly safer than childbirth. There is no evidence of an association between abortion and breast cancer. Women who have abortions are not at increased risk of mental health problems over and above women who deliver an unwanted pregnancy. There is no negative effect of abortion on a woman’s subsequent fertility. It is not possible for a fetus to perceive pain before 24 weeks’ gestation. Misinformation on abortion is widespread. Literature and websites are cited to demonstrate how data have been manipulated and misquoted or just ignored.

Citation of non-peer reviewed articles is also common. Mandates insisting on provision of inaccurate information in some US State laws are presented. Attention is drawn to how women can be misled by Crisis Pregnancy Centres.

Conclusion There is extensive promulgation of misinformation on abortion by those who oppose abortion. Much of this misinformation is based on distorted interpretation of the scientific literature.

Source : Royal College of Obstetricians and Gynaecologists

Source VIDAL

Source British Medical Journal