Effect and pathway of abortion stigma on depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly.

Abstract

To explore the effect and pathway of abortion stigma on depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly. Based on literature review, a self-made general demographic information questionnaire, the Edinburgh Postnatal Depression Scale, the Individual Level Abortion Stigma Scale, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire-Fusion, the Responses to Stress Questionnaire and the Perceived Social Support Scale were used to investigate pregnant women with fetal anomaly before abortion in tertiary general hospitals and specialist maternity hospitals in Changsha, to develop a hypothesis model of the factors influencing depressive symptoms before terminating the pregnancy. The hypothesis model was verified by applying structural equation modelling analysis. The structural equation model showed that the stigma directly or indirectly influenced depressive symptoms before terminating the pregnancy via psychological flexibility, social support and avoidance coping. The total effect value was 0.55 (P<0.05), the direct effect value was 0.22 (P<0.05), and the indirect effect value was 0.33 (P<0.05). Psychological flexibility and social support had protective mediating effects, while avoidance coping had harmful mediating effects. Abortion stigma has large positive effect on the depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly. Among direct and indirect effect, the indirect effect is major. Effective measures to reduce the stigma, increase psychological flexibility, improve social support and coping style will have an important influence on the prevention and reduction of depressive symptoms before terminating the pregnancy.