Psychiatric Sequelae to Term Birth and Induced Early and Late Abortion: A Longitudinal Study

Abstract

Three obstetric groups matched for parity, age, color, marital and socioeconomic status, were compared for the psychosocial antecedents to abortion or term delivery and sequelae that did exist. One group had induced abortion by suction curettage, the second had induced abortion by saline injection, and the third had term delivery. 373 women were interviewed during pregnancy; 211 were included in follow-up after an average of 16 months for abortion patients and 13 months for the term delivery group. The 373 women received a structured 90-minute interview about family relationships, consort relationships, living arrangements, income, education, religious behavior, sexual behavior, contraceptive knowledge and use, pregnancy history and desired family size. The Srole Anomia scale and the Rosenberg Self-Esteem scale were also used. At the followup interview, similar questions were asked and the two attitude scales were again presented. The MMPI (Minnesota Multiphasic Personality Inventory) and the SCL (Symptom Check List) were also used. 12% of the 211 follow-up scored higher than 70 on the MMPI for mania and psychopathy scales; these women were evenly divided among the three groups. SCL scales showed the three groups of patients to be similar after abortion or birth, with the only statistically significant difference being the suction curettage group, which had fewer complaints after abortion than either of the other two groups. There was no difference on the anomia or self-esteem scale between pre- or post-procedure for any of the groups. The data suggest neither great harm nor great benefit with regard to these variables due to either early or late abortion or term birth. Early abortion by suction curettage was possibly more therapeutic than carrying a pregnancy to term. There were striking improvements with regard to contraceptive use after the procedure. 71% of each group used effective contraception for more than 12 months after abortion or birth: a 20% increase for the term birth group, a 13% increase for the suction curettage group, and a 26% increase for the saline abortion group. Among abortion patients, those found to have low self-esteem, low contraceptive knowledge, high alienation, and who delayed in seeking abortion were related to long recovery times, a high MMPI psychopathology scale, and a number of unpleasant body symptoms post-abortion. These patients could be predicted with accuracy 32% better than chance alone.