Regional prospective study of psychiatric sequelae of legal abortion

Abstract

117 (45%) of the 263 women of German nationality who underwent socially indicated abortions in the postal-code area 2300 (Kiel) in the first quarter of 1982 were investigated before the abortion as well as one year later. As far as age, marital status and number of children were concerned, these women did not differ significantly from the other 55%. One year later information was collected on the women's emotional adjustment by means of a questionnaire concerning feelings of guilt and loss, personal reports of adjustment process and the investigator's judgement. According to the findings, 79% of the women had adjusted without any problems, 14% were still in a state of emotional imbalance, 7% were clearly impaired emotionally and in their everydays functioning. 21% of the women, who had adjustment problems, had already been more depressive before the abortion. One year later, they were also more depressive than the other women, more dissatisfied with their lives in general and with their sex lives. They were in greater doubt as to whether they had made the right decision, showed less inclination to consider a further abortion and reported stronger post-abortive feelings of guilt. Significantly connected with later emotional difficulties were low social class, a difficult financial situation, lack of intrapsychic differentiation between sex and reproduction, no partner or negative relation with partner and partner disagreements, particularly in the case where the male partner was more in favour of abortion than the woman. Statistically insignificant, although tendencially noticeable were social isolation, non-employment and pre-pregnancy psychical problems. Age, marital status, number of children, simultaneous abortion/sterilisation, previous abortions, a broken home in the patient's youth had no effect on the emotional adjustment after the abortion. The common factor of all variables predicting post-abortive emotional problems seems to be an external motivation for abortion together with a greater ambivalence towards the pregnancy.