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2014, Number 4

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Salud Mental 2014; 37 (4)

Abortion, unwanted childbearing, and mental health

Felipe RN

Language: English
References: 42
Page: 283-291
PDF size: 320.42 Kb.


ABSTRACT

There is a substantial literature of correlational findings from studies in developed countries where abortion is legal that are riddled with methodological problems and selective biases that exaggerate post-pregnancy mental health risks of abortion while minimizing risks for unwanted childbearing. Health professionals need to be able to critically evaluate this literature and use caution when generalizing findings across contexts differing in legal grounds for abortion. The impact of diversity in women’s characteristics, circumstances, and reasons for avoiding childbirth has not been adequately incorporated in theory or research seeking to explain the variations that are found in women’s post-abortion mental health. Critical reviews have established that predictors of problems after abortion or childbirth are similar. Further, when a woman has an unwanted pregnancy, i.e., a pregnancy that she does not wish to end in a term birth, the likelihood that she will have post-pregnancy mental health problems is similar regardless of pregnancy outcome (abortion vs. delivery). Selective sampling bias that advantages the delivery group, common risk factors, and confounding of abortion with unintended pregnancy explain the correlation of legal abortion with negative outcomes observed in the literature from developed countries. Meanwhile, documented negative effects of unwanted pregnancy and childbearing are multiple, severe, and long-lasting for mother and child. Changing societal conditions, particularly in developing countries, provide an opportunity for correcting biases and limitations of current research. High quality studies aimed at understanding the varied relationships of unintended pregnancy to mental health outcomes –both positive and negative– in the context of the diverse circumstances of women’s lives are sorely needed. Such studies can inform the development of programs to reduce unwanted childbearing and promote pre- and post-pregnancy mental health for all women, regardless of how they choose to end their pregnancy.


REFERENCES

  1. Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Studies Family Planning 2008;39(1):18-38.

  2. Singh S, Wulf D, Hussain R, Bankole A et al. Abortion worldwide: A decade of uneven progress. New York: Guttmacher Institute; 2009.

  3. World Health Organization. Unsafe abortion: global and regional estimates of incidence of unsafe abortion and associated mortality in 2008. Geneva: Sixth edition; 2011. Abortion, unwanted childbearing, and mental health Vol. 37, No. 4, julio-agosto 2014 291

  4. Cohen SA. Still true: abortion does not increase woman’s risk of mental health problems. Guttmacher Policy Review 2013;16(2):13-22.

  5. Major B, Applebaum M, Beckman L, Dutton MA et al. Abortion and mental health: Evaluating the evidence. American Psychologist 2009;64:863-890. doi: 10.1037/a0017497

  6. American Psychological Association. Task force on mental health and abortion. Report of the Task Force on Mental Health and Abortion, 2008. http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf>, accessed May 20, 2014.

  7. Charles VE, Polis CB, Sridhara SK et al. Abortion and long-term mental health outcomes: a systematic review of the evidence. Contraception 2008;78:436–450.

  8. National Collaborating Centre for Mental Health. Induced abortion and mental health, London: Academy of Medical Royal Colleges, 2011,, accessed May 20, 2014.

  9. Robinson GE, Stotland NL, Russo NF et al. Is there an “Abortion Trauma Syndrome”? Critiquing the evidence. Harvard Review Psychiatry 2009;17:268-290.

  10. Steinberg JR, Russo NF. Evaluating research on abortion and mental health. Contraception 2009;80:500–503.

  11. Kendall T, Bird V, Cantwell R, et al. To meta-analyse or not to metaanalyse: Abortion, birth, and mental health. Br J of Psychiatry 2012; 200:12–14.

  12. Coleman PK. Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009. Br J Psychiatry 2011;199:180– 186.

  13. Howard LM, Rowe M, Trevillion K, Khalifeh H et al. Abortion and mental health: guidelines for proper scientific conduct ignored. Br J Psychiatry 2012;200:74.

  14. Steinberg JR, Trussel J, Hall, KS, Guthrie K. Fatal flaws in a recent meta-analysis on abortion and mental health. Contraception, 2012;86(5):430-437.

  15. Rubin L, Russo, NF. Abortion and mental health: What therapists need to know. Women Therapy, 2004;27(3/4):69-90.

  16. Upadhyay UD, Cockerill K, Freedman LR. Informing abortion counseling: An examination of evidence-based practices used in emotional care for other stigmatized and sensitive health issues. Patient Education Counseling; 2010;81:415–421.

  17. Bankole A, Singh, S, Hass T. Characteristics of women who obtain induced abortion: a worldwide view. International Family Planning Perspectives 1999:25(2):68-77.

  18. Munk-Olsen T, Laursen TM, Pedersen CB et al. Induced first-trimester abortion and risk of mental disorder. New England J Medicine 2011;364:332-339.

  19. Steinberg JR, Finer LB. Examining the association of abortion history and current mental health: a reanalysis of the National Comorbidity Survey using a common-risk-factors model. Social Science Medicine 2011;72:72–82.

  20. Russo NF, Rubin, L, Becker-Blease K, Breitkopf E. Gendered violence and reproductive issues. In: Sigal J, Denmark FL (eds). Violence against girls and women – International perspectives. Vol 1. Santa Barbara, CA: ABC-CLIO, Inc.; 2013.

  21. Russo NF, Steinberg JR. Contraception and abortion: Critical tools for achieving reproductive justice. In: Chrisler JC (ed). Reproductive justice: A global concern. Santa Barbara, CA: ABC-CLIO, Inc.; 2012.

  22. World Health Organization (WHO), UNICEF, UNFPA and World Bank. Trends in maternal mortality: 1990 to 2010. Geneva, Switzerland: 2010.

  23. UNICEF. State of the world’s children: maternal and newborn health. New York: 2009.

  24. UNFPA. Motherhood in childhood: facing the challenge of adolescent pregnancy. New York: 2013.

  25. Santelli J, Rochat R, Hatfield-Timajchy K, Gilbert BC et al. The measurement and meaning of unintended pregnancy. Perspectives Sexual Reproductive Health 2003;35(2):94-101.

  26. Bankole A, Singh S, Hass T. Reasons why women have induced abortions: evidence from 27 countries. International Family Planning Perspectives; 1998;24(3):117-127,152.

  27. Finer LB, Frohwirth LF, Dauphinee LA, Singh S et al. Reasons US women have abortions: Quantitative and qualitative perspectives. Perspectives Sexual Reproductive Health 2005;37(3):110-118.

  28. Ravindran TKS, Balasubramanian P. “Yes” to abortion but “no” to sexual rights: The paradoxical reality of married women in rural Tamil Nadu, India. Reproductive Health Matters 2004;12(23):88-99.

  29. National Institute of Health and Clinical Excellence. The guidelines manual. London: 2009.

  30. American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice. ACOG committee opinion. No. 434: Induced abortion and breast cancer risk. Obstet Gynecol 2009;113:1417-1418.

  31. Grimes DA et al. Unsafe abortion: the preventable a pandemic. Lancet 2006;368(9550):1908-1919. doi:10.1016/S0140-6736(06)69481-486.

  32. World Health Organization. Trends in maternal mortality: 1990 to 2010, WHO, UNICEF, UNFPA and The World Bank estimates. Geneva, Switzerland: 2012; P.139.

  33. Singh S, Darroch J, Ashford LS, Vlassoff M. Adding it up. The costs and benefits of investing in family planning and maternal and newborn health. New York, Guttmacher Institute; 2009.

  34. Barber JS, Axinn WG, Thornton A. Unwanted childbearing, health, mother-child relationships. J Health Social Behavior 1999;40:231-257.

  35. David HP. Born unwanted: Mental health costs and consequences. American J Orthopsychiatry 2011:81:184-192.

  36. Forssman H, Thuwe I. The Göteberg cohort, 1939-1977. In: David HP, Dytrych Z, Matejcek Z, Schüller V (eds). Born unwanted: Developmental effects of denied abortion. New York: Springer; 1988; pp.37-45.

  37. Hőők K. Refused abortion: A follow-up study of 249 women whose applications were refused by the National Board of Health in Sweden. Acta Psychiatrica Scandinavica 1963;39(supp):168.

  38. Joukamaa M, Kokkonen P, Vejola J, Läksy K et al. Psychosomatic Medicine 2003;65:307-312.

  39. Blomberg S. Influence of maternal distress during pregnancy and fetal malformations. Acta Psychiatrica Scandinavica 1980;62(4):315-330.

  40. Shah PS, Balkhair T, Ohlsson A, Beyene J et al. Intention to become pregnant and low birth weight and preterm birth: A Systematic Review. Maternal Child Health J 2011;15:205-216.

  41. McNeil TF et al. Unwanted pregnancy as a risk factor for offspring schizophrenia-spectrum and affective disorders in adulthood: a prospective high-risk study. Psychol Med 2009;39(6):957-965.

  42. Myhrman A, Rantakallio P, Isohanni M, Jones P. Unwanted nacelle pregnancy and schizophrenia in the child. Br J Psychiatry 1996;169:637-640.




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