Recent Studies - Revision history

Barb: /* 2010 */

2010-10-21T19:55:11Z

2010

← Older revision		Revision as of 14:55, 21 October 2010
Line 1:		Line 1:
	== 2010 ==		== 2010 ==

			'''''[http://www.informaworld.com/smpp/content~db=all~content=a923120522~frm=titlelink Motherhood: is it good for women's mental health?] Holtona S, Fishera J, Rowea H. Journal of Reproductive and Infant Psychology, Volume 28, Issue 3 August 2010 , pages 223 - 239'''''

			:Abstract
			:There is ongoing debate regarding whether the child-bearing years, including the postpartum period, are a time of increased risk for mental health problems in women. Comparisons of the mental health of mothers and childless women have inconsistent findings. This is probably attributable to differences in the kinds of mothers and non-mothers investigated, and variations in the conceptualisation of mental health, but suggests that firm conclusions about the relationship between motherhood and women's mental health remain less clear than claimed. This study investigated the relationship between motherhood and mental health in a population-based, cross-sectional survey of a broadly representative sample of 569 women aged 30-34 years living in Victoria, one Australian state, in 2005. It was found that the rates of mental health conditions in mothers, including those who had given birth in the preceding year, were no higher than in women without children. Further, mothers reported significantly better subjective well-being and greater life satisfaction than childless women. These data suggest that being a mother is associated with enhanced mental health for women, and challenge the view that the child-bearing years are a period of diminished psychological well-being for women.

			'''''Long term follow-up of emotional experiences after termination of pregnancy: women's views at menopause. Dykesa K, Sladeb P; Haywood A. Journal of Reproductive and Infant Psychology,, First published on: 20 October 2010'''''
			:Abstract
			:The objective was to explore women’s long-term experiences and perspectives on their terminations of pregnancy (TOP) when perimenopausal. Eight women attending a menopause clinic who had experienced termination a minimum of 10 years previously (mean 24 years) completed semi-structured interviews. Transcripts were analysed using Template Analysis. Five TOP themes were identified: ‘Impression left’ involved sadness, regret, and guilt which affected women’s self-perceptions. ‘Judgement’ encompassed judgement on themselves and how censure was feared from others. ‘Growth and development’ noted the development of resilience and compassion for others. ‘Coming to terms and managing effects’ identified beliefs in the correctness of the decision, but effortful avoidance of thoughts still intruding into life. ‘Contradictions’ identified dramatic inconsistencies within almost all individual accounts indicating lack of resolution and full acceptance. Considering menopause and TOP together revealed a further three themes; Changes to thinking, Menopause as a time of reflection and Linkages or separateness. For some women termination may be continually reappraised in their changing life context and remain an active yet hidden feature managed through active avoidance. Menopause was viewed as a time of vulnerability to TOP-related negative thoughts, especially where wishes for more children were unfulfilled. Accessibility of post-termination counselling throughout life is recommended.

	'''''[http://www.ncbi.nlm.nih.gov/pubmed/20435289 Young age and termination of pregnancy during the second trimester are risk factors for repeat second-trimester abortion.]''''' Mentula MJ, Niinimäki M, Suhonen S, Hemminki E, Gissler M, Heikinheimo O. Am J Obstet Gynecol. 2010 Aug;203(2):107.e1-7.		'''''[http://www.ncbi.nlm.nih.gov/pubmed/20435289 Young age and termination of pregnancy during the second trimester are risk factors for repeat second-trimester abortion.]''''' Mentula MJ, Niinimäki M, Suhonen S, Hemminki E, Gissler M, Heikinheimo O. Am J Obstet Gynecol. 2010 Aug;203(2):107.e1-7.

Barb: /* 2009 */

2010-09-27T16:46:02Z

2009

← Older revision		Revision as of 11:46, 27 September 2010
Line 113:		Line 113:

	== 2009 ==		== 2009 ==
			'''''[http://www.ncbi.nlm.nih.gov/pubmed/19888037 Immediate complications after medical compared with surgical termination of pregnancy.]''''' Niinimäki M, Pouta A, Bloigu A, Gissler M, Hemminki E, Suhonen S, Heikinheimo O. Obstet Gynecol. 2009 Oct;114(4):795-804.
			OBJECTIVE: To estimate the immediate adverse events and safety of medical compared with surgical abortion using high-quality registry data.

			:'''METHODS:''' All women in Finland undergoing induced abortion from 2000-2006 with a gestational duration of 63 days or less (n=42,619) were followed up until 42 days postabortion using national health registries. The incidence and risk factors of adverse events after medical (n=22,368) and surgical (n=20,251) abortion were compared. Univariable and multivariable association models were used to analyze the risk of the three main complications (hemorrhage, infection, and incomplete abortion) and surgical (re)evacuation.

			:'''RESULTS:''' The overall incidence of adverse events was fourfold higher in the medical compared with surgical abortion cohort (20.0% compared with 5.6%, P<.001). Hemorrhage (15.6% compared with 2.1%, P<.001) and incomplete abortion (6.7% compared with 1.6%, P<.001) were more common after medical abortion. The rate of surgical (re)evacuation was 5.9% after medical abortion and 1.8% after surgical abortion (P<.001). Although rare, injuries requiring operative treatment or operative complications occurred more often with surgical termination of pregnancy (0.6% compared with 0.03%, P<.001). No differences were noted in the incidence of infections (1.7% compared with 1.7%, P=.85), thromboembolic disease, psychiatric morbidity, or death.

			:'''CONCLUSION:''' Both methods of abortion are generally safe, but medical termination is associated with a higher incidence of adverse events. These observations are relevant when counseling women seeking early abortion.

			:'''LEVEL OF EVIDENCE: II.'''

	'''''[http://www.ncbi.nlm.nih.gov/pubmed/19880932 Reactions to abortion and subsequent mental health.]''''' Fergusson DM, Horwood LJ, Boden JM. Br J Psychiatry. 2009 Nov;195(5):420-6.		'''''[http://www.ncbi.nlm.nih.gov/pubmed/19880932 Reactions to abortion and subsequent mental health.]''''' Fergusson DM, Horwood LJ, Boden JM. Br J Psychiatry. 2009 Nov;195(5):420-6.

Barb: /* 2010 */

2010-09-27T16:42:10Z

2010

← Older revision		Revision as of 11:42, 27 September 2010
Line 1:		Line 1:
	== 2010 ==		== 2010 ==

			'''''[http://www.ncbi.nlm.nih.gov/pubmed/20435289 Young age and termination of pregnancy during the second trimester are risk factors for repeat second-trimester abortion.]''''' Mentula MJ, Niinimäki M, Suhonen S, Hemminki E, Gissler M, Heikinheimo O. Am J Obstet Gynecol. 2010 Aug;203(2):107.e1-7.

			:'''OBJECTIVE:''' The objective of the study was to characterize women undergoing a termination of pregnancy (TOP) during the second trimester and to evaluate the risk factors and timing of repeat TOP.

			:'''STUDY DESIGN:''' This nationwide retrospective cohort study investigated 41,750 women who underwent TOP during the first (n = 39,850) or second (n = 1900) trimester in Finland in 2000-2005. The follow-up time was until repeat TOP or until Dec. 31, 2006.

			:'''RESULTS:''' TOP during the second trimester increases the risk of repeat TOP (hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.3-1.6), repeat second-trimester TOP (HR, 3.8; 95% CI, 2.9-5.1), and repeat TOP after 16 weeks of gestation (HR, 5.0; 95% CI, 3.3-7.7). The other risk factor for these is young age (HR, 7.0, 95% CI, 5.3-9.3; and HR, 12.5; 95% CI, 3.1-50.4 for age <20 years).

			:'''CONCLUSION:''' Second-trimester TOP and young age are risk factors for repeat second-trimester TOP. Special focus on these women might be effective in decreasing repeat abortions.

	'''''[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914778/ Use of psychotropic drugs before pregnancy and the risk for induced abortion: population-based register-data from Finland 1996-2006]''''' Gissler M, Artama M, Ritvanen A, Wahlbeck K. BMC Public Health. 2010 Jun 30;10:383.		'''''[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914778/ Use of psychotropic drugs before pregnancy and the risk for induced abortion: population-based register-data from Finland 1996-2006]''''' Gissler M, Artama M, Ritvanen A, Wahlbeck K. BMC Public Health. 2010 Jun 30;10:383.

Barb: /* 2010 */

2010-09-27T16:39:51Z

2010

← Older revision		Revision as of 11:39, 27 September 2010
Line 1:		Line 1:
	== 2010 ==		== 2010 ==

			'''''[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914778/ Use of psychotropic drugs before pregnancy and the risk for induced abortion: population-based register-data from Finland 1996-2006]''''' Gissler M, Artama M, Ritvanen A, Wahlbeck K. BMC Public Health. 2010 Jun 30;10:383.

			(ABSTRACT)
			:'''Background''' Some, though not all studies have reported an increased risk for mental health problems after an induced abortion. Problems with design and data have compromised these studies and the generalisation of their results.
			:'''Methods''' The Finnish Medication and Pregnancy database (N = 622 671 births and 114 518 induced abortions for other than fetal reasons) in 1996-2006 was utilised to study the use of psychotropic drugs in the three months before a pregnancy ending in a birth or an induced abortion.
			:'''Results''' In total 2.1% of women with a birth and 5.1% of women with an induced abortion had used a psychotropic medicine 0-3 months before pregnancy. Psychotropic drug users terminated their pregnancies (30.9%) more often than other pregnant women (15.5%). Adjustment for background characteristics explained one third of this elevated risk, but the risk remained significantly increased among users of psychotropic medicine (OR 1.94, 95% confidence intervals 1.87-2.02). A similar risk was found for first pregnancies (30.1% vs. 18.9%; adjusted OR 1.53, 95% confidence intervals 1.42-1.65). The rate for terminating pregnancy was the highest for women using hypnotics and sedatives (35.6% for all pregnancies and 29.1% for first pregnancies), followed by antipsychotics (33.9% and 36.0%) and antidepressants (32.0% and 32.1%).
			:'''Conclusions''' The observed increased risk for induced abortion among women with psychotropic medication highlights the importance to acknowledge the mental health needs of women seeking an induced abortion. Further studies are needed to establish the impact of pre-existing differences in mental health on mental health outcomes of induced abortions compared to outcomes of pregnancies ending in a birth.

	'''''[http://www.guttmacher.org/pubs/psrh/full/4223010.pdf Do Depression and Low Self-Esteem Follow Abortion Among Adolescents? Evidence from a National Study]''''' Perspectives on Sexual and Reproductive Health, 42(4):230–235, (2010) Warren, Harvey, and Henderson.		'''''[http://www.guttmacher.org/pubs/psrh/full/4223010.pdf Do Depression and Low Self-Esteem Follow Abortion Among Adolescents? Evidence from a National Study]''''' Perspectives on Sexual and Reproductive Health, 42(4):230–235, (2010) Warren, Harvey, and Henderson.

Barb: /* 2010 */

2010-09-27T14:54:29Z

2010

← Older revision		Revision as of 09:54, 27 September 2010
Line 18:		Line 18:
	##A common tactic of researchers trying to prove "no association" between A and B is to report results based on a small sample and may also include the use of only those control variables which reduce the statistical association.		##A common tactic of researchers trying to prove "no association" between A and B is to report results based on a small sample and may also include the use of only those control variables which reduce the statistical association.
	##The 95% confidence interval reported by the authors (.027-2.09) indicates that it is 95% likely that the true risk of depression following abortion may be anywhere between 27% and 209% of depression rate found among teens who have not been pregnant. In other words, these findings do not contradict research showing higher rates of depression associated with abortion. Given the small sample size, this broad confidence interval is fully consistent with studies using larger populations which find the range of depression to be in the range of 110% to 200% higher than for women without a history of abortion.		##The 95% confidence interval reported by the authors (.027-2.09) indicates that it is 95% likely that the true risk of depression following abortion may be anywhere between 27% and 209% of depression rate found among teens who have not been pregnant. In other words, these findings do not contradict research showing higher rates of depression associated with abortion. Given the small sample size, this broad confidence interval is fully consistent with studies using larger populations which find the range of depression to be in the range of 110% to 200% higher than for women without a history of abortion.
			##The findings fail to show any benefit from abortion. When abortion was legalized, it was argued that abortion would decrease the rate of depression and mental health problems because it would spare women the difficulties associated with an unplanned pregnancy and unwanted parenthood. Since the study does not show any statistically significant benefits or risks, it is actually a study that tells us nothing because the range of risk is just way to broad to be informative.

	#The outcome measures were superficial assessments. Specifically, the measure of depression was an abbreviated 9 item scale and self-esteem was measure with only 4 items.		#The outcome measures were superficial assessments. Specifically, the measure of depression was an abbreviated 9 item scale and self-esteem was measure with only 4 items.

Barb: /* 2010 */

2010-09-27T14:49:24Z

2010

← Older revision		Revision as of 09:49, 27 September 2010
Line 1:		Line 1:
	== 2010 ==		== 2010 ==
			'''''[http://www.guttmacher.org/pubs/psrh/full/4223010.pdf Do Depression and Low Self-Esteem Follow Abortion Among Adolescents? Evidence from a National Study]''''' Perspectives on Sexual and Reproductive Health, 42(4):230–235, (2010) Warren, Harvey, and Henderson.

			Abstract
			:METHODS: Data from the National Longitudinal Study of Adolescent Health were used to examine whether abortion in adolescence was associated with subsequent depression and low self-esteem. In all, 289 female respondents reported at least one pregnancy between Wave 1 (1994–1995) and Wave 2 (1996) of the survey. Of these, 69 reported an induced abortion. Population-averaged lagged logistic regression models were used to assess associations between abortion and depression and low self-esteem within a year of the pregnancy and approximately five years later, at Wave 3 (2001–2002).

			:RESULTS: Abortion was not associated with depression or low self-esteem at either time point. Socioeconomic and demographic characteristics did not substantially modify the relationships between abortion and the outcomes.

			:CONCLUSIONS: Adolescents who have an abortion do not appear to be at elevated risk for depression or low self esteem in the short term or up to five years after the abortion.

			::EDITOR'S COMMENTS
			<blockquote>
			#This journal is published by the pro-abortion Alan Guttmacher Institute which was founded by Planned Parenthood.
			#The sample of women who aborted was very small (n= 69) reducing the statistical power.
			##This is very important because with small sample size it is much more ''likely'' that one will not find any statistically significant results.
			##The authors acknowledge on page 234 that “The lack of association between abortion and our outcomes could reflect other factors including insufficient sample size to detect an effect.”
			##Very few control variables were employed despite the fact that this data set contains dozens of personal history, personality, relationship, situational, familial, and demographic variables that could have been controlled to isolate the effect of abortion.
			##A common tactic of researchers trying to prove "no association" between A and B is to report results based on a small sample and may also include the use of only those control variables which reduce the statistical association.
			##The 95% confidence interval reported by the authors (.027-2.09) indicates that it is 95% likely that the true risk of depression following abortion may be anywhere between 27% and 209% of depression rate found among teens who have not been pregnant. In other words, these findings do not contradict research showing higher rates of depression associated with abortion. Given the small sample size, this broad confidence interval is fully consistent with studies using larger populations which find the range of depression to be in the range of 110% to 200% higher than for women without a history of abortion.

			#The outcome measures were superficial assessments. Specifically, the measure of depression was an abbreviated 9 item scale and self-esteem was measure with only 4 items.
			#The choice of the comparison group is suspect. The comparison group could have been unintended pregnancy carried to term since the data is available in ADD Health, but the researchers chose the broader “no pregnancy” group as their control group. Another study published regarding the same data set which did use unintended pregnancy delivered as the control group found significant associations between abortion history and marijuana usage, having received counseling for psychological or emotional problems, and sleep difficulties. Seeking professional counseling services is a much more valid measure of psychological distress than abbreviated self-report measures, one of which is merely “predictive of depression”. (See Coleman, P. K. (2006). Resolution of unwanted pregnancy during adolescence through abortion versus childbirth: Individual and family predictors and psychological consequences. The Journal of Youth and Adolescence, 35, 903-911.)


			</blockquote>




	'''''[http://www.hindawi.com/journals/jp/2010/130519.html Late-Term Elective Abortion and Susceptibility to Posttraumatic Stress Symptoms.] ''''' Journal of Pregnancy Volume 2010 (2010)Coleman PK, Coyle CT, Rue VM		'''''[http://www.hindawi.com/journals/jp/2010/130519.html Late-Term Elective Abortion and Susceptibility to Posttraumatic Stress Symptoms.] ''''' Journal of Pregnancy Volume 2010 (2010)Coleman PK, Coyle CT, Rue VM

Barb: /* 2010 */

2010-08-11T15:29:00Z

2010

← Older revision		Revision as of 10:29, 11 August 2010
Line 1:		Line 1:
	== 2010 ==		== 2010 ==

			'''''[http://www.hindawi.com/journals/jp/2010/130519.html Late-Term Elective Abortion and Susceptibility to Posttraumatic Stress Symptoms.] ''''' Journal of Pregnancy Volume 2010 (2010)Coleman PK, Coyle CT, Rue VM

			:(Abstract)

			:The primary aim of this study was to compare the experience of an early abortion (1st trimester) to a late abortion (2nd and 3rd trimester) relative to Posttraumatic Stress Disorder (PTSD) symptoms after controlling for socio-demographic and personal history variables. Online surveys were completed by 374 women who experienced either a 1st trimester abortion (up to 12 weeks gestation) or a 2nd or 3rd trimester abortion (13 weeks gestation or beyond). Most respondents (81%) were U.S. citizens.

			:Later abortions were associated with higher Intrusion subscale scores and with a greater likelihood of reporting disturbing dreams, reliving of the abortion, and trouble falling asleep. Reporting the pregnancy was desired by one’s partner, experiencing pressure to abort, having left the partner prior to the abortion, not disclosing the abortion to the partner, and physical health concerns were more common among women who received later abortions. Social reasons for the abortion were linked with significantly higher PTSD total and subscale scores for the full sample.

			:Women who postpone their abortions may need more active professional intervention before securing an abortion based on the increased risks identified herein. More research with diverse samples employing additional measures of mental illness is needed.



	'''''[http://www.ncbi.nlm.nih.gov/pubmed/20577979 Previous experience of spontaneous or elective abortion and risk for posttraumatic stress and depression during subsequent pregnancy.]''''' Hamama L, Rauch SA, Sperlich M, Defever E, Seng JS. Depress Anxiety. 2010 Jun 23.		'''''[http://www.ncbi.nlm.nih.gov/pubmed/20577979 Previous experience of spontaneous or elective abortion and risk for posttraumatic stress and depression during subsequent pregnancy.]''''' Hamama L, Rauch SA, Sperlich M, Defever E, Seng JS. Depress Anxiety. 2010 Jun 23.

Barb: /* 2010 */

2010-08-03T15:24:59Z

2010

← Older revision		Revision as of 10:24, 3 August 2010
Line 44:		Line 44:

	<br>		<br>
			'''First-time pregnant women's experience of the decision-making process related to completing or terminating pregnancy - a phenomenological study.''' Scand J Caring Sci. 2010 Jul 7. Kjelsvik M, Gjengedal E.

			:(Abstract)
			:Every year about 30,000 women in Norway become unexpectedly pregnant and have to decide whether to complete or terminate the pregnancy. Few studies have been performed of these women's experiences. The aim of this qualitative study was to get new and more extensive information regarding women's experiences relating to their considerations of whether to terminate a pregnancy in the first trimester.

			:In-depth interviews with four participants between 25 and 32 years were conducted. None of them had previously given birth or had had an abortion. Each woman was interviewed twice during a period of 2 weeks. The first interview took place between 7 and 11 weeks into the pregnancy. None of the women had reached a decision on whether to complete or terminate the pregnancy. All the women described an increased awareness of their body and a struggle to make 'the right decision'. They described a desire for autonomy as well as a need for understanding and acknowledgement from significant others and health care providers. They experienced a tension between their pregnant body and the surrounding world, between their own body and the foetus and between their own choice and the opinions of others.

			:One consequence of a woman's right to choose can be an unwanted loneliness or giving in to other people's choices. There is consequently a need for professionals who are able to exercise skilled judgement and who are aware of their own power in the relationship so as to assure that the pregnant woman does in fact makes her own decision.

	== 2009 ==		== 2009 ==

Barb: /* 2008 */

2010-07-27T20:11:40Z

2008

← Older revision		Revision as of 15:11, 27 July 2010
Line 151:		Line 151:

	::"Although decisions on whether to proceed with induced abortion are made on the basis of clinical assessments of the extent to which abortion poses a risk to maternal mental health, these clinical assessments are not currently supported by population-level evidence showing the provision of abortion reduces mental health risks for women having unwanted pregnancy."		::"Although decisions on whether to proceed with induced abortion are made on the basis of clinical assessments of the extent to which abortion poses a risk to maternal mental health, these clinical assessments are not currently supported by population-level evidence showing the provision of abortion reduces mental health risks for women having unwanted pregnancy."

			== 2007 ==

	[[Category:Commentary]] [[Category:Abortion_Risks]] [[Category:Research]]		[[Category:Commentary]] [[Category:Abortion_Risks]] [[Category:Research]]

Barb: Undo revision 1023 by Barb (Talk)

2010-07-27T20:11:14Z

Undo revision 1023 by Barb (Talk)

← Older revision		Revision as of 15:11, 27 July 2010
Line 46:		Line 46:

	== 2009 ==		== 2009 ==

	'''''''[http://tmt.sagepub.com/cgi/content/abstract/1534765609347550v1 "Inadequate Preabortion Counseling and Decision Conflict as Predictors of Subsequent Relationship Difficulties and Psychological Stress in Men and Women"]''''' Catherine T. Coyle, Priscilla K. Coleman, and Vincent M. Rue, ''Traumatology''first published on November 16, 2009 as doi:10.1177/1534765609347550 ''

	:(Abstract)The purpose of this study was to examine associations between perceptions of preabortion counseling adequacy and partner congruence in abortion decisions and two sets of outcome variables involving relationship problems and individual psychological stress. Data were collected through online surveys from 374 women who had a prior abortion and 198 men whose partners had experienced elective abortion. For women, perceptions of preabortion counseling inadequacy predicted relationship problems, symptoms of intrusion, avoidance, and hyperarousal, and meeting full diagnostic criteria for posttraumatic stress disorder (PTSD) with controls for demographic and personal/situational variables used. For men, perceptions of inadequate counseling predicted relationship problems and symptoms of intrusion and avoidance with the same controls used. Incongruence in the decision to abort predicted intrusion and meeting diagnostic criteria for PTSD among women with controls used, whereas for men, decision incongruence predicted intrusion, hyperarousal, meeting diagnostic criteria for PTSD, and relationship problems. Findings suggest that both perceptions of inadequate preabortion counseling and incongruence in the abortion decision with one’s partner are related to adverse personal and interpersonal outcomes. :



	'''''[http://www.ncbi.nlm.nih.gov/pubmed/19880932 Reactions to abortion and subsequent mental health.]''''' Fergusson DM, Horwood LJ, Boden JM. Br J Psychiatry. 2009 Nov;195(5):420-6.		'''''[http://www.ncbi.nlm.nih.gov/pubmed/19880932 Reactions to abortion and subsequent mental health.]''''' Fergusson DM, Horwood LJ, Boden JM. Br J Psychiatry. 2009 Nov;195(5):420-6.