Academic journal article Journal of Prenatal & Perinatal Psychology & Health

Universal Responses to Abortion? Attachment, Trauma, and Grief Responses in Women Following Abortion

Academic journal article Journal of Prenatal & Perinatal Psychology & Health

Universal Responses to Abortion? Attachment, Trauma, and Grief Responses in Women Following Abortion

Article excerpt

ABSTRACT: Twenty-six million legal abortions occur each year worldwide. Of these an unknown percentage of women have adverse psychological sequelae. This article reports on interviews with a nonrandom sample of fifty women regarding reproductive history, abortion experiences and emotional responses in the former Soviet Union country of Belarus, where abortions are often used as a primary form of birth control. Both positive and negative responses were queried but emphasis was on cross-cultural comparisons with western samples regarding posttraumatic sequelae, depression, grief and guilt, and using an objective measure of trauma symptoms, the Impact of Events Scale-Revised (IES-R). Comparisons with existing Western literature allowed the question of: Similar to the cross-cultural concept of posttraumatic stress disorder are their possibly universal responses to abortion as well? As in western samples, attachment and recognition of life during pregnancy were present for many women despite choosing abortion, and eightytwo percent of the sample reported posttraumatic sequelae, which is high. Grief, guilt, dissociation, depression, anxiety and psychosomatic responses were also in common across cultures. The authors conclude that despite disparate circumstances and abortion use, women who have adverse responses are very similar across these two divergent cultures. They call for more research using representative samples to learn what percentage of women are likely to have adverse responses and which variables predict negative responses.

KEY WORDS: PTSD, abortion, attachment, avoidance, grief, guilt, pregnancy decision-making, physicians and abortion, cross-cultural aspects.

INTRODUCTION

Worldwide there are an estimated twenty six million legal abortions per year (Alan Guttmacher Institute, 1999). While most women fare well after abortion, there are some women for whom abortions involve health or psychosocial consequences. Studies of American women and more recently Russian women have shown that at least small minorities of women opting for abortion suffer psychological consequences. Their symptoms range from short-term mild distress to posttraumatic stress disorders (Bagarozzi, 1994; Barnard, 1990; Butterfield, 1988; Forst, J.G., 1992; Major, et al., 2000; Mufel, 2000b; Ney, 1982; Rue & Speckhard, 1996; Speckhard, 1987; Speckhard & Rue, 1992). Given the huge numbers of women involved, it is of interest to understand the dynamics of post-abortion distress and to untangle why some women do not cope well with abortion and are at times even traumatized by it. Likewise given that in every culture the choice for abortion and its psychosocial consequences are influenced by societal practices, it is of interest to learn if negative psychosocial responses to abortion are different or similar across divergent cultures.

The main purpose of this study was to examine women in an Eastern European country (Belarus) in regard to contraceptive attitudes, behaviors and decision-making and psychosocial responses to abortion. Abortion practices in many regions of Eastern Europe and the former Soviet Union differ from the West. Modern contraceptives are less readily available, whereas abortion is widely available, meaning that abortion often becomes de facto the primary form of fertility control. Likewise, the grim economics and housing shortages create a situation in which women who are faced with an unplanned, ill-timed or unhealthy pregnancy find abortion a necessary fact of life.

For the purposes of this study, an American and Belarusian psychologist collaborated in an exploratory study of abortion experiences to discover if there are significant differences across cultures or if women react similarly to their abortions even in such divergent social contexts. It was of interest to the researchers to learn if a minority of Belarusian women might experience posttraumatic responses to abortion, similar to that reported in Western clinical studies, or if they would evidence guilt or grief responses as reported in western samples. …

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