Citation

Biggs MA, Rowland B, McCulloch CE, Foster DG. BMJ Open 2016; 6(2): e009698.

Affiliation

Advancing New Standards in Reproductive Health, A Program of the University of California, San Francisco, Oakland, California, USA.

Copyright

(Copyright © 2016, BMJ Publishing Group)

DOI

10.1136/bmjopen-2015-009698

PMID

26832431

Abstract

OBJECTIVE: To prospectively assess women's risk for post-traumatic stress disorder (PTSD) and of experiencing post-traumatic stress symptoms (PTSS) over 4 years after seeking an abortion, and to assess whether symptoms are attributed to the pregnancy, abortion or birth, or other events in women's lives.

DESIGN: Prospective longitudinal cohort study which followed women from approximately 1 week after receiving or being denied an abortion (baseline), then every 6 months for 4 years (9 interview waves). SETTING: 30 abortion facilities located throughout the USA. PARTICIPANTS: Among 956 women presenting for abortion care, some of whom received an abortion and some of whom were denied due to advanced gestational age; 863 women are included in the longitudinal analyses. MAIN OUTCOME MEASURES: PTSS and PTSD risk were measured using the Primary Care PTSD Screen (PC-PTSD). Index pregnancy-related PTSS was measured by coding the event(s) described by women as the cause of their symptoms. ANALYSES: We used unadjusted and adjusted logistic mixed-effects regression analyses to assess whether PTSS, PTSD risk and pregnancy-related PTSS trajectories of women obtaining abortions differed from those who were denied one.

RESULTS: At baseline, 39% of participants reported any PTSS and 16% reported three or more symptoms. Among women with symptoms 1-week post-abortion seeking (n=338), 30% said their symptoms were due to experiences of sexual, physical or emotional abuse or violence; 20% attributed their symptoms to non-violent relationship issues; and 19% said they were due to the index pregnancy. Baseline levels of PTSS, PTSD risk and pregnancy-related PTSS outcomes did not differ significantly between women who received and women who were denied an abortion. PTSS, PTSD risk and pregnancy-related PTSS declined over time for all study groups.

CONCLUSIONS: Women who received an abortion were at no higher risk of PTSD than women denied an abortion.

Language: en