The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up studyReport as inadecuate

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BMC Medicine

, 3:18

First Online: 12 December 2005Received: 08 July 2005Accepted: 12 December 2005DOI: 10.1186-1741-7015-3-18

Cite this article as: Broen, A.N., Moum, T., Bødtker, A.S. et al. BMC Med 2005 3: 18. doi:10.1186-1741-7015-3-18


BackgroundMiscarriage and induced abortion are life events that can potentially cause mental distress. The objective of this study was to determine whether there are differences in the patterns of normalization of mental health scores after these two pregnancy termination events.

MethodsForty women who experienced miscarriages and 80 women who underwent abortions at the main hospital of Buskerud County in Norway were interviewed. All subjects completed the following questionnaires 10 days T1, six months T2, two years T3 and five years T4 after the pregnancy termination: Impact of Event Scale IES, Quality of Life, Hospital Anxiety and Depression Scale HADS, and another addressing their feelings about the pregnancy termination. Differential changes in mean scores were determined by analysis of covariance ANCOVA and inter-group differences were assessed by ordinary least squares methods.

ResultsWomen who had experienced a miscarriage had more mental distress at 10 days and six months after the pregnancy termination than women who had undergone an abortion. However, women who had had a miscarriage exhibited significantly quicker improvement on IES scores for avoidance, grief, loss, guilt and anger throughout the observation period. Women who experienced induced abortion had significantly greater IES scores for avoidance and for the feelings of guilt, shame and relief than the miscarriage group at two and five years after the pregnancy termination IES avoidance means: 3.2 vs 9.3 at T3, respectively, p < 0.001; 1.5 vs 8.3 at T4, respectively, p < 0.001. Compared with the general population, women who had undergone induced abortion had significantly higher HADS anxiety scores at all four interviews p < 0.01 to p < 0.001, while women who had had a miscarriage had significantly higher anxiety scores only at T1 p < 0.01.

ConclusionThe course of psychological responses to miscarriage and abortion differed during the five-year period after the event. Women who had undergone an abortion exhibited higher scores during the follow-up period for some outcomes. The difference in the courses of responses may partly result from the different characteristics of the two pregnancy termination events.

Electronic supplementary materialThe online version of this article doi:10.1186-1741-7015-3-18 contains supplementary material, which is available to authorized users.

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Author: Anne Nordal Broen - Torbjørn Moum - Anne Sejersted Bødtker - Øivind Ekeberg


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