Emotional Impact of
Abortion, Miscarriage Varies

Although women who have an abortion may have a lesser immediate emotional reaction than those who miscarry, the long-term impact may be stronger for some, a new study suggests.

Researchers in Norway found that women who'd had an abortion two years earlier were more likely than those who'd miscarried to be suppressing thoughts and feelings about the event -- although most women did not show this reaction.

Overall, nearly 17 percent of 80 women who'd had an abortion scored highly on a scale measuring such "avoidance" symptoms, compared with about three percent of those who'd miscarried.

That's in contrast to responses 10 days after the miscarriage or abortion, when nearly half of those who miscarried and 30 percent of those who had an abortion scored highly on measures of avoidance or "intrusion," which includes symptoms such as flashbacks and bad dreams.

The findings suggest that women who have an abortion or miscarriage should be encouraged to talk about their feelings instead of holding them inside, according to study leader Dr. Anne Nordal Broen.

"We know that suppression of thoughts and feelings connected to an event is not a healthy way to deal with difficult psychological responses," Broen, a specialist in psychiatry at the University of Oslo, stated.

"It is better to talk about what happened, let the natural feelings come out," she said.

Broen and her colleagues report their findings in the journal Psychosomatic Medicine.

The study included 120 women between the ages of 18 and 45 treated at one Norwegian hospital; 80 had an abortion before the 14th week of pregnancy, and 40 miscarried in the first or second trimester. The women completed standard questionnaires on avoidance and intrusion symptoms 10 days, six months and two years after the miscarriage or abortion.

Broen's team found that women with strong feelings of shame, grief or loss at the first time point were more likely than others to have continuing symptoms of avoidance or intrusion two years out.

Broen said this suggests that doctors should be "extra observant" of such women over the long term, and be ready to provide them with more follow-up care. Family and friends, she noted, should also be prepared to give support.

"Women with a miscarriage or an induced abortion should be encouraged to talk and allow themselves to have feelings about what happened," she said.

SOURCE: Psychosomatic Medicine, March/April 2004.

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