Newly Published Journal Articles

Adair, L., Lozano, N., & Ferenczi, N. (2024). Abortion attitudes across cultural contexts: Exploring the role of gender inequality, abortion policy, and individual values.International Perspectives in Psychology: Research, Practice, Consultation, 13(3), 138–152.​

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https://doi.org/10.1027/2157-3891/a000101

https://psycnet.apa.org/fulltext/2025-01759-004.html

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Between-country and within-country variability in abortion attitudes were examined, using country-level factors and individual-level factors as predictors. Respondents were from Mexico (N = 215), India (N = 215), the United States (N = 215), and the United Kingdom (N = 206). As hypothesized, individuals living in countries with greater gender inequality and more restrictive abortion policies expressed more restrictive abortion attitudes and stronger endorsement for banning abortion. More traditional gender role ideologies, belief in “big/moralizing gods,” and use of long-term sexual strategies were associated with more restrictive abortion attitudes and more robust support for banning abortion. The authors concluded that both contextual factors (e.g., local abortion legislation and gender inequality) and individual difference factors (e.g., gender role attitudes and religious/spiritual beliefs) are instrumental in shaping people’s attitudes toward abortion. Implications of bidirectional relationship between attitudes and policy in the reproductive health arena are discussed.​

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Aflaki, K., Ray, J., Edwards, W. et al. (2024). Maternal deaths by suicide and drug overdose in two Canadian provinces; Retrospective review. Journal of Obstetrics and Gynaecology Canada. 46. 102581. 10.1016/j.jogc.2024.102581.​

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https://www.jogc.com/article/S1701-2163(24)00404-3/fulltext

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The stated objective of this study was to “identify and review factors associated with maternal deaths by suicide and drug overdose” by looking at records in the Canadian Coroner and Medical Examiners Database between the years 2017 and 2019. The authors identified potential deaths related to maternity for females aged 10 to 60 years. Of the 90 deaths reviewed, it was found that 15 were the result of suicide, and 20 were caused by drug overdose. The ages for these deaths varied, and their life and pregnancy status varied. Additional findings found that 10 of the suicides were by hanging, and 15 had fentanyl in their system. The authors conclude from the totality of their conclusions that, alarmingly, maternal deaths related to suicide and overdose may be a more significant factor in the overall level of maternal deaths in Canada than was previously thought. More deaths occurred after the index pregnancy than during the pregnancy, especially after a miscarriage or induced abortion. The authors suggest that specific programs are needed to help identify the women who are at the highest risk of these mortality outcomes and provide intervention not only during pregnancy but even beyond the postpartum period.​

Aryal, S., & Basnet, R. S. (2024). First Trimester Abortion and Psychiatric Morbidity. Journal of Nepal Health Research Council, 22(1), 58–65.​

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https://pubmed.ncbi.nlm.nih.gov/39080938/

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The general aim of this study was to find the prevalence of depression and anxiety before and after undergoing spontaneous or induced first-trimester abortion. Also analyzed were demographic and obstetric factors associated with mental health outcomes. This study was conducted at Kathmandu Medical College (KMC) for a year from September 2022 through August 2023. The clients were assessed at their first hospital visit and then at two weeks and two months post-abortion. Levels of anxiety and depression were measured about socio-demographic factors as well as the type of abortion. Pre-abortion, severe anxiety was present in 13% of the 171 clients with spontaneous abortion, and mild to severe anxiety was present in 67.3% of clients. Two weeks and two months in 11, 23.9%  and 23.9% of clients reported severe and mild to severe anxiety, respectively. In clients undergoing an induced abortion, varying levels of anxiety were present in 43.2% pre-abortion and 38.4% 43.2% at two weeks and two months, respectively. Mild to moderate depression was seen in 45.6% of those who experienced spontaneous abortion and 51 40.8% of clients who had an induced abortion. The mean score on the depression measure decreased with time. The authors concluded by noting that anxiety and depression were common in response to early pregnancy loss, with anxiety decreasing over time in spontaneous abortion but remaining persistent in induced abortion. The rate of depression tends to decrease with time for both types of loss.​

Ayen, S. S., Kasahun, A. W., & Zewdie, A. (2024). Depression during pregnancy and associated factors among women in Ethiopia: a systematic review and meta-analysis. BMC pregnancy and childbirth, 24(1), 220.​

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https://doi.org/10.1186/s12884-024-06409-y

https://link.springer.com/article/10.1186/s12884-024-06409-y

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For background purposes, the authors noted that an estimated 25-35% of pregnant women experience depressive symptoms, with 20% meeting criteria for major depression. This study systematic review and meta-analysis was undertaken to examine depression during pregnancy in Ethiopia. The overall pooled prevalence of depression derived from the 18 included studies in Ethiopia was 27.85%. Factors significantly associated with depression included unplanned pregnancies, low social support, low income, previous history of depression, intimate partner violence, and history of abortion.​

Baron, T., Svingen, E., & Leyva, R. (2024). Surrogacy and Adoption: An Empirical Investigation of Public Moral Attitudes. Journal of bioethical inquiry, 10.1007/s11673-024-10343-1. Advance online publication.

 

https://doi.org/10.1007/s11673-024-10343-1

https://link.springer.com/article/10.1007/s11673-024-10343-1

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For context, relinquishment and adoption are both subject to heavy levels of regulation domestically and internationally due to them being “family-making measures.” For this study. 1552 individuals were surveyed to gather information on public opinion in the UK regarding the different forms of surrogacy and methods of adoption in practice. Part of the motivation for this was a recent proposal to make a legal path for “double donor” surrogacy. They not only looked for opinions on general support levels for adoption and surrogacy but also to gauge the impact on the opinions of the participants that the adoptive parent’s fertility had but also looked for similarities in how they viewed double donor adoption vs. planned private adoptions and the moral implications they had for the participants. The results showed a decent baseline of support across the board for all methods of surrogacy and adoption and also that this level of support tends to rise significantly if at least one of the adoptive parents isn’t fertile. Findings also suggested that the language that is used to characterize the arrangements had a larger positive impact on moral support than items such as biological relationships.

Bartlomiejczyk, M., Poellabauer, S., & Straczek-Helios, V. (2024). Activist interpreting in abortion clinics: Emotional challenges and self-care strategies. Translation & Interpreting Studies: The Journal of the American Translation and Interpreting Studies Association, (online first), 1-28. 

 

https://doi.org/10.1075/tis.23064.bar

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https://ucrisportal.univie.ac.at/en/publications/activist-interpreting-in-abortion-clinics-emotional-challenges-an

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The authors of this study sought to take a closer look at a group of pro-choice activists from Vienna, “Clocia Wienia,” and their role as “interpreters” for people who travel to obtain an abortion (Poland to Austria) and to examine how their job impacts their own mental health and ability to self-care. The authors used data from interviews with members or people associated with Clocia Wienia to gain insight. Results showed that their work was taxing for them, and many experienced negative emotions such as anger and sadness. It was also difficult for them to develop self-care strategies and coping strategies in the unusual environment and role they were in. Not all had negative experiences; however, the authors found a distinct lack of self-care and positivity within this line of work.

Bialek, K., Sadowski, M., Adamczyk-Gruszka, O., Młodawski, J., & Świercz, G. (2024). Level of basic hope and symptoms of anxiety and depression in women after miscarriage. Archives of medical science: AMS, 20(1), 332–338.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10895938/

 

The aim of this study was to measure the level of basic hope as well as symptoms of anxiety and depression among women following miscarriage. Patients hospitalized at the Provincial Combined Hospital in Kielce due to miscarriage were the participants, with the assessment period from September 2019 to August 2021. Results revealed that the level of hope significantly increased after 3 months compared to this level during hospitalization. Stronger feelings of hope were associated with lower levels of anxiety and depression.

Bolsby, S., Breen, K., & Wu, H. (2024). Bringing birth fathers to the forefront: A two‐decade scoping review of birth father experiences in adoption. Journal of Family Theory & Review. Advance online publication.

 

https://doi.org/10.1111/jftr.12590

https://onlinelibrary.wiley.com/doi/10.1111/jftr.12590?af=R

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Part of the motivation for this article was the lack of representation of birth fathers within what the authors refer to as the “Adoption Galaxy” or the conversation and consideration held around and given towards the adoptive process. The authors specifically aimed to gain a robust understanding of our collective current information regarding the experiences of birth fathers in adoption. A review was conducted of 100 articles that had been peer-reviewed and published between the years 2000 and 2022 on the topic of birth fathers in adoption. The authors confirmed that their quantitative analysis showed a general global lack of research on birth. Some important emergent themes on birth fathers were “a lack of openness, negative stereotypes, gatekeeping, and emotional impacts.” The authors conclude that their findings highlight the importance of considering this underrepresented group.

Boydell, N., Buijsen, S., Reynolds-Wright, J. J., Cameron, S. T., & Harden, J. (2024). Abortion patients' perspectives on enhancing a telemedicine model of post-abortion contraception: a qualitative study. BMJ sexual & reproductive health, bmjsrh-2024-202428. Advance online publication.

 

https://srh.bmj.com/content/early/2024/09/04/bmjsrh-2024-202428

 

Access to contraception after a woman has an abortion is identified as “critical” for curbing unintended pregnancies among women who have had an abortion. When seeking contraception, women often have trouble with identification access and choice due to a lack of knowledge or provided information. This service evaluation aimed to explore the perspectives on contraceptive telemedical consultations of patients who had previously had an abortion as well as their decision-making process regarding contraceptive seeking in order to help inform future telemedicine service models. Interviews with 15 patients who had utilized a telemedicine service from home were conducted and then subjected to “reflexive” thematic analysis. The results of the interviews showed that discussions about contraceptives during the consultation were seen as valuable due to the fact that they helped inform choices. It was also found that decision-making was impacted by a variety of factors, including “previous contraception experiences, emotional state at the time of the abortion and concerns about contraceptive ‘failure’.”.  In addition, some interviewees preferred non-hormonal contraceptive methods due to previous negative experiences with them. Barriers found for the women attempting to access their preferred method of contraception included primarily the availability of appointments and/or the patient's responsibility to care for others. The need for flexibility in consultations and personalized interactions with experts is highlighted.

Bradford, B.F., Hayes, D.J.L., Damhuis, S. et al. (2024). Decreased fetal movements: Report from the International Stillbirth Alliance conference workshop. Int J Gynecol Obstet. 2024; 165: 579-585. doi:10.1002/ijgo.15242

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https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.15242

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Reports by women of decreased fetal movement (DFM) are often a reason for pregnant women to seek maternity care and has been associated with stillbirth as well as other serious adverse outcomes. The authors put forward that promoting better awareness of DFM and a higher level of attention to fetal movements has been a way to somewhat reduce stillbirths. In order to persuade clinical management of these presentations further evidence is needed.  A workshop in Sydney, Australia, “The International Stillbirth Alliance Virtual Conference” provided an opportunity for experts in fetal movement from around the world to share their findings and bring awareness of current trials. After this workshop summaries were made and the information shared compiled, so that the information can be used to guide further DFM research.

Brandt, E., & Maner, J. K. (2024). Attitudes and Laws About Abortion Are Linked to Extrinsic Mortality Risk: A Life-History Perspective on Variability in Reproductive Rights. Psychological science, 35(2), 111–125.

 

https://journals.sagepub.com/doi/10.1177/09567976231217410?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

 

The authors note that abortion policy has been conventionally perceived to be a political matter with “religious overtones” and they propose a different view. The authors argue that from the perspective of evolutionary biology, abortion at a young age may represent prioritization of long-term development over immediate reproduction, a pattern established in other species “as resulting from stable ecologies with low mortality.” The authors examined the extent to which laws and moral beliefs regarding abortion are linked to local mortality rates. Data from 50 U.S. states, 202 world societies, 2,596 adult individuals in 363 U.S. counties, and 147,260 respondents across the globe suggested that lower levels of mortality risk are associated with more permissive laws and attitudes toward abortion. The associations were observed after controlling for religiosity, political ideology, wealth, education, and industrialization. However, controls were not instituted for the average number of children per household and other macro-level variables. The authors also cautioned that third-variable and reverse-causality explanations are plausible. They cautioned, “Because the current findings are based on analyses of correlational, cross-sectional, aggregated data coming from different years, we cannot draw strong causal conclusions about the nature of the relationship.”

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Clapton, G. (2024). “The Past Is Never Dead. It’s Not Even Past” (Faulkner, 1919 Requiem for a Nun p. 85): Mapping and Taking care of the ghosts in adoption. Genealogy, 8(2), 37.

 

https://doi.org/10.3390/genealogy8020037

https://www.mdpi.com/2313-5778/8/2/37

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The author of this paper purports that while the “Code of Ethics of the Association of Professional Genealogists” promotes coherent, concise, and organized information, it’s not so straightforward doing so when adoption is a factor for a family. In this paper, it’s put forward that “standard approaches” to understanding adoption family tree composition don’t provide a complete picture, including “the complexities, gaps, and challenges” that adoption entails. The author makes a case in this paper that there is a need for “family historians” to be alert to the adoption process and keep a quantitative record of those affected. A primary objective of this paper was the author's argument that some in the adoption process are essentially “erased” by it in terms of consideration for them within it. The author presents a “ghost world” where many possible “could be” lives and those disenfranchised from the adoption process exist outside of public consideration.  The author concludes the paper by saying, “Should genealogists overlook adoption’s ghosts, then they overlook the opportunity to professionally map a rich and varied world of family knowledge and connections.”

Cawayu, A., & Sacré, H.P. (2024). Can first parents speak? A Spivakean reading of first parents’ agency and resistance in transnational Adoption. Genealogy, 8(1),8.

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https://www.mdpi.com/2313-5778/8/1/8

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The goal of this article was to make an analysis of the search strategies birth families/parents in Bolivia use to continue contact and avoid complete separation from their biological child after they have been through the transnational adoption process. The desire for acknowledgment and visibility by these parties has been mostly ignored by adoption policy and academia, favoring support for adoptive families in other countries instead.  In this article, the authors discuss strategies for searching utilized by birth families seeking contact to fill in the knowledge gap in the public space. They gathered information by analyzing the ethnographic fieldwork pertaining to 14 families in Bolivia. According to the authors, these families found that the legal rights of these families had been significantly diminished through the international adoption process. Because of this, the authors conclude the act of searching for a child should be seen as a claim and request to regain consent to have contact with their birth child, as they do not have other avenues to travel to seek reunion.

Chemouny M, Wendland J. (2024). The experience of miscarriage and its impact on prenatal attachment during the following pregnancy: A mixed-methods study. Midwifery, 136:104072. DOI: 10.1016/j.midw.2024.104072. PMID: 38945103.

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https://www.sciencedirect.com/science/article/pii/S0266613824001554?via%3Dihub

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Miscarriages in France impact almost 200,000 women yearly and it is known that miscarriages have negative consequences in terms of the mother’s mental health as well as mother-child relationships with subsequent children. The objective of this cross-sectional study was to gather information about the impact of miscarriages on mothers, particularly regarding their subsequent pregnancies. The participant pool consisted of 267 French women who had previously had a miscarriage They answered online questionnaires regarding their experiences. The questions were intended to measure “prenatal attachment, partner support, history of previous pregnancies and miscarriages, the current pregnancy,” and “body experience.” Results showed that those who reported a high degree of investment in their current pregnancy, a supportive partner, and a positive body image had greater amounts of attachment prenatal. In addition, having a miscarriage tended to influence attachment, and those with a high degree of pregnancy investment had higher, more positive attachment. The authors conclude that the findings underline the importance of classifying miscarriage as perinatal loss so that proper support can be allocated to the women affected and the correct advice given

Cheng, J. & Xu, P., & Thostenson, C. (2024). Psychological traits and public attitudes towards abortion: the role of empathy, locus of control, and need for cognition, Palgrave Communications, Palgrave Macmillan, 11(1), pages 1-1

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https://ideas.repec.org/a/pal/palcom/v11y2024i1d10.1057_s41599-023-02487-z.html

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The purpose of this study was to examine the role of psychological traits such as empathy, locus of control, and need for cognition in association with abortion attitudes. A sample of 294 U.S. adults were asked to provide their attitudes on seven abortion scenarios in addition to responding to questions measuring empathy toward the pregnant woman and the unborn, locus of control, and need for cognition. Principal Component Analysis divided abortion attitudes into two categories: traumatic abortions (e.g., pregnancies due to rape) and elective abortions (e.g., the woman does not to give birth). After control for the respondents’ religious beliefs and political ideology, the study results revealed that psychological factors accounted for substantial variation in abortion attitudes. Specifically, empathy toward the pregnant woman correlated positively with abortion support across both categories, while empathy toward the unborn revealed an inverse relationship with the two categories. An internal locus of control was positively linked to support for both types of abortions. External locus of control and need for cognition only positively correlated with attitudes toward elective abortion. The authors concluded, “Collectively, these findings underscore the significant and unique role psychological factors play in shaping public attitudes toward abortion.”​

Christiansen, F., Petersen, J., Thorius, I. H., Ladelund, A., Jimenez-Solem, E., Osler, M., & Ankarfeldt, M. Z. (2024). Adverse Pregnancy Outcomes and Subsequent First-Time Use of Psychiatric Treatment Among Fathers in Denmark. JAMA network open, 7(5), e249291.

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https://doi.org/10.1001/jamanetworkopen.2024.9291

https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2818118

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The authors noted little is known how different adverse pregnancy outcomes are associated with increased paternal risk for need of psychiatric treatment in the post partum. The objective of the study was to examine adverse pregnancy outcomes predictors of first-time psychiatric treatment in first-time fathers. This was a national cohort study with data gathered from Danish, registers. Participants included first-time fathers with no history of psychiatric treatment. Adverse pregnancy outcomes included induced abortion, spontaneous abortion, stillbirth, small for gestational age (SGA) and not preterm, preterm with or without SGA, minor congenital malformation, major congenital malformation, and congenital malformation combined with SGA or preterm compared with a full-term healthy offspring. Outcomes included prescription of psychotropic drugs, nonpharmacological psychiatric treatment, or having a psychiatric hospital contact up to 1 year after the end of the pregnancy. Of the 192455 fathers included, 31.1% experienced an adverse pregnancy outcome. Results revealed that fathers who experienced a stillbirth had a significantly increased risk of nonpharmacological psychiatric treatment and treatment with hypnotics. Fathers who had experienced an early induced abortion (≤12 wk) had an increased risk of initiating treatment with hypnotics and anxiolytics. Late induced abortion (>12 wk) and major congenital malformation predicted increased risk of nonpharmacological treatment. Finally, fathers who had a child born preterm, SGA, or with a minor congenital malformation did not experience any increased risks. The authors concluded by noting, their findings indicate a need for increased awareness around fathers’ psychological state after experiencing adverse pregnancy outcomes.​

Cowan, S. K., Hout, M., & Perrett, S. (2024). Updating a Time-Series of Survey Questions: The Case of Abortion Attitudes in the General Social Survey. Sociological Methods & Research, 53(1), 193-234.

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 https://doi.org/10.1177/00491241211043140

https://journals.sagepub.com/doi/abs/10.1177/00491241211043140

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The authors propose a protocol for updating measures to preserve content and construct validity in light of social change. The process includes the following steps: First, experts describe the current and anticipated future terms of debate. Second, experts use this input and their knowledge of existing measures to develop and pilot a large set of new items. Third, researchers analyze the pilot data to select items to include in the survey of record. Finally, the items comprise the survey-of-record and are available to the user community. Surveys-of-record would have procedures for changing content designed to assess if the new items should appear just once or become part of the core. In the article, the authors provide an example of the development of new abortion attitude measures in the General Social Survey. Current questions ask whether abortion should be legal under different circumstances. In addition, the new abortion items address morality, access, state policy, and interpersonal dynamics. The authors note that the new items “improve content and construct validity and add new insights into Americans’ abortion attitudes.”

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Doyle, C., Che, M., Lu, Z., Roesler, M., Larsen, K., & Williams, L. A. (2023). Women's desires for mental health support following a pregnancy loss, termination of pregnancy for medical reasons, or abortion: A report from the STRONG Women Study. General hospital psychiatry, 84, 149–157.

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https://pubmed.ncbi.nlm.nih.gov/37490825/

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This study was undertaken to explore women's mental health care desires following a miscarriage, medical termination, or abortion. The participants included 689 women, who completed a questionnaire on reproductive history, health care following miscarriage/medical termination/abortion, and current mental health. Results revealed that current mental health did not differ between women with a history of miscarriage/termination/abortion and those with only live births. Following miscarriage, 68% of women discussed options for the medical management with their provider, 32% discussed grief/loss, and 25% reported receiving mental health care recommendations. Engagement in mental health services was reported by 16% of women who had a miscarriage, by 38% following a medical termination, and by19% after an abortion. Examination of a subgroup of women who became pregnant after their most recent miscarriage/termination/abortion and did not receive mental health services, revealed that 55% wished they had done so during the subsequent pregnancy. The authors recommended improved access to mental health care for these individuals experiencing the forms of reproductive loss examined in the study.​

Eilat S. (2024). "Just forget about it and move on": Stillbirth ruptured and repaired narratives beyond expectant futures. Sociology of health & illness, 46(6), 1275–1291.

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https://onlinelibrary.wiley.com/doi/10.1111/1467-9566.13810

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For context, literature regarding the important sociological aspects of women who experience stillbirths has been done. However, little attention has been paid to how these explored consequences can be expressed through “narrative negotiations” over time. This article focuses on the experiences of Jewish-Israeli women with stillbirths in their history. Of note in their narratives, women disagreed with expectations held for them by professionals, family, and friends. Especially “dictation of their future”, such as wanting the woman to get pregnant again shortly after for the needs of others. A way of reshaping their narratives in a positive way is by doing something that the author refers to as “thickening a present tense” by extending caring feelings or behaviors to the stillborn in the aftermath. This article serves as a contribution to the existing literature and provides a perspective on the concept of narrative changing pertaining to stillbirth.

Froeliger, A., Deneux-Tharaux, C., & Loussert, L. et al. (2024). Prevalence and risk factors for postpartum depression 2 months after a vaginal delivery: a prospective multicenter study. American Journal of Obstetrics and Gynecology, 230 (3).

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https://www.sciencedirect.com/science/article/pii/S0002937823005963?casa_token=b0QrGs95NUIAAAAA:1MzcbKwI7ZyfOjBygoiNNfN3ggv6amNHD7kvodT2fJQqdOvmBZrnNkFtYsu3wLBFQ8DdhnzDIA

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The authors noted that very little is known about the prevalence and risk factors of postpartum depression among women with vaginal births who do not experience major pregnancy complications. Data were gathered from 15 French hospitals in 2015 and 2016, enrolling women with singleton vaginal deliveries after 35 weeks of gestation. The characteristics of labor, delivery, and the immediate postpartum experience, including the experience of childbirth, were prospectively measured while medical records were utilized to gather data on other characteristics. The study questionnaire was returned by 2811 of 3891 women (72.2%). The characteristics associated with higher risks of postpartum depression were mostly related to pre-pregnancy characteristics, including younger age, advanced age, migration from North Africa, previous abortion, and psychiatric history. A few characteristics of labor and delivery were related to post-partum depression (induced labor and operative vaginal delivery). Bad memories of childbirth in the immediate postpartum were strongly associated with postpartum depression symptoms at 2 months following birth. A screening approach that targets women at risk of postpartum depression who may benefit from early intervention is suggested.​

Gautam, P., Puri, M. C., Karki, S., & Foster, D. G. (2024). Deaths among Women of Reproductive Age: An explorative Case Study among Abortion Seekers. Journal of Nepal Health Research Council, 21(4), 692–696.

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https://doi.org/10.33314/jnhrc.v21i4.4871

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Abortion was legalized in Nepal in 2002, yet many women are denied abortion services and continue their pregnancies or find abortion care elsewhere. What remains unknown is the consequences (to the women and children) after abortion or after being denied one. Women were interviewed after six weeks and then every six months for three years. During the follow-up interviews, the field research assistants were informed about the death of the clients. Once the death was reported, a trained senior research staff visited the deceased person’s house and the family of the deceased (husbands, maternal parents, in-laws) to explore the cause of death. Nine deaths were reported between April 2019 and December 2022. Of the nine deceased women, four had abortions, while five of them were initially denied abortion services. The majority of the deaths were due to suicide, followed by tuberculosis. None of the deaths were caused by abortion or birth.​

Goldberg, M., Sberro-Cohen, S., Tamsot, N., Valid, T.B., & Kasten, C. (2024) From darkness to light: Accompanying women giving stillbirth in a public hospital. Int J Nurs Health Care Res, 7, 526. DOI

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https://doi.org/10.29011/2688-9501.101526

https://www.gavinpublishers.com/assets/articles_pdf/From-Darkness-to-Light-Accompanying-Women-Giving-Stillbirth-in-a-Public-Hospital.pdf

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For context, the event of stillbirth is seen as traumatic, bearing long-lasting impacts both psychologically and emotionally on women and men. Sadly, the level of care and support received for those who experience a stillbirth is often lacking, leading to prolonged grief and suffering. This article aimed to examine stillbirth experiences and assess the care used to support these patients. The authors found that, among other things, communication and inadequate support from medical professionals were two pervasive issues being reported. Greater levels of distress were found to be worsened by things such as “social isolation, insensitive comments, and a lack of support groups.” The authors conclude that it is pivotal for these women that we improve their level of care and support. Better training and support for professionals to help them provide empathetic, supportive care is needed, as well as implementing more comprehensive protocols such as “respectful rituals” and memory items to facilitate a healthy grief process.​

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Gouy, G., Attali, L., Voillot, P., Fournet, P., & Agostini, A. (2024). Experiences of Women with Medical Abortion Care Reflected in Social Media (VEILLE Study): Noninterventional Retrospective Exploratory Infodemiology Study. JMIR infodemiology, 4, e49335.

 

https://doi.org/10.2196/49335

 

The authors of this exploratory study aimed to analyze, through French social media posts, personal medical symptoms and the different experiences and information dynamics associated with medical abortion. Social media posts from publicly available web forums published from January 1, 2017 through November 30, 2021 were analyzed. Biterm topic modeling was used to identify the main discussion themes and the Medical Dictionary for Regulatory Activities was used to identify medical terms. Encountered difficulties were explored qualitatively. Analysis of 5398 identified posts (3409 users) led to 9 major topics: personal experience (n=2413 posts, 44.7%), community support (n=1058, 19.6%), pain and bleeding (n=797, 14.8%), psychological experience (n=760, 14.1%), questioned efficacy (n=410, 7.6%), social pressure (n=373, 6.9%), positive experiences (n=257, 4.8%), menstrual cycle disorders (n=107, 2%), and reported inefficacy (n=104, 1.9%). Pain, mentioned in 30.1% was the most frequently reported medical term. Pain was considered severe to unbearable in 24.5% of the cases. Lack of information was the most frequently reported difficulty during and after the process.

He, Y., Wang, L., Tang, R., Jin, H., Liu, B., Chen, S., Mu, H., & Wang, X. (2024). Common mental disorders and risk of spontaneous abortion or recurrent spontaneous abortion: A two-sample Mendelian randomization study. Journal of affective disorders, 354, 258–266.

 

https://doi.org/10.1016/j.jad.2024.03.026

 

The general aim was to explore causal relationships between common mental disorders (anxiety disorders, broad depression, major depressive disorder (MDD), bipolar disorder, and insomnia) and miscarriage and recurrent spontaneous abortion (RSA). Mendelian randomization results revealed the four mental disorders were found to be causally associated with spontaneous abortion (anxiety disorder, major depressive disorder, bipolar disorder, and insomnia. No causal relationship was detected between broad depression and spontaneous abortion, and five common mental disorders were not causally associated with the RSA. The authors recommend future studies on whether mental disorders directly lead to RSA (particularly unexplained RSA).

Hsu, H. W., Huang, J. P., Au, H. K., Lin, C. L., Chen, Y. Y., Chien, L. C., Chao, H. J., Lo, Y. C., Lin, W. Y., & Chen, Y. H. (2024). Impact of miscarriage and termination of pregnancy on subsequent pregnancies: A longitudinal study of maternal and paternal depression, anxiety and eudaimonia. Journal of affective disorders, 354, 544–552.

 

https://doi.org/10.1016/j.jad.2024.03.054

https://www.sciencedirect.com/science/article/pii/S0165032724004701?casa_token=syYn3hCdtAQAAAAA:vJpC-r-q_WWeY2EIPs_wGWhCm0UzjWgth_tmXk7CqNzUHGihoPEMnDWfvJ9eYJxPxj7SzvylQQ

 

This longitudinal study explored associations between miscarriage and termination and indicators of parental well-being in subsequent pregnancies (prenatal to postpartum years), with consideration for parity. Positive mental health (e.g., eudaimonia) of both first-time and multi-time parents, focusing on paternal responses was considered a new contribution given limited existing data in professional literature. Pregnant women and their partners were recruited during early prenatal visits extending from 2011 to 2022 in Taiwan. Follow-up occurred from mid-pregnancy to 1 year postpartum with 6 waves of self-report data collection. Among the 1813 women sampled, 11.3 % and 14.7 % reported histories of miscarriage and termination, respectively. Experience of miscarriage was associated with increased risk for paternal depression, higher levels of anxiety, and lower eudaimonia scores from the prenatal to postpartum year, particularly among multiparous individuals. Experiences of termination were associated with increased risks of depression in partners. The authors concluded, “These findings highlight the decreased well-being of men whose partners have undergone termination of pregnancy or experienced miscarriage and stress the importance of interventions aimed at preventing adverse consequences among these individuals.”

Irmscher, L., Marx, R., Linke, M., Zimmermann, A., Drössler, S., & Berth, H. (2024). Anxiety, depression, somatization and psychological distress before and 2-6 years after a late termination of pregnancy due to fetal anomalies. BMC women's health, 24(1), 255.

 

https://doi.org/10.1186/s12905-024-03082-3

https://link.springer.com/article/10.1186/s12905-024-03082-3 

 

The authors noted that few studies have investigated the long-term psychological impact of late termination of pregnancy (TOP) for fetal anomaly. The data for this study were derived from 90 women who answered a questionnaire about anxiety, depression and somatization shortly before (T1) and 2-6 years after (T4) their late termination of pregnancy. Results revealed that before the late TOP, 57.8% of participants showed above-average levels of overall psychological distress (66.7% anxiety, 51.1% depression, 37.8% somatization). Significant decreases were observed over time and at 2-6 years post-termination, 10.0% of women still reported above-average levels psychological disturbance (17.8% anxiety, 11.1% depression, 10.0% somatization). The authors identified limitations of their study that included monocentric data collection, drop-out between T1 and T4, and the relatively extended time span of two to six years after TOP. Finally, the authors concluded, “Our results support those of previous research showing that late TOP has a substantial psychological impact on those experiencing it in the short-term. In the long-term, most women return to normal levels of psychological distress, although some still show elevated levels.”

Jozkowski, K.N., Bueno, X., LaRoche, K.J., Crawford, B.L., Turner, R.C., & Lo, W. (2024). Participant‐driven salient beliefs regarding abortion: Implications for abortion attitude measurement. Social Science Quarterly.

 

https://onlinelibrary.wiley.com/doi/10.1111/ssqu.13343

 

Applying a Reasoned Action Approach, the authors used salient belief elicitation (SBE) to generate participants' beliefs regarding abortion. The investigators administered their SBE to English—and Spanish-speaking U.S. adults (N = 608) from NORC’s AmeriSpeak® panel. Inductive content and thematic analyses were employed to assess open-ended questions. The results revealed participants’ control and behavioral beliefs referring to circumstances addressed to assess abortion attitudes in polling and reasons people seek abortion, as well as potential negative emotions and positive consequences associated with abortion. Participants indicated pregnant people’s partners and people seeking abortion as salient referents. Although the participants described several contexts reflected in existing measures used to assess attitudes by national surveys and polls, they also found circumstances not reflected in common measures and a range of salient referents.

Kemppainen, V., Mentula, M., Seppälä, T., Gissler, M., Rouhe, H., Terhi, S., Heikinheimo, O., & Niinimäki, M. (2024). Fear of childbirth after induced abortion in primiparous women: Population-based register study from Finland. Acta obstetricia et gynecologica Scandinavica, 103(2), 241–249.

 

https://doi.org/10.1111/aogs.14718

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.14718 

 

Fear of childbirth (FOC) is a common challenge that characterizes about 10% of pregnancies. The current study focused on the association between induced abortion (IA) and FOC in subsequent pregnancies. This was a population-based register study utilizing three Finnish national registers: the Register of Induced Abortions, the Medical Birth Register and the Hospital Discharge Register. The analyses focused on primigravid women undergoing an IA between 2000 and 2015 who also experienced a subsequent pregnancy ending in a live singleton birth up to 2017. Controls were implemented for age, residential area, and first pregnancies ending in a live birth. The main outcome was the incidence of FOC in the subsequent pregnancy. The cohort consisted of 21455 target women and 63425 controls. Results revealed that 4.2% of women had a diagnosis of FOC. The incidence was higher in women with a history of IA than in controls (5.6% vs 3.7%). In addition, a history of psychiatric diagnosis, high maternal age, and smoking were associated with increased odds for FOC. The associations of FOC with a history of psychiatric diagnosis and elevated maternal age (especially ≥40 years old) were more pronounced than the association between IA and FOC.

Kimport, K., & Weitz, T. A. (2024). Abortion as a sociological case. Sociological Forum, 39(1), 7–21. 

 

https://doi.org/10.1111/socf.12988

https://onlinelibrary.wiley.com/doi/10.1111/socf.12988

 

The authors begin by noting that for over a century, abortion has been politically and socially contested in the United States. Yet they argue that the sociological literature on abortion is not well-developed. In an initial attempt to remedy the situation, the authors review research on abortion and opportunities for sociological work across eight content areas: gender, race, the body and embodiment, political economy, organizations, occupations and work, medical sociology, law and society, and social movements. The authors contend that sociologists have much to contribute to characterizing and understanding abortion. With its multifaceted social and political status and intersections with key areas of sociology, the phenomenon of abortion offers an opportunity for furthering sociological concepts, subfields, and constructs. The authors are interested in “showcasing how a topic that spurs strong opinions can also catalyze sociological insights.”

​

Kirk, E. & Hanlon, R., Informing Choice: The Role of Adoption in Women’s Pregnancy Decision-Making (February 1, 2024). 39 Notre Dame J.L. Ethics & Pub. Pol'y (2025, Forthcoming), Available at SSRN.

 

https://ssrn.com/abstract=4744517

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The authors draw on their academic expertise in law and social science to discuss the paradox of general high societal regard for the institution of adoption, yet in practice it is rarely accessed as an option for unintended pregnancy. Social science data and literature on women’s pregnancy decision-making is examined to support the need for laws and policies that promote informed choice. They describe never published survey data and analysis from the largest study on birth mothers’ decision-making and coercion experiences in addition to aggregating and analyzing existing published studies related to pregnancy decision-making regarding adoption. They also conducted a 50-state survey of abortion-specific informed consent laws, described the findings, and proposed reform. Specifically, to promote principles of autonomy and self-determination, they recommended all states require disclosure of information about adoption. This change is necessary for women to receive accurate and sufficient information to make a fully informed decision that is free from pressure or coercion.

Klemets, L., & Makenzius, M. (2024). Exposure to violence and associated factors among abortion-seeking women - A multicentre study in Sweden during the Covid-19 pandemic. Sexual & reproductive healthcare: official journal of the Swedish Association of Midwives, 39, 100927.  

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8882666/  

 

Factors associated with exposure to violence over the past 12 months were examined among women seeking abortion. This cross-sectional study involved 623 abortion-seeking women in Sweden from January to June 2021. In the sample, 9.9% (n = 59) reported exposure to physical, psychological, and/or sexual violence that occurred within the past 12 months. After adjustment for confounding, the significant factors included: age 16-26, poor physical and mental well-being prior to pregnancy, having had ≥ 2 previous abortions, and being single. The authors concluded, “Abortion providers have a crucial role and should consistently identify women exposed to violence, offering them the necessary guidance and referrals for further support.” 

Liu, H., Wu, F., Liao, G., Mai, S., & Ouyang, M. (2023). Impact of the intensive psychological intervention care on post-traumatic stress disorder and negative emotions of teenage female patients seeking an induced abortion. Frontiers in psychiatry, 14, 1033320. 

 

https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2023.1033320/full  

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The objective of this study was to investigate the effects of intensive psychological intervention on adverse emotions and post-traumatic stress disorder (PTSD) symptoms among teens who had an abortion. Using a prospective cohort design with 100 patients seeking induced abortion, participants were randomly divided into two groups, those who received intensive psychological intervention care and those who received standard routine nursing. Measures included the PTSD checklist for DSM-5 (PCL-5), a self-report depression scale (SDS), and self-rating anxiety scale (SAS). The intervention group had lower risk of developing PTSD (24% vs. 44%), depression (10% vs. 32%), and anxiety (0% vs. 12%) symptoms at 1-month post-abortion. No significant differences were found between the groups at 3 months following abortion. 

Li, J., Liu, F., Liu, Z. et al. Prevalence and associated factors of depression in postmenopausal women: a systematic review and meta-analysis. BMC Psychiatry 24, 431 (2024).

 

https://doi.org/10.1186/s12888-024-05875-0

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Depression is a relatively common mental health problem in postmenopausal women. This systematic review and meta-analysis evaluated depression worldwide and explored predictors among postmenopausal women. The meta-analysis incorporated 50 studies involving 385,092 postmenopausal women. The prevalence of depression in postmenopausal women was 28.00%. Risk factors for depression among postmenopausal women included the following: marital status, history of mental illness, chronic disease, menstrual cycle, abortion numbers, menopausal symptoms, and hormone replacement therapy, whereas physical activity, number of breastfed infants, and menopause age were preventive factors. The authors commented it is “necessary to improve screening and management and optimize prevention and intervention strategies to reduce the harmful effects of postmenopausal depression.”

Li, X., Peng, A., Li, L., & Chen, L. (2024). The association between repeated abortions during childbearing age and the psychological well-being of postmenopausal women in Southwest China: an observational study. BMC Pregnancy and Childbirth, 24(1), 805.

 

https://doi.org/10.1186/s12884-024-07005-w

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https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-07005-w

​

There is a lot of debate surrounding the topic of whether or not abortion puts women at an increased risk of developing mental health issues, and part of the reason for that may be the dearth of studies with large subject pools conducted in countries where many abortions are performed, such as China. The authors of this study looked to identify potential associations between negative mental health and abortion with a focus on repeat abortion as well among women in China. For methodology, standardized questionnaires were administered and assessed using the “Patient Health Questionnaire-9” and “The 7-item Generalized Anxiety Disorder Scale (GAD-7)” among a pool of 9991 postmenopausal women. The average age was 60.51, and results showed that 11.09% of respondents experienced mental health problems, with a 5.54% and 8.27% split for depression and anxiety, respectively. Additionally, having a history of three or more abortions was a strong indicator of significant issues. The authors concluded that it’s important for women capable of reproduction to increase their knowledge of contraceptives to avoid falling into this category of at-risk women and that institutions in charge of providing care need to better utilize counseling for those who have had the experience.

Li, J., Yang, J., Lv, M., Wang, X., Chen, Z., Zhou, N., Hou, X., & Song, Z. (2023). Development and internal validation of a clinical prediction model for spontaneous abortion risk in early pregnancy. Clinics (Sao Paulo, Brazil), 79, 100318.

 

https://pubmed.ncbi.nlm.nih.gov/38103265/

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The purpose of this study was to develop a predictive model for estimating the risk of spontaneous abortion in early pregnancy (miscarriage). The type of study was a prospective cohort, and it included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was employed to develop the prediction model using spontaneous abortion as the outcome. The model was internally validated with bootstrapping techniques, and then the model’s discrimination and calibration were measured. The spontaneous abortion rate was 5.95%, and the final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression, and stress. The model showed good discrimination, and its calibration was adequate. The authors recommended further external validation is recommended before clinical application.

Lindman, J., Vomstein, K., Egerup, P., Krog, M.C., & Nielsen, H.S. (2024). Is lifestyle different in male partners experiencing recurrent pregnancy loss compared to men fathering a live birth? Andrology.

 

https://onlinelibrary.wiley.com/doi/10.1111/andr.13764

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For context, pregnancy loss is a distressing and well-studied event. However, it’s not as well studied, and we have less documentation regarding women’s male counterparts. The objective of this study was to look at how the lifestyle factors of men, as well as chronic illness, play a role in RPL or recurrent pregnancy loss within a Danish context and cohort. A total of 741 Danish males referred to a pregnancy loss unit between 2009 and 2021 were included in the cohort, and a control group of 1173 males was included as well. Results indicated that the RPL group's mean average for negative lifestyle factors and illness was higher, and though a trend was noticed of obesity, particularly for the loss group, it was not significant. Smoking and obesity did seem to be associated factors, however. The authors concluded that there are potential associations between men smoking and male obesity and RPL.

Lewandowska, M., Scott, R., Meiksin, R., Reiter, J., Salaria, N., Lohr, P. A., Cameron, S., Palmer, M., French, R. S., Wellings, K., & SACHA Study Team (2024). How can patient experience of abortion care be improved? Evidence from the SACHA study. Women's health (London, England), 20, 17455057241242675.

 

https://doi.org/10.1177/17455057241242675

https://journals.sagepub.com/doi/full/10.1177/17455057241242675 

 

Using qualitative, in-depth, semi-structured interviews this study examined women's satisfaction with abortion care and their suggestions for improvements. The sample was comprised of 48 women with recent experience of abortion, utilizing independent sector and National Health Service providers in Scotland, Wales, and England. Interviews were conducted by phone or video call. Participants ranged in age from 16 to 43 years; 39 had a medical abortion, 8 had a surgical abortion, and 1 had both. Results revealed the majority were satisfied with their clinical care. The supportive, kind, and non-judgmental attitudes of abortion providers were identified positively, as was the convenience of home management of medical abortion. Suggestions for improvement focused on the need for timely care, greater correspondence between expectations and reality, the importance of choice, and the need for greater personal and emotional support.

Lloyd, C.A., & Hutti, M.H. (2024). Grief intensity following adolescent miscarriage or abortion: A descriptive study of recollections of adult women. Heliyon, 10

 

https://www.sciencedirect.com/science/article/pii/S2405844024096658

 

The stated objective of this study was to take a close look at “women’s recollected lifespan perceptions of the effect of grief intensity” about their experiences with perinatal death and grief. Women filled out online surveys. Results showed that when participants were adolescents, the level and intensity of care received weren’t impacted much by the loss they experienced. However, abortion was associated with greater grief intensity despite the quality of care not having changed. It was also found that 25% of women who participated had an increasing level of grief as time went on. The authors concluded from the totality of their findings that beyond what was stated above, women’s grief after this form of loss can change in intensity in response to events in their lives, and it’s important for professionals to be able to identify women at higher risk and when they are suffering the most.

Masten, M., Sheeder, J., & Lazorwitz, A. (2024). Substance Use and Anxiety About Pain Among Patients Seeking Abortion Services. Cureus, 16(3), e57034.

​​

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11047799/  

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The goal of the study was to evaluate how recent opioid, marijuana, and cannabidiol use are related to pre-procedure pain-related anxiety among patients seeking abortion. A prospective, cross-sectional, anonymous survey was conducted. The results revealed that among the 217 participants, recent opioid users had higher median anxiety scores for pain during and after abortion than non-opioid users. Anxiety scores did not differ for marijuana and cannabidiol users. The authors noted that assessing recent opioid use may help guide counseling on abortion-related anxiety.

Mendes, D. C. G., Fonseca, A., & Cameirão, M. S. (2024). The relationship between healthcare satisfaction after miscarriage and perinatal grief symptoms: A cross-sectional study on Portugal residents. Social science & medicine (1982), 353, 117037.​​

​

https://pubmed.ncbi.nlm.nih.gov/38941727/

​

Approximately 15-20 % of known pregnancies end in miscarriage. Employing a cross-sectional design, symptoms of perinatal grief, degree of satisfaction with healthcare received, and information and support provision data were gathered via an online survey targeting women in Portugal who suffered a miscarriage. The researchers identified 873 eligible participants. Results revealed that healthcare lower satisfaction correlated significantly with higher perinatal grief scores. Among those sampled, 61.1% had received information about the physical consequences of miscarriage and showed a significantly lower rate of above-threshold perinatal grief symptoms. Mental health consequences information was received by 18.2%, and there were no significant differences in above-threshold symptom rates observed within this group. Finally, 11.7% were offered or recommended mental health support, but no significant differences in above-threshold symptom rates were revealed. The authors concluded, “Training for healthcare providers dealing with pregnancy loss, implementing national guidelines that include follow-up on the parents' physical and psychological health, and including a specialized area in medical structures are advised.”

Meng, L. C., Lin, C. W., Chuang, H. M., Chen, L. K., & Hsiao, F. Y. (2024). Benzodiazepine Use During Pregnancy and Risk of Miscarriage. JAMA psychiatry, 81(4), 366–373.

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​https://pubmed.ncbi.nlm.nih.gov/38150230/

​

Benzodiazepine use in pregnancy has raised significant concerns due to the potential harmful effects on neonates. Prior studies on the association between benzodiazepine use and the risk of miscarriage are limited. The objective of this study was therefore to quantify the risk of miscarriage associated with benzodiazepine use during pregnancy after controls were implemented for confounding variables and exposure time trends. This was a nationwide, population-based case-time-control study using the Taiwan’s National Birth Certificate Application database and the National Health Insurance database. Pregnancies resulting in miscarriage between 2004 and 2018 were included in the case group and were matched with controls. Miscarriage was defined as any pregnancy loss occurring between the first prenatal care visit (usually 8 weeks) and the 19th completed week of pregnancy. This study incorporated data from a total of 3,067,122 pregnancies among 1,957,601 women, and136,134 or 4.4% resulted in miscarriage. The use of benzodiazepines during pregnancy was associated with an increased risk of miscarriage. In subgroup analyses, an increased risk of miscarriage was significantly associated with each form of benzodiazepine. The authors concluded, “These findings underscore the necessity for health care professionals to meticulously balance the risk-benefit ratio when considering the use of benzodiazepines to treat psychiatric and sleep disorders during pregnancy.”

Merner, B., Haining, C. M., Willmott, L., Savulescu, J., & Keogh, L. A. (2024). Health providers' reasons for participating in abortion care: A scoping review. Women's health (London, England), 20, 17455057241233124.

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https://doi.org/10.1177/17455057241233124

https://pmc.ncbi.nlm.nih.gov/articles/PMC10908244/

​

This scoping review aimed to identify what is known about health providers’ reasons for participating in abortion provision. Empirical studies published from 2000 to 2022 were eligible if they addressed health providers’ reasons for participating in legal abortion. The literature search yielded 3251 records, and 68 studies were included. Reasons for participating in abortion were identified as 1) supporting women’s choices and advocating for women’s rights (76%); 2) being professionally committed to participating in abortion (50%); 3) aligning with personal, religious or moral values (39%); 4) finding provision satisfying and important (33%); 5) being influenced by workplace exposure or support (19%); 6) responding to the community needs for abortion services (14%) and 7) participating for practical and lifestyle reasons (8%).

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Milmine, L., & Fetner, T. (2024). Practice What You Preach: Complicating the Relationship among Christian Religious Identity, Abortion Attitudes, and Reported Abortion Experiences among Canadians. Socius, 10.

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https://doi.org/10.1177/23780231241245843

https://journals.sagepub.com/doi/10.1177/23780231241245843

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Abortion providers have noted that patients who view abortion as immoral often access abortion. The authors’ question motivating the study was, does religion have a greater impact on attitudes toward abortion than on personal decisions to terminate one’s own pregnancy?  Canadian women (n = 1,181) were surveyed to examine religious affiliation and attendance, as well as abortion attitudes and abortion experience. Religious affiliation and attendance were found to predict abortion attitudes more than abortion behavior.​​

Morolli, V., Menghoum, N., Manigart, Y., & Rozenberg, S. (2024). Characteristics of patients requesting an abortion beyond 14 weeks of gestation: Retrospective study in Brussels. Contraception, 110751. Advanced online publication.

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https://doi.org/10.1016/j.contraception.2024.110751

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https://www.contraceptionjournal.org/article/S0010-7824(24)00465-7/abstract

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The stated objectives of this study were to examine the characteristics of patients who have requested an abortion after at least 14 weeks gestation (generally past the legal limit) in the Netherlands to compare their social and demographic characteristics to those of women who sought an abortion within the 14 weeks of their pregnancy. To do this, the authors looked at the relevant data on individuals making these types of requests between January 2022 and March 2023, seeking to identify factors that may predict the outcome. The results from their regression analysis of 627 abortion-requesting patients (593 within 14 weeks and 34 after) indicated that those patients who sought an abortion due to “precarity” or rape were at greater risk of late requests. Additionally, they found factors that increased the likelihood of the woman seeking an abortion within the legal time frame to include personal reasons for having the procedure, such as not having a desire for children.

Nkansah, O., Osei, E.A., Richardson, D., & Menlah, A. (2024). Unveiling silent stories of women with stillbirth at Shai Osudoku District Hospital. Gynecology and Obstetrics Clinical Medicine.

 

https://gocm.bmj.com/content/gocm/4/3/e000025.full.pdf

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Because stillbirth remains a major issue globally, adversely impacting those less fortunate with fewer resources, both human and financial, like in countries such as Africa, which has a very high stillbirth rate, the authors of this study looked to give more of a voice to women who experience stillbirth in Africa. They conducted structured interviews with women who had experienced a miscarriage and analyzed their findings for themes. The results yielded three primary themes, the first of which was “Factors leading to loss,” which incorporated associated factors for miscarriage experienced by the women. The second theme was “Women’s experiences with stillbirth,” and the third was “Standard care for mother’s coping with stillbirth.” The first theme was found to have three subthemes, which were “refusing admission,” “delay in referral,” and “Reoccurrences.” The subthemes about the second theme were “Psychological experience of women with stillbirth”, Emotional experiences of women with stillbirth,” and “Spiritual experience of women with stillbirth”. The final subthemes of standard care were “Poor communication by healthcare providers”, “Lack of urgency”, and “Inadequate logistic”(s). The authors concluded from the totality of their findings that the need for essential support has been underscored, and future research would be well advised to look further into the coping strategies of women.

Or, M., Kazma, J., Alpern, R. R., Folarin-Amode, F., & Jamshidi, R. (2024). Oh My GAD: Evaluating Anxiety in Current Pregnant Patients Who Have Had a Prior Termination Abortion. Obstetrics & Gynecology, 143 (5S), p 60S. 

 

https://journals.lww.com/greenjournal/abstract/2024/05001/oh_my_gad__evaluating_anxiety_in_current_pregnant.208.aspx

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The purpose of this study was to examine the effect of abortion on anxiety in future pregnancies carried to term using a cross-sectional design. Pregnant patients seeking obstetric care were surveyed to assess demographics, obstetric history, and the Generalized Anxiety Disorder-7 (GAD-7). One hundred seventy-nine patients completed the survey (72 reported a history of anxiety) and were the focus of the current investigation; however, the study is ongoing. Of those who have had a prior pregnancy, those with a history of abortion were more likely to have severe anxiety with a GAD-7 score greater than 15 in the target pregnancy (18.2% versus 4.5%; P=.01). The authors concluded, “Patients who have experienced abortion therefore have specific needs for prenatal care that are currently unmet. Furthermore, as GAD-7 is not routinely administered in pregnancy, these patients may be underdiagnosed with anxiety that then goes untreated.”

Pacilli, M. G., Spaccatini, F., Pagliaro, S., & Giovannelli, I. (2024). From “bad” and “good” motivations to abort to “bad” and “good” women: Abortion stigma and backlash against women who interrupt their pregnancy. Sexuality Research & Social Policy: A Journal of the NSRC, 21(2), 645–656.

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https://doi.org/10.1007/s13178-023-00927-8

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https://link.springer.com/article/10.1007/s13178-023-00927-8

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For context, because abortion is chosen for a multitude of reasons, the public discourse surrounding it developed a hierarchy in terms of how justified a particular reason may be. For this study, the authors looked at the “impact of different motivations” that are generally seen in the public discourse as more justified or less justified regarding how poorly society perceives the woman and her decision to abort. The results of the study showed that participants felt a greater degree of moral outrage towards women who abort for reasons seen as categorically bad or selfish. Having reasons that participants saw as unacceptable dehumanized the woman to the participant. The results served to highlight the effect the collectively established hierarchy of reasons for abortion has on how those around them perceive women.

Prasad, M., Roy, S., Vishnu, MV., Kaul, S., & Dalei, B. (2024). Occurrence and Determinants of Psychological Distress among Women Undergoing Abortion/Medical Termination of Pregnancy Journal of South Asian Federation of Obstetrics and Gynaecology, 16 (1), 20-24.

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https://www.jsafog.com/doi/JSAFOG/pdf/10.5005/jp-journals-10006-2312 

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The authors utilized the Goldberg Health Questionnaire-12 to assess women undergoing treatment for abortion-related issues. Specifically examined were demographic, social, obstetric, and medical factors in association with post-abortion stress levels. Those with prior psychiatric illnesses and those undergoing MTP for failure of contraception were excluded. Participants included 106 participants with an average age of 25.7 years, 86% were Hindus, 83% were employed, and 63.2% were multigravidae. Results revealed that 89% (94 patients) had typical distress and 11% experienced more than usual psychological distress. The presence of prior living issues, prior abortions, medical comorbidity, and desire for future progeny were associated with higher distress.

Qeadan, F., Tingey, B., & Mensah, N. A. (2024). The risk of opioid use disorder among women undergoing obstetric-related procedures: Results from the Cerner Real-World Database. Drug and alcohol dependence reports, 10, 100210.

 

https://www.sciencedirect.com/science/article/pii/S277272462300080X 

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This study was implemented to explore immediate and prolonged risks of opioid use disorder (OUD) among women who have had vaginal and cesarean deliveries, induced abortions, and treatments related to miscarriages and ectopic pregnancies. Retrospective data (n = 632,872) from the Cerner Real-World Data™ for pregnant females (age 15-44) between January 2010 and March 2020 were used. Compared to patients with a vaginal delivery, those with an ectopic pregnancy, a cesarean delivery, miscarriage, and an induced abortion had 84%, 46%, 119%, and 131% significantly higher odds of OUD respectively. Among opioid naïve patients, all additional obstetric procedure groups (besides miscarriage) had a significantly higher risk of being prescribed new opioids compared to women who had a vaginal delivery.  When considering patients with newly prescribed opioids, patients from all other groups demonstrated a significantly higher risk of continued opioid prescriptions compared to the vaginal delivery group. The authors concluded, “The association between specific obstetric outcomes, notably miscarriage and induced abortions, and opioid use patterns should inform safer and more effective pain management in a maternal population.”

Reardon, D. C. (2024). A forensic investigation and critique of suicidal ideation reported in a Turnaway Study. 

 

The Linacre Quarterly. doi:10.1177/00243639241281978

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https://journals.sagepub.com/doi/abs/10.1177/00243639241281978

 

In a published report of suicidal ideation rates in the Turnaway Study, the abortion advocacy group Advancing New Standards in Reproductive Health (ANSIRH) claimed their findings showed abortion has no impact on suicidal ideation. Laws requiring notification of abortion's link to higher suicide rates were therefore not based on solid science. But how valid is the science that ANSIRH offers to invalidate an abortion-suicide association? The Turnaway Study is drawn from a non-random, non-representative convenience sample with a 68% refusal to participate rate and a 50% attrition rate. No conclusions applicable to the general population of women who abort can be drawn from such a sample. Moreover, on closer examination, ANSIRH's suicidal ideation analysis is highly flawed and violates Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The author notes that the Turnaway Study authors withheld basic and critical information, including mean scores and the number of women with suicidal thoughts. He further contends that “Readers are provided with only highly massaged results from a mixed-effects logistic regression employing thirteen covariates that appear to have been chosen precisely to water down the confidence intervals to such a high degree that virtually nothing was statistically significant.” The author articulates other serious criticisms, and he concludes, “Rather than proving that abortion does not affect suicidal behaviors, ANSRIH's published analysis provides evidence of deliberate obfuscation and disinformation by a group funded and dedicated to the expansion of abortion rates around the world.”

Rezaee N, Afhami H, Navvabi-Rigi S. (2004). The effects of positive self-talk on anxiety and grief among women with spontaneous abortion: A Quasi-Experimental Study. Shiraz E-Med J., 25(2): e140347. 

 

https://doi.org/10.5812/semj-140347

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https://brieflands.com/articles/semj-140347

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Spontaneous abortion (SA) can lead to stress, anxiety, depression, and grief for parents. The purpose of this study was to assess the effects of positive Self Talk on anxiety and grief among women with SA. A two-group (intervention and control) pre-test-post-test design was conducted with 80 women with SA randomly selected from a teaching hospital in Iran. Participants in the intervention group received education about positive Self Talk in eight 20-minute sessions held twice a week. The mean scores of anxieties and grief significantly decreased in both groups; however, the mean amount of decrease in the intervention group was significantly more than in the control group. The authors concluded that nurses and psychologists can use positive Self-talk to reduce post-SA psychological complications among afflicted women.

Røseth, I., Sommerseth, E., Lyberg, A., Sandvik, B. M., & Dahl, B. (2024). No one needs to know! Medical abortion: Secrecy, shame, and emotional distancing. Health care for women international, 45(1), 67–85.

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https://pubmed.ncbi.nlm.nih.gov/35797465/

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This was a phenomenological study that used data from Norway. The authors noted that in 2021, 10,841 abortions were carried out nationally (95.3% were medical abortions). The focus of the study was on women’s experiences with medical abortions that took place at home. For this study, 1161 women between the ages of 41 to 45 were surveyed regarding their abortions, and the results revealed that women who felt pressure to abort were more likely to report more negative post-abortion reactions. In addition, the women who felt pressured to abort also had more difficulty completing the survey. The authors concluded from the data collected that women frequently choose abortion due to perceived pressure, which then negatively impacts many of their lives.

Schultz, A., Smith, C., Johnson, M., Bryant, A., & Buchbinder, M. (2024). Impact of Post-Dobbs Abortion Restrictions on Maternal Fetal Medicine Physicians in the Southeast: A Qualitative Study. American journal of obstetrics & gynecology MFM, 101387. 

 

https://www.ajogmfm.org/article/S2589-9333(24)00113-7/abstract

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The purpose of this study was to characterize the impact of abortion restrictions on maternal fetal medicine physicians (MFMs) in the Southeastern U. S. following Dobbs. Qualitative, semi-structured interviews were conducted with 35 MFMs in 10 Southeastern states between February and June 2023.  Convenience and snowball sampling were employed. A conceptual framework was developed based on the predominant themes identified. Abortion laws and external constraints following Dobbs resulted in ethical, professional, and legal challenges for MFMs that led to changes in clinical practice and deviations from the MFMs’ perceptions of patient-centered care. Forced changes resulted increased fear, hypervigilance, and workload for MFMs. The changes also prompted concerns about physical and psychological health issues for patients. The authors reported that supportive colleagues, hospital systems, and policies were associated with decreased stress, emotional distress, and disruption of healthcare delivery. This study did not incorporate any form of random sampling; therefore results observed may have reflected only a small subset of MFM opinions working in southern states and they should not be generalized.

Silver, R. M., & Reddy, U. (2024). Stillbirth: we can do better. American journal of obstetrics and gynecology, S0002-9378(24)00628-8. Advance online publication.

 

https://doi.org/10.1016/j.ajog.2024.05.042

https://www.ajog.org/article/S0002-9378(24)00628-8/abstract

 

The stillbirth rate in the United States is 5.73 per 1000. This translates out to approximately 1 in 175 pregnancies, accounting for about 21,000 infants lost per year. Rates are much higher in low-income countries; however, the stillbirth rate in the U.S. is much higher than most higher income countries. There are substantial disparities in stillbirth, with rates twice as high for non-Hispanic Black and Native Hawaiian or Other Pacific Islanders compared to non-Hispanic Whites. The authors note that there is considerable opportunity for reduction in stillbirths, even in wealthy countries like the United States. The authors review the epidemiology, risk factors, causes, evaluation, medical and emotional management, and prevention of stillbirth. They emphasize novel data regarding genetic etiologies, placental assessment, risk stratification, and prevention.

Shields, D. E., & Nicholl, P. (2024). An analysis of reunifications between adopted adults and their birth relatives. Child Care in Practice. Advance online publication. 

 

https://doi.org/10.1080/13575279.2024.2359939

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https://www.tandfonline.com/doi/full/10.1080/13575279.2024.2359939

 

For context, the nature of adoption reunification (the fragile relationships established with difficulty) emphasizes the role of adoption agencies in providing comprehensive services that are accessible to everyone. For this study, the authors analyzed 15 case files selected from between the years 2009 and 2018 to gain a further understanding of the reunification process between adults who had been adopted as children and their birth relatives. The authors found from their analysis that there was diversity among their sample pool, even with their motivations and reasons for restricting their involvement time. Levels of social work involvement were much higher pre-contact, further highlighting the need for guidance provided by adoption agencies to continue their participation and support to a greater degree.

Skjeldestad, F. E., Gissler, M., Geirsson, R. T., Heino, A., Sigbjörnsdottir, H. B., Akerkar, R., Gemzell-Danielsson, K., Heikinheimo, O., & Løkeland, M. (2024). Trends over 50 years with liberal abortion laws in the Nordic countries. PloS one, 19(7), e0305701.

 

https://doi.org/10.1371/journal.pone.0305701

 

The purpose of this study was to assess epidemiological trends related to induced abortion in all Nordic countries. New legislation has led to increased surveillance of induced abortion in all countries and has mandated hospitals to report to national abortion registers. After an increase in abortion rates during the first years following liberalization, the general abortion rates stabilized and then decreased in all Nordic countries, especially for women under age 25.  Most terminations (80-86%) are now done before the 9th gestational week in all countries, primarily by medical as opposed to surgical means. Ultrasound screening in pregnancy during the late 1980s increased the number of 2nd-trimester abortions due to fetal anomalies. Refinement of ultrasound screening and non-invasive prenatal diagnostic methods led to a slight increase in early 2nd trimester abortions after 2000. Country-specific differences in abortion rates have been stable over the last half century of liberalized abortion laws.

Slade, L. J., Louise, J., D'Onise, K., & Dodd, J. M. (2024). 50 years of comprehensive state-wide data on pregnancy termination in South Australia: a retrospective, population-based, cohort study.  The Lancet. Public health, 9(11), e925–e934.

 

https://doi.org/10.1016/S2468-2667(24)00214-7

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https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(24)00214-7/fulltext

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For context, abortion is a common procedure around the world regardless of the legality and logistics of a particular region. This study aimed “to document changes in procedural characteristics and demographic factors over time in South Australia.” An additional goal of this study was to “examine how key sociodemographic variables affect gestational age at pregnancy termination.” For methodology, they utilized state mandatorily collected data from Australia on all known terminations between 1970 and 2020. Their findings showed that between the stated years, abortions occurred at a median gestational period of 8 weeks. Additionally, it was found that the majority of pregnant women (77.9%), for whom the median age was 24, lived in urban areas, a relevant factor when it comes to logistics, and that surgical termination was most common at 78.4%. The frequency of complications going up with age was another trend noted by the authors, as well as gestational age at the time of pregnancy going down through the years. The authors conclude from their findings that demographic changes have occurred among the women who seek abortion over the years and that this is the case even in rich countries with good access to legal abortions.

Sobel, L., Bernstein, M., Arunkumar, N., Fortin, J., Fulcher, I., Hwang, Y., & Goldberg, A. B. (2024). The impact of lifetime intimate partner violence on abortion method choice. Contraception, 110732.

 

https://www.contraceptionjournal.org/article/S0010-7824(24)00441-4/fulltext

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The purpose of this study was to evaluate if the type of abortion patients preferred differed based on history of intimate partner violence (IPV). The authors specifically compared the choice of medication versus procedural abortion between those with a history of lifetime IPV and those without a history of IPV among patients seeking a first-trimester abortion. The participants were recruited at Planned Parenthood League of Massachusetts, Boston Health Center, from September 2021 to August 2022. The researchers enrolled 342 participants. Seventy-one women (21%) reported a lifetime history of IPV. A majority of individuals with a lifetime history of IPV chose procedural abortion. However, their abortion method choice did not differ significantly from individuals with no history of IPV. Those with an IPV history accessed funds for abortion more than those without a history. There was no statistical difference between individuals with and without a lifetime history of IPV relative to what was considered important for the type of abortion chosen.

Spach, N. C., & Henkel, A. (2024). Aftercare following second trimester abortion procedures. Current Opinion in Obstetrics & Gynecology, 36(6), 388–393.

 

https://doi.org/10.1097/GCO.0000000000000987

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https://journals.lww.com/co-obgyn/abstract/2024/12000/aftercare_following_second_trimester_abortion.3.aspx

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The stated purpose of this review was to look closely at the experiences of women after they receive second-trimester abortion care in a clinical setting to identify interventions that improve the outcome of their aftercare. The authors note that utilization of a “five-question Reproductive Grief Screen” may help with earlier identification of “maladaptive” responses of grief. It was also learned that, in general, patients want to discuss grief with their providers and often prefer frequent checkups regarding it. The authors suggest that clinicians need to be prepared for this and trained to handle their patient's grief responsibly and helpfully. They need to be ready for conversations regarding cremation or burial, and hospitals should try to find local resources to aid in this recovery.

Stanhope, K. K., Temple, J. R., Christiansen-Lindquist, L., Dudley, D., Stoll, B. J., Varner, M., & Hogue, C. J. R. (2024). Short Term Coping-Behaviors and Postpartum Health in a Population-Based Study of Women with a Live Birth, Stillbirth, or Neonatal Death. Maternal and child health journal, 28(6), 1103–1112. https://doi.org/10.1007/s10995-023-03894-z

 

https://link.springer.com/article/10.1007/s10995-023-03894-z#citeas

 

Responding to the National Institutes of Health Working Group's call for research on the psychological impact of stillbirth, the authors compared coping behaviors by the form of index birth (surviving live birth or perinatal loss - stillbirth or neonatal death). Further, among individuals who experienced loss, coping strategies were examined along with their association with depressive symptoms measured at 6-36 months postpartum. Data were secured from the Stillbirth Collaborative Research Network follow-up study (2006-2008) of 285 women who experienced a stillbirth, 691 who had a live birth, and 49 who endured a neonatal death. Compared to those with a surviving live birth and adjusting for pre-pregnancy drinking and smoking, history of stillbirth, and age, women who had a loss were more likely to drink or smoke more in the two months postpartum. Those who smoked or drank more had increased odds of depression at 6 to 36 months postpartum. Among those who experienced loss, recommended coping strategies included communication, support groups, memorializing the loss, and spirituality. The authors concluded by noting, “Access to a variety of evidence-based and culturally-appropriate positive coping strategies may help individuals experiencing perinatal loss avoid adverse health consequences.”

Studnicki, J., Longbons Cox, T., Fisher, J. (2024). First pregnancy abortion or natural pregnancy Loss: A cohort study of mental health services utilization. Issues in Law and Medicine 39 (2).

 

https://issuesinlawandmedicine.com/articles/first-pregnancy-abortion-or-natural-pregnancy-loss-a-cohort-study-of-mental-health-services-utilization/

 

Natural pregnancy loss and induced abortion have been positively associated with mental health issues, and the author of this study notes that comparison studies between these two groups are rare despite this knowledge of them having similar impacts on women; because of that, the purpose of this study was to make those comparisons between the groups of women in regard to mental health morbidity in particular. Participants were aged 16 in 1999 and were sorted into two cohorts based on the outcome of their first pregnancy. A total of 1331 women had an abortion following their first pregnancy, and a total of 605 women were in the natural loss group. Outcomes indicated that both groups experienced outpatient visits and inpatient visits, and the extent of these visits was compared. Results indicated that utilization of psychiatric care rates prior to pregnancy were higher for the women who had experienced natural loss. For the abortion group, it was found that the “per-patient per-year increase” was significant for all service utilizations. These rates did not increase significantly among the natural loss group. The authors conclude that the higher utilization of service rates for women who had a natural loss can’t be attributed to pre-existing mental health issues alone due to their comparatively lower rates to the other cohort and that utilization rates post-loss are much higher in the abortion group.

Sullins, D. P. (2024). Persistent Emotional Distress after Abortion in the United States. Preprints 2024, 2024071463.

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https://www.researchgate.net/publication/382409301_Persistent_Emotional_Distress_after_Abortion_in_the_United_States

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The purpose of this study was to examine retrospective population data on 226 ever having aborted U.S. women between the age of 41 and 45, at an average of 20 years following the abortion, with extensive measures of Persistent Emotional Distress (PED). Most women who had experienced and abortion (55.2%) had little or no distress from their abortion(s); however, 44.8% reported moderate (20.7%) to high (24.1%) distress related to their abortion(s). The results revealed that 37.7% had negative emotions, 31.2% experienced frequent feelings of loss, grief or sadness, 24.6%  reported “frequent thoughts, dreams, or flashbacks”, and  23.2% indicated thoughts and feelings about their abortion “negatively interfered with life, work, or relationships.” A mean of 20 years had elapsed since the abortion (range 0-31 years) and time elapsed was not correlated with PAD. For women who experienced PAD, the emotions persisted for decades. As noted by the author, “An estimated 7.5 million women in the U.S. currently experience persistent high PAD.”

Su, X., & Sun, L. (2024). Prevalence and associated factors of abortion among women with severe mental disorders. Journal of affective disorders, 355, 432–439.

 

https://doi.org/10.1016/j.jad.2024.03.116

https://www.sciencedirect.com/science/article/pii/S0165032724005408?casa_token=FfK4MzIixjoAAAAA:XH-_nG2hBtOxbNf4djur9Qr5Wp9ElYViU4QsqnoUlpIiwzSNwc6cQ-ZNI7zUk67S-hlgTN6uXA

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The authors of this study examined the prevalence and associated factors of abortion in women with severe mental disorders from rural communities in China. A cross-sectional study was conducted with 276 women aged 18 and above who experienced severe mental disorders. Data included pregnancy history, abortion history, and socio-demographic characteristics measured with a questionnaire. Results revealed 82.61% of patients had a pregnancy history. Among these women, 43.42 % reported an induced abortion history, whereas spontaneous abortion was reported by 31.58%. Age at first pregnancy and age at last pregnancy were associated with abortion. Anxiety was related to spontaneous and repeat abortions. Religion, number of children, and family functioning were predictors of induced abortion. The authors concluded, “Gestational age and anxiety of pregnant patients deserve attention and preventive measures to avoid the outcomes of abortion.” 

Sudhinaraset, M., Gipson, J. D., Nakphong, M. K., Soun, B., Afulani, P., Upadhyay, U., & Patil, R. (2024). Person-centered abortion care scale: Validation for medication abortion in the United States. Contraception, 110485. Advance online publication.

 

https://www.sciencedirect.com/science/article/pii/S0010782424001574 

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The purpose of this study was to adapt and validate the Person-Centered Abortion Care Scale (PCAC) for medication abortions that was developed in Kenya) for use in the United States. Medication abortion patients from a hospital-based clinic who had one of two modes of service delivery served as the participants for the study: 1) telemedicine with no physical exam or ultrasound; or 2) in-person with clinic-based exams and ultrasounds. The scale development process included the following phases: 1) defining constructs and item generation; 2) expert reviews; 3) cognitive interviews (n=12); 4) survey development and online survey data collection (N=182, including 45 telemedicine patients and 137 in-person patients); and 5) psychometric analyses. Exploratory factor analyses resulted in 29-items  with three subscales: 1) Respect & Dignity (10 items), 2) Responsive & Supportive Care (9 items for the full scale, 1 abortion mode-specific item, and 3) Communication & Autonomy (10 items for the full scale, and 1 abortion mode specific item). The authors concluded that the US-PCAC had high content, construct, and criterion validity as well as high internal consistency reliability (alpha for the 29-item US-PCAC scale = .95). Scores on the US-PCAC were associated with overall satisfaction.

Tang, B. W. J., Ibrahim, B. B., & Shorey, S. (2024). Complex journeys of adolescents after induced abortion: A qualitative systematic review. Journal of pediatric nursing, S0882-5963(24)00100-3. Advance online publication.

 

https://www.sciencedirect.com/science/article/pii/S0882596324001003?casa_token=6yXzLp20UYoAAAAA:uU0g0Hp8MP9FDO7G5ZRUQl8GG_To_wjCt2Aa-afH3DzeHHhJM0j8asrl1FV4Se4Ly43zOKB5hQ 

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This review was undertaken to address adolescents' post-abortion experiences to help inform healthcare professionals. Qualitative and mixed-methods studies were included. Studies reporting adolescent experiences from third party perspective were not included. Search of five electronic databases (CINAHL, PubMed, PsycINFO, Web of Science, and Embase) yielded 2834 articles retrieved, with 45 studies included in this review. A thematic analysis resulted in three main themes emerging: post-abortion experiences and emotions, social dynamics and support, and life post-abortion/future perspectives. More specifically, the results demonstrated that adolescents who underwent abortion faced physical and emotional challenges, adopted particular coping strategies, and had mixed experiences with social support and healthcare professionals. The authors concluded, “Healthcare providers should implement practice changes, including providing accurate information, offering tailored mental health support, and undergoing adolescent-friendly training, to enhance care for adolescents.”

Tsevat, D. G., Bullington, B. W., Arora, K. S., & Allison, B. A. (2024). Beliefs and behaviors regarding abortion counseling among U.S. clinicians caring for adolescents. Journal of Pediatric and Adolescent Gynecology, S1083-3188(24)00351-6. Advanced online publication.

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https://doi.org/10.1016/j.jpag.2024.12.004

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https://www.jpagonline.org/article/S1083-3188(24)00351-6/abstract

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The primary goal for the authors of this study was to identify factors in a clinical setting that can be associated with the discussion around abortion and unplanned pregnancy in adolescents. For methodology, they surveyed 146 clinicians currently caring for pregnant adolescent patients recruited from a conference and more obscure means such as mail lists. Results indicated that of those surveyed, 57% of the clinicians regularly talked about abortion with their adolescent patients. Furthermore, 58% of them regularly made referrals for abortion, and 76% of the respondents “did not routinely advise against termination.” The authors concluded that their findings highlight the reality of clinicians' personal beliefs surrounding abortion and that the differences they hold in those beliefs impact their care. The authors suggest that this shows an existing need for “education and policy interventions” so that all patients get unbiased care.

Umar, H. & Ajuwon, A. J. (2024). Depression and post-traumatic stress disorder among women experiencing spontaneous abortion in Katsina, NorthWestern Nigeria. African Journal of Reproductive Health, 8 (3), 37-44.  

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https://www.ajrh.info/index.php/ajrh/article/view/4353/pdf

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The focus of this study was on examining the prevalence of depression and post-traumatic stress disorder (PTSD) after spontaneous abortion. Participants included 222 women who had spontaneous abortions one to two months before they were interviewed. The prevalence of depression and PTSD was 6.3% and 3.6% respectively. The prevalence of experiencing both depression and PTSD was 0.5%. Logistic regression showed that the experience of 3 or more previous miscarriages was a predictor of both depression and PTSD. The authors concluded by noting, “These findings help in the evaluation of the mental health of women who suffered spontaneous abortions and have a previous history of three or more spontaneous abortions.”  

Van Tuyl, R. (2004). Improving access, understanding, and dignity during miscarriage recovery in British Columbia, Canada: A patient-oriented research study. Women’s Health, 20.

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​https://journals.sagepub.com/doi/full/10.1177/17455057231224180

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An estimated 15%–25% of clinical pregnancies end in miscarriage, with more than 15,000 miscarriages occurring annually in British Columbia. Despite the significant rates of loss, research and healthcare services for pregnancy loss remain underdeveloped and rare.As stated by the researcher, the aims of this investigation were twofold “(1) aid miscarriage recovery through the identification and sharing of equitable pregnancy loss care practices and supports and (2) present policy recommendations to improve prenatal care guidelines and employment standards for pregnancy loss.” Applying a mixed-methods design, specific components included policy research on prenatal care guidelines, provincial, and territorial legislation on employment leave for bereavement, semi-structured interviews (n = 27), and a discovery action dialogue (n = 4). The results revealed the need for the following improvements: prenatal care guidelines for early pregnancy loss, follow-up care after a miscarriage, mental health screening and support, as well as bereavement leave legislation. Future research needs are also addressed.

Wallis, E. L. G., Heath, J., & Spong, A. (2024). How do people story their experience of miscarriage? A systematic review of qualitative literature. Sexual & reproductive healthcare: official journal of the Swedish Association of Midwives, 41, 100997.

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​https://pubmed.ncbi.nlm.nih.gov/38901061/

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While there is a broad base of literature surrounding the issue of miscarriage, constructions of narratives after the loss are not well researched. In particular, few studies have sought to gather information about and understand the “sense-making processes” following a miscarriage. This review aimed to “gain insight” into what has already been learned about how people “story” their experiences following a miscarriage. To achieve this, the authors carried out a systematic review of literature from four databases and identified the work that pertained to “miscarriage narratives and sense-making” with eligibility criteria employed. A total of 10 studies were selected to be included in the review, and the authors used them to form and present a narrative synthesis. The literature falls into five themes: "women’s experiences, male partner’s perspectives, couples’ perspectives, healthcare professional’s perspectives, and cultural perspectives.” Some findings from the summarization of this data include that there is a need for healthcare professionals to be trained well in order to utilize compassion in the care they provide and the decisions they make, and also that the role of the language used requires much heavier consideration due to over-medicalized phraseology. Also, it is suggested that a greater understanding of women’s need for expression and how they do so is needed. .

Wang, X., Deng, M., Wu, S., & Mao, Q. (2024). Induced abortion and ectopic pregnancy: A systematic review and meta-analysis. Journal of evidence-based medicine, 10.1111/jebm.12619. Advance online publication.  

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https://doi.org/10.1111/jebm.12619  

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This systematic review examined induced abortion (IA) as a potential predictor of ectopic pregnancy (EP). PubMed, EMBASE, Web of Science, Cochrane, CNKI, WanFang, and Sinomed databases were examined. Case‐control studies and cohort studies that included the target variables were included. A total of 33 case‐control studies and 7 cohort studies were identified involving 132,926 participants. In case‐control studies, there was a significant association between induced abortion and ectopic pregnancy. Subgroup analysis by region suggested no statistical significance in the Americas and in the Eastern Mediterranean. In cohort studies, statistical significance was found after omitting one study in sensitivity analysis. The authors concluded, “The combined results of the two types of studies suggested that induced abortion would increase the risk of ectopic pregnancy to some degree, but the conclusion needs to be considered with caution.” 

Yang, S., Wang, Y., Fang, B. et al. Childhood adversity, perceived social support, and depressive symptoms among pre-abortion Chinese women. Reprod Health 21, 68 (2024).

 

https://doi.org/10.1186/s12978-024-01811-3

https://link.springer.com/article/10.1186/s12978-024-01811-3

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The authors begin by noting that unintended pregnancy is a health issue with psychosocial consequences for individuals, families, and society. This study was designed to explore the connections between childhood adversity, perceived social support, and depressive symptoms among pre-abortion women (women who have decided to have an abortion) in a clinical setting using the common risk factor approach and social support theory. The sample was comprised of 299 Chinese women, 18 to 45 years old. They were recruited from a hospital in Shantou, China. The results revealed that 37.2% of participants reported at least one adverse experience in childhood. Over half of the women were at risk for depression. Childhood adversities were negatively associated with depressive symptoms, but when sources of perceived social support were added, the effect of childhood adversity was not significant. Being married and the number of siblings were significantly related to depressive symptoms. The authors concluded that “Strengthening the role of various sources of social support can help to improve the mental health conditions of pre-abortion women.”

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Yazdanpanahi, Zahra., Hajifoghaha, Mahboubeh., Hesamabadi, Alimohammad Keshtvarz. et al. (2004). Comparison of depression, anxiety, perceived stress, and resilience in parents faced with abortion in Iran: a longitudinal study. BMC Psychol, 12, 575

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https://doi.org/10.1186/s40359-024-02078-w.

https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-024-02078-w

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The participants for this longitudinal study included 200 hospitalized women and their spouses. The scores of parents’ anxiety, depression, and perceived stress peaked 24 hours following an abortion and then decreased 12 weeks later. Resilience was also measured, and as time passed, it increased. The fathers’ scores on the various mental illness measures were lower than those of the mothers, but the mean resilience score was always higher in fathers. Fathers´ age and mothers’ age, mothers’ age at the time of marriage, fathers’ job, number of children, gender of the last child (boy or girl), and unwanted pregnancy were among the significant predictors of anxiety, depression, perceived stress, and resilience of both parents following abortion. The authors noted that identifying and managing the mental health issues observed is crucial for enhancing the well-being of both parents. They concluded that “How parents navigate the challenges of pregnancy, childbirth, and abortion can significantly impact the couple’s health.”

Yıldız Karaahmet, A., & Bilgiç, F. Ş. (2024). The Effect of Psychotherapy Interventions After Stillbirth on the Grief Process and Depression: Systematic Review and Meta-Analysis. Omega, 302228241272686. Advance online publication.

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https://journals.sagepub.com/doi/full/10.1177/00302228241272686?casa_token=y8zOBCb5XhIAAAAA%3A6tCSseOK3E6qA-U0yl3xIltOCowVch9pVDVkvOm-lCD5I-oUAFOwiVgNKQIdIQPhZwlmCr6qahLV

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This study provides a systematic overview of previously published quantitative research on the effects of psychotherapy interventions for women who experience a stillbirth on grief and depression in the postpartum period. Four databases (PubMed (MEDLINE), Cochrane, Google Scholar, Web of Science) were searched, yielding ten studies for inclusion. Meta-analysis results showed that psychotherapeutic interventions reduced mothers’ grief adaptations associated with the mourning process. Sub-group analyses revealed mothers' depression and stress levels were positively impacted by the interventions as well. The authors concluded, “Psychotherapeutic interventions given to women positively affect their grief adaptation and reduce stress, anxiety, and depression.”

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Zahmatkesh, M., Faal Siahkal, S., Alahverdi, F., Tahmasebi, G., & Ebrahimi, E. (2024). The role of art therapy on quality of life of women with recent pregnancy loss: A randomized clinical trial. PloS One, 19(7), e0305403.

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https://doi.org/10.1371/journal.pone.0305403

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https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0305403

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For context, the grief surrounding pregnancy loss often leads to what the authors refer to as “psychological adverse effects” on a woman’s overall QoL or quality of life. Because of this, the authors of this study aimed to “evaluate the effect of art therapy” in relation to QoL after grief experienced by women resulting in pregnancy loss. A randomized trial with 60 women who had a recent stillbirth or abortion experience was conducted, and two groups were formed. The first group was the art intervention group, and the other was a control group. The results indicated a significant difference in the two groups at 8 weeks post-intervention and that the QoL score for the group incorporating art therapy was much higher in multiple regards.

Zehetleitner, M., & Singer, L. (2024). Preregistration for attitudes toward abortion in Germany: Moral values, political attitudes, and religiousness. PsychArchives.

 

https://doi.org/10.23668/psycharchives.14635

https://psycharchives.org/en/item/93de52a7-207f-4001-8f32-6421d327d79d

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For context, abortion is a very polarizing issue in Germany as it is around the world, and in previous studies, public attitudes towards abortion have been looked at as well as predictors of outlooks. For this study, the authors wanted to look at some of the existing gaps in the literature on this topic, such as the politicization of attitudes about abortion, how individual moral values affect attitudes and the role religion plays. The primary objective was to look at how religion and political identity affect one's moral values and attitudes about abortion in Germany; however, they also then sought to “determine if attitudes towards abortion are multi-dimensional. Finally, they identified groups of individuals with similar moral values, political attitudes, religiosity, and abortion attitudes using cluster analysis. The authors provide detailed information and charts about the clusters identified.

Zheng, Q., Yin, X., Liu, L., Jevitt, C., Fu, D., Sun, Y., & Yu, X. (2024). The influence of culture and spirituality on maternal grief following stillbirth in China: A qualitative study. International Journal of Nursing Studies, 160, 104863.

 

https://doi.org/10.1016/j.ijnurstu.2024.104863

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https://www.sciencedirect.com/science/article/pii/S0020748924001767

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Stillbirth is a unique problem in terms of how its impact can be mended by parents suffering from the loss. In China, not much research is conducted regarding this form of loss, and the authors of this paper see the unknown as a reason to delve into the experiences of the lesser-studied women in China. A study was conducted by interviewing 28 women in China using trained interviewers to identify important themes that provide insight into the experiences and opinions of these women.  The first of three key themes was “The influence of culture on grief expression,” the second was “Cultural characteristics of post-stillbirth experiences,” and the third was “Finding significance in the spiritual healing process.” From the totality of these findings and the subthemes that composed the key themes, the authors felt that spirituality and culture in China are different in a way that can often hinder the grief and healing process. According to the authors, culturally appropriate interventions need to be developed for better results in the future.