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[Psychological aspects of induced abortion].

  • Mouniq, C
  • Moron, P
Published Article
Psychologie médicale
Publication Date
Jun 01, 1982
PMID: 12268236


Results are presented of a literature review to identify social and psychological aspects of abortion. The literature does not provide a true profile of women requesting abortions, but some characteristics emerge. Reasons for requesting abortion include economic problems, difficult previous pregnancies, general medical contraindications to pregnancy, marital conflicts, feelings of loneliness, professional aspirations, problems with existing children, and feelings of insecurity about the future. However, the same feelings are found among women carrying their pregnancies to term. Unplanned pregnancies are more common during periods of depression. Most authors have found about 1/2 of women seeking abortions to be single and about 1/2 to be under 25 years old. Religion does not appear to be a determining factor. 1 study of psychological factors in abortion seekers found that a large number of single women seeking abortion had suffered traumatic experiences in childhood and were seeking security in inappropriate amorous relationships. Helene Deutsch stressed the destructive impulses latent in all pregnancies. Others have cited the ambivalence of the desire for pregnancy and feelings of loss after abortion. Studies published after legalization of abortion in the US and France however have stressed the nearly total absence of moderate or severe psychiatric symptoms after abortion. Responses immediately after the abortion may include feelings of relief, guilt, indifference, or ambivalence. Secondary affects appear minor to most authors. Psychological effects do not appear to be influenced by age, marital status, parity, intelligence, occupation, existence of a later pregnancy, or concommitant sterilization. "Premorbidity" and coercion by spouse or family were most closely associated with psychological symptoms. Numerous authors have found about twice as many negative reactions among women undergoing abortion for medical reasons. Most patients undergoing abortions for genetic reasons have been found to experience shame and guilt. Repeat abortion constitutes about 10-15% of all abortions, and reflects resistence to contraception. 1 study found repeat abortion seekers to have a low educational level, lack of knowledge of sex, image of sexuality as degrading, self-punishing masochistic tendencies, passivity, and other pathology. Routine psychiatric consultations for abortion should be avoided, and primary responsibility should be assumed by the physician for identifying patients at risk of psychological sequelae. Factors placing women at high psychological risk after abortion can be identified in the American literature: severe psychiatric ailment, lack of familial support, abortion for medical reasons, severe ambivalence, and familial or medical pressure. A consultation or brief treatment permitting the woman to elaborate her decision can help prevent postabortal difficulties. The interviewer should help the woman to understand whether her unexpected pregnancy was in reality an accident or the expression of an intense but unconscious desire for pregnancy, and thus to understand the reasons for her indecision. Various patterns of disturbance may be uncovered during treatment.

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