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Psychological Impact on Women of Miscarriage Versus Induced Abortion: A 2-Year Follow-up Study

From the University of Oslo, Oslo, Norway.

Address correspondence and reprint requests to Anne Nordal Broen, MD, Department of Behavioral Sciences in Medicine, Sognsvannsveien 9, University of Oslo, P.O. 1111 Blindern, 0317 Oslo, Norway. E-mail: a.n.broen{at}basalmed.uio.no

OBJECTIVE: To compare the psychological trauma reactions of women who had either a miscarriage or an induced abortion, in the 2 years after the event. Further, to identify important predictors of Impact of Event Scale (IES) scores.

METHOD: A consecutive sample of women who experienced miscarriage (N = 40) or induced abortion (N = 80) were interviewed 3 times: 10 days (T1), 6 months (T2), and 2 years (T3) after the event.

RESULTS: At T1, 47.5% of the women who had a miscarriage were cases (IES score 19 points on 1 or both of the IES subscales), compared with 30% for women who had an induced abortion (p = .60). The corresponding values at T3 were 2.6% and 18.1%, respectively (p = .019). At all measurement time points, the group who had induced abortion scored higher on IES avoidance. Women who had a miscarriage were more likely to experience feelings of loss and grief, whereas women who had induced abortion were more likely to experience feelings of relief, guilt, and shame. At T3, IES intrusion was predicted by feelings of loss and grief at T1, whereas avoidance at T3 was predicted by guilt and shame at T1.

CONCLUSION: The short-term emotional reactions to miscarriage appear to be larger and more powerful than those to induced abortion. In the long term, however, women who had induced abortion reported significantly more avoidance of thoughts and feelings related to the event than women who had a miscarriage.

Key Words: miscarriage, • induced abortion, • psychological impact, • Impact of Event Scale, • posttraumatic stress disorder.

Abbreviations: PTSD = posttraumatic stress disorder;; IES = Impact of Event Scale;; OLS = ordinary least squares.

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