Current Psychiatry Reports

, 19:77 | Cite as

Unintended Pregnancy, Induced Abortion, and Mental Health

  • Sarah HorvathEmail author
  • Courtney A. Schreiber
Reproductive Psychiatry and Women’s Health (CN Epperson, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Reproductive Psychiatry and Women's Health


Purpose of Review

The early medical literature on mental health outcomes following abortion is fraught with methodological flaws that can improperly influence clinical practice. Our goal is to review the current medical literature on depression and other mental health outcomes for women obtaining abortions.

Recent Findings

The Turnaway Study prospectively enrolled 956 women seeking abortion in the USA and followed their mental health outcomes for 5 years. The control group was comprised of women denied abortions based on gestational age limits, thereby circumventing the major methodological flaw that had plagued earlier studies on the topic.


Rates of depression are not significantly different between women obtaining abortion and those denied abortion. Rates of anxiety are initially higher in women denied abortion care. Counseling on decision-making for women with unintended pregnancies should reflect these findings.


Abortion Depression Anxiety Substance abuse Postpartum depression Post-abortion syndrome 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major impotance

  1. 1.
    McCoy SB. Postpartum depression: an essential overview for the practitioner. South Med J. 2011;104(2):128–32.CrossRefGoogle Scholar
  2. 2.
    Gauthreaux C, Negron J, Castellanos D, Ward-Peterson M, Castro G, de la Vega PR, Acuña JM. The association between pregnancy intendedness and experiencing symptoms of postpartum depression among new mothers in the United States, 2009 to 2011: a secondary analysis of PRAMS data. Medicine. 2017;96(6).Google Scholar
  3. 3.
    • Major B. Report of the APA task force on mental health and abortion. American Psychological Association; 2008. A well-conducted review of the literature on mental health after abortion and call for better conducted studies. Google Scholar
  4. 4.
    Russo NF, Zierk KL. Abortion, childbearing, and women’s well-being. Professional Psychology: Research and Practice. 1992;23(4):269.CrossRefGoogle Scholar
  5. 5.
    Russo NF, Dabul AJ. The relationship of abortion to well-being: do race and religion make a difference? Professional Psychology: Research and Practice. 1997;28(1):23.CrossRefGoogle Scholar
  6. 6.
    Reardon DC, Cougle JR. Depression and unintended pregnancy in the National Longitudinal Survey of Youth: a cohort study. BMJ. 2002;324(7330):151–2.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Cougle JR, Reardon DC, Coleman PK. Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Med Sci Monit. 2003;9(4):CR105–12.PubMedGoogle Scholar
  8. 8.
    Gilchrist AC, Hannaford PC, Frank P, Kay CR. Termination of pregnancy and psychiatric morbidity. Br J Psychiatry. 1995;167(2):243–8.CrossRefPubMedGoogle Scholar
  9. 9.
    •• Biggs MA, Upadhyay UD, McCulloch CE, Foster DG. Women’s mental health and well-being 5 years after receiving or being denied an abortion: a prospective, longitudinal cohort study. JAMA psychiatry. 2017;74(2):169–78. This paper includes the depression and anxiety data from the complete 5 years of interview data collected in the Turnaway Study. CrossRefPubMedGoogle Scholar
  10. 10.
    Foster DG, Steinberg JR, Roberts SC, Neuhaus J, Biggs MA. A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one. Psychol Med. 2015;45(10):2073–82.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Psychol Med. 1983;13(03):595–605.CrossRefPubMedGoogle Scholar
  12. 12.
    Major B, Cozzarelli C, Cooper ML, Zubek J, Richards C, Wilhite M, et al. Psychological responses of women after first-trimester abortion. Arch Gen Psychiatry. 2000;57(8):777–84.CrossRefPubMedGoogle Scholar
  13. 13.
    Kroenke K, Spitzer RL, Williams JBW. The Phq-9. J Gen Intern Med. 2001;16(9):606–13.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Sit D, Rothschild AJ, Creinin MD, Hanusa BH, Wisner KL. Psychiatric outcomes following medical and surgical abortion. Hum Reprod. 2006;22(3):878–84.CrossRefPubMedGoogle Scholar
  15. 15.
    Steinberg JR, Finer LB. Examining the association of abortion history and current mental health: a reanalysis of the National Comorbidity Survey using a common-risk-factors model. Soc Sci Med. 2011;72(1):72–82.CrossRefPubMedGoogle Scholar
  16. 16.
    Roberts SC, Delucchi K, Wilsnack SC, Foster DG. Receiving versus being denied a pregnancy termination and subsequent alcohol use: a longitudinal study. Alcohol Alcohol. 2015;50(4):477–84.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Roberts SC, Subbaraman MS, Delucchi KL, Wilsnack SC, Foster DG. Moderators and mediators of the relationship between receiving versus being denied a pregnancy termination and subsequent binge drinking. Drug Alcohol Depend. 2016;159:117–24.CrossRefPubMedGoogle Scholar
  18. 18.
    Roberts SC, Foster DG. Receiving versus being denied an abortion and subsequent tobacco use. Matern Child Health J. 2015;19(3):438–46.CrossRefPubMedGoogle Scholar
  19. 19.
    Roberts SC, Rocca CH, Foster DG. Receiving versus being denied an abortion and subsequent drug use. Drug Alcohol Depend. 2014;134:63–70.CrossRefPubMedGoogle Scholar
  20. 20.
    Biggs MA, Rowland B, McCulloch CE, Foster DG. Does abortion increase women’s risk for post-traumatic stress? Findings from a prospective longitudinal cohort study. BMJ Open. 2016;6(2):e009698.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Rocca CH, Kimport K, Gould H, Foster DG. Women’s emotions one week after receiving or being denied an abortion in the United States. Perspect Sex Reprod Health. 2013;45(3):122–31.CrossRefPubMedGoogle Scholar
  22. 22.
    Biggs MA, Upadhyay UD, Steinberg JR, Foster DG. Does abortion reduce self-esteem and life satisfaction? Qual Life Res. 2014;23(9):2505–13.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Berglas NF, Gould H, Turok DK, Sanders JN, Perrucci AC, Roberts SC. State-mandated (mis)information and Women’s endorsement of common abortion myths. Womens Health Issues. 2017;27(2):129–35.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Family PlanningHospital of the University of PennsylvaniaPhiladelphiaUSA
  2. 2.Family PlanningPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA

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