Study: Relief Most Common Emotion 5 Years Post-Abortion

After five years, relief was the most common feeling among women who had had an abortion, with intensity of all emotions associated with abortion declining over time, according to data from the Turnaway Study.

The intensity of all emotions — including sadness, guilt, regret, anger, happiness, and relief — decreased among these women, and 5 years after having an abortion, 99% of women indicated that it was the right choice for them, reported Corrine Rocca, PhD, MPH, of the University of California San Francisco, and colleagues, writing in Social Science and Medicine.

“[This research] put into context that having an abortion is one of the many complex and difficult things that women in this country are dealing with in their lives,” Rocca said in an interview with MedPage Today. “What I didn’t expect is that even though it remained low, relief remained the most reported emotion after five years.”

Claims that abortion harms women through prolonged negative emotions and regret has shaped both federal and local reproductive health policy, Rocca and colleagues wrote. Eight states require that every patient seeking an abortion is informed about possible lasting negative effects on their mental health. In 27 states, patients seeking an abortion are required to wait a specific period of time — usually 24 hours — to ensure they’ve had sufficient time to decide whether or not abortion is the right decision.

While some research identified factors that may contribute to short-term negative emotions after an abortion, little evidence supports the idea that women who have an abortion experience negative long-term impacts on their mental health, they said. Indeed, data from the Turnaway Study found “declining emotions” among women, 3 years post-abortion.

Turnaway Study participants were at least age 15, spoke primarily English or Spanish, and had a pregnancy with no known fetal anomalies. They participated in 11 waves of phone interviews addressing both their “abortion emotions” and “decision rightness.” Researchers also asked questions that measured decision difficulty and perceived community stigma of abortion. The first interview occurred approximately a week after a woman sought care, and then once every 6 months for 5 years. Among the 956 women that participated in the study, 667 completed an interview in the final two years.

The average age of participants at the start of the study was 25, and 35% of participants were white, 32% were black, and 21% were Latina. Mean gestation was 15 weeks.

Overall, 97.5% of women reported that abortion was the right choice at baseline, and that increased to 99% after 5 years.

About half of women responded it was a “difficult” or “somewhat difficult” decision to have an abortion and around half responded it was not a difficult decision. Women reporting difficulty with their decision were more likely to have more negative feelings about the pregnancy and were more likely to be seeking near-limit abortions. Decision difficulty increased with higher levels of perceived abortion stigma in their community, the authors said. At the start of the study, 31% of women reported high perceived community stigma.

Over 5 years, the portion of women who reported feeling none/few emotions increased sharply. One week after the abortion, around 20% reported feeling no or few emotions, which increased to 45% after 1 year. But after 5 years, 84% reported feeling mostly positive or few emotions about their decision, with only 6% feeling negative emotions.

While women with high decision difficulty reported more sadness and less relief a week after the abortion, feelings of sadness declined across all groups over time, and levels of relief were no different after 5 years. But relief was the most commonly felt emotion by participants at all time points, the authors said. After 5 years, anger was the only emotion significantly higher for women reporting high perceived stigma in their community.

Rocca and colleagues noted that probing women about their emotions after having an abortion may have led to higher levels of emotions. However, Rocca said this should not bias the results as researchers found a decline in the intensity of emotions overall.

While Rocca said that “the biggest implications are for policy,” she hopes that clinicians understand there is no “one-size-fits-all approach” when it comes to abortion counseling.

“There’s really no need to counsel women at an abortion clinic about these notions of emerging regret,” Rocca said. “I do think we should be counseling women about strategies to combat stigma in their communities.”

last updated 01.14.2020