Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study

BMJ Open. 2016 Feb 1;6(2):e009698. doi: 10.1136/bmjopen-2015-009698.


Objective: To prospectively assess women's risk for post-traumatic stress disorder (PTSD) and of experiencing post-traumatic stress symptoms (PTSS) over 4 ears after seeking an abortion, and to assess whether symptoms are attributed to the pregnancy, abortion or birth, or other events in women's lives.

Design: Prospective longitudinal cohort study which followed women from approximately 1 week after receiving or being denied an abortion (baseline), then every 6 months for 4 years (9 interview waves).

Setting: 30 abortion facilities located throughout the USA.

Participants: Among 956 women presenting for abortion care, some of whom received an abortion and some of whom were denied due to advanced gestational age; 863 women are included in the longitudinal analyses.

Main outcome measures: PTSS and PTSD risk were measured using the Primary Care PTSD Screen (PC-PTSD). Index pregnancy-related PTSS was measured by coding the event(s) described by women as the cause of their symptoms.

Analyses: We used unadjusted and adjusted logistic mixed-effects regression analyses to assess whether PTSS, PTSD risk and pregnancy-related PTSS trajectories of women obtaining abortions differed from those who were denied one.

Results: At baseline, 39% of participants reported any PTSS and 16% reported three or more symptoms. Among women with symptoms 1-week post-abortion seeking (n=338), 30% said their symptoms were due to experiences of sexual, physical or emotional abuse or violence; 20% attributed their symptoms to non-violent relationship issues; and 19% said they were due to the index pregnancy. Baseline levels of PTSS, PTSD risk and pregnancy-related PTSS outcomes did not differ significantly between women who received and women who were denied an abortion. PTSS, PTSD risk and pregnancy-related PTSS declined over time for all study groups.

Conclusions: Women who received an abortion were at no higher risk of PTSD than women denied an abortion.


Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Induced / psychology*
  • Adult
  • Female
  • Humans
  • Longitudinal Studies
  • Pregnancy
  • Pregnancy, Unwanted / psychology*
  • Prospective Studies
  • Risk Factors
  • Stress Disorders, Post-Traumatic / etiology*
  • Time Factors
  • United States
  • Young Adult