Psychological impact of abortion: methodological and outcomes summary of empirical research between 1966 and 1988

Health Care Women Int. 1989;10(4):347-76. doi: 10.1080/07399338909515861.


A systematic "roadmap" through the medical literature that empirically examines the incidence of psychological sequelae of induced abortion is presented. Because outcome incidence rates and methodological profiles vary substantially across studies, selective use of articles from this literature without an accompanying rationale for that selectivity could foster erroneous conclusions. Information compiled here can facilitate a rapid methodological critique of citations in abortion-related materials. Investigations published in English between January 1966 and April 1988 that quantitatively examined psychological sequelae using prospective, retrospective, or comparative methodologies are summarized in tables to produce a synopsis of the demographics, methodological limitations, and gross statistical features of each article. This quantitative guide is designed to facilitate appropriate use of the current literature, provide needed background to assess positions arising from the currently available data, and provide methodological focus for planning better studies in the future.

PIP: To facilitate generalizations on the longterm psychological effects of induced abortion, all English-language studies reported in the medical literature on this topic between January 1966-April 1988 were assessed for their findings and degree of methodological sophistication. Of the 280 articles on the psychological sequelae of abortion located through a computer search of the literature, 204 were excluded because they did not report original empirical data. The remaining 76 studies were comparative (13), prospective (31), and retrospective (32). A form was developed to summarize each study. Included was information on the type of study; date of data collection; country; details concerning the demographics, sampling, and follow-up; incidence of women reported to have negative or neutral-positive postabortion experiences; the dependent variable used to measure outcome; quantitative outcome mean scores; and the methodological limitations of the study. Overall, the review of these 76 studies revealed substantial variation in outcome incidence rates and serious methodological flaws. The most common flaws encountered were variability in the follow-up period, use of evaluative instruments of low or unknown validity, the inclusion of subjects with multiple abortions, interviewer bias, a lack of baseline measurements, and inadequate sample size (i.e., under 385, the size required to detect a psychosocial problem in 20% of the sample with a 95% confidence level). None of the existing studies allows for the definitive establishment of a link between abortion and subsequent emotional stability. Rather, the literature is, at this point, descriptive and correlational. Needed are prospective, longitudinal cohort studies that match nonequivalent comparison groups on key background variables and compare psychological stability over time.

Publication types

  • Review

MeSH terms

  • Abortion, Induced / psychology*
  • Abortion, Induced / statistics & numerical data
  • Female
  • Humans
  • Pregnancy
  • Research Design / standards*