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clinmed/2001030002v1 (April 25, 2001)
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Depression associated with abortion and childbirth: A long-term analysis of the NLSY cohort

Jesse R Cougle, David C Reardon, and Priscilla K Coleman

Available research indicates that although abortion is generally a stressful event, most women do not suffer from severe negative reactions at the time of the initial post-abortion assessment. Among the few studies examining reactions over a year after the abortion, however, Major et al (2000) and Miller et al (1998), it has been discovered that delayed reactions are not uncommon. In addition, the trend line over time is toward increasing negative emotions and regret. Longitudinal studies examining a period of time in excess of one year have been recommended. Our study employed the National Longitudinal Survey of Youth (NLSY), a general purpose study, which has interviewed 6283 women since 1979. It contains psychological assessments administered in 1979 (the Rotter Internal-External Locus of Control scale) and 1992 (the Center for Epidemiological Studies Depression scale) and variables related to pregnancy outcome. Compared to post-childbirth women, aborting women (n=735) were found to have significantly higher depression scores as measured an average of10years after their pregnancy outcome. Higher depression scores could not be accounted for by confounding variables. Controlling for age, total family income, and locus of control scores prior to the first pregnancy event, post-abortive women were found to be 41% more likely than non-aborting women to score in the "high-risk" range for clinical depression. Furthermore, in response to a self-assessment question administered in 1998, aborting women were 73% more likely to complain of "depression, excessive worry, or nervous trouble of any kind" an average of 17 years post-abortion. A weakness of this study is that only 40% of the expected abortions are reported the NLSY population. Since concealment would tend to dilute the observed effects, the actual rate of depression in the "high-risk" range may be considerably higher than suggested by this data. Concealment of abortions in the NLSY was lowest among whites and married women. As expected, analysis by race and marital status confirmed that the differences in depression scores were highest among the groups with the least concealment. Pre-abortion and pre-childbirth locus of control scores were analyzed. As predicted, the locus of control scores correlated well with depression scores for both nulliparous and childbearing women but this correlation disappeared for aborting women. This suggests that aborting women may either (1) experience a shift toward a more external locus of control, or (2) experience a different type of depression than other women. Additional longitudinal research is warranted. Implications for future research are discussed.