Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-18T18:53:09.909Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric outcome of termination of pregnancy for foetal abnormality

Published online by Cambridge University Press:  09 July 2009

Susan Iles  and
Dennis Gath
Susan Iles
Affiliation:
Department of Psychiatry, University of Oxford
Dennis Gath*
Affiliation:
Department of Psychiatry, University of Oxford
*
1Address for correspondence: Dr Dennis Gath, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Termination of pregnancy for foetal abnormality has become frequent with the increasing sophistication of techniques of antenatal diagnosis. The aim of this study was to obtain quantitative and qualitative information about psychiatric morbidity in women after termination of pregnancy for foetal abnormality.

Two samples of women were compared. The first consisted of 71 women who had had a termination of pregnancy for foetal abnormality (FA group). The second consisted of 26 women who had experienced so-called missed abortion (MA group). Both groups had lost a pregnancy in the mid-trimester of pregnancy, but the MA group had no element of choice.

Standardized psychiatric and social measures were used to assess both groups on three occasions after the termination. In both groups, 4 weeks after the termination psychiatric morbidity was high (four to five times higher than in the general population of women), and social adjustement was impaired. Six months and 12 months after the abortion, levels of psychiatric morbidity were near normal.

Semi-structured interviewing was used to obtain information about the experience of grief after mid-trimester termination. For many women, symptoms of grief persisted throughout the year. These symptoms included typical features of grief as well as grief symptoms specific to pregnancy loss. The findings have implications for the counselling of women after termination for foetal abnormality or after missed abortion.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 2 , May 1993 , pp. 407 - 413
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blumberg, B., Golbus, M. S. & Hanson, K. H. (1975). The psychological sequelae of abortions performed for a genetic indication. American Journal of Obstetrics and Gynaecology 122, 799–808.CrossRefGoogle ScholarPubMed
Cooper, P., Osborn, M., Gath, D. & Fegetter, G. (1982). Evaluation of a modified self-report measure of social adjustment. British Journal of Psychiatry 141, 68–75.CrossRefGoogle ScholarPubMed
Cooper, P. J., Campbell, E. A., Day, A., Kennerley, H. & Bond, A. (1988). Non-psychotic psychiatric disorder after childbirth: a prospective study of prevalence, incidence, course and nature. British Journal of Psychiatry 152, 799–806.CrossRefGoogle ScholarPubMed
Donnai, D., Charles, N. & Harris, R. (1981). Attitude of patients after ‘genetic’ termination of pregnancy. British Medical Journal 282, 621–622.CrossRefGoogle ScholarPubMed
Freud, S. (1917). Mourning and Melancholia. Hogarth Press: London.Google Scholar
Iles, S. (1989). The loss of early pregnancy. In Bailliére's Clinical Obstetrics and Gynaecology, vol. 3, No. 4. (ed Oates, M.), p 769–790. Bailliére Tindall: London.Google Scholar
Jorgensen, C., Uddenberg, N. & Ursing, I. (1985). Ultrasound diagnosis of foetal malformation in the second trimester: the psychological reactions of women. Journal of Psychosomatic Obstetrics and Gynaecology 4, 31–40.CrossRefGoogle Scholar
Leschot, N. J., Verjaal, M. & Treffers, P. E. (1982). Therapeutic abortion on genetic indications – a detailed follow-up study of 20 patients. Journal of Psychosomatic Obstetrics and Gynaecology 1, 47–56.CrossRefGoogle Scholar
Lloyd, J. & Laurence, M. (1985). Sequelae and support after termination of pregnancy for foetal abnormality. British Medical Journal 290, 907–909.CrossRefGoogle Scholar
Office of Population Censuses and Surveys (1970). Classification of Occupations. HMSO: London.Google Scholar
Office of Population Censuses and Surveys (1991). Abortion Statistics. HMSO: London.Google Scholar
Pare, C. M. B. & Raven, H. (1970). Follow-up of patients referred for termination of pregnancy. Lancet i, 635–638.CrossRefGoogle Scholar
Paykel, E. S. (1982). Life events and early environment. In Handbook of Affective Disorder (ed. Paykel, E. S.), pp 146–161. Churchill Livingstone: Edinburgh.Google Scholar
Peck, A. & Marcus, H. (1966). Psychiatric sequelae of therapeutic interruption of pregnancy. Journal of Nervous and Mental Disease 143, 417–425.CrossRefGoogle Scholar
Ryan, B. F., Joiner, B. L. & Ryan, T. A. (1985). Minitab Handbook, 2nd edn.Duxbury Press: Boston.Google Scholar
Surtees, P. G., Dean, C., Ingham, J. G., Kreitman, W. B., Miller, P. McC. & Sashidharan, S. P. (1983). Psychiatric disorder in women from an Edinburgh community: associations with demographic factors. British Journal of Psychiatry 142, 238–246.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wing, J. K., Mann, S. A., Left, J. P. & Nixon, J. M. (1978). The concept of a ‘case’ in psychiatric population studies. Psychological Medicine 8, 203–217.CrossRefGoogle Scholar
World Health Organization (1977). International Classification of Diseases, Injuries and Causes of Death, 9th revision. WHO: Geneva.Google Scholar