Posttraumatic Stress Among Women After Induced Abortion
Of 1457 women who were qualified responders at baseline, 76 were never reported to the study centre and consequently never received the follow-up questionnaire. Response rates were 742/1381 (54%) at the three-month follow-up and 641/1381 (46%) at the six-month assessment (Figure 1).
Dropouts at the three-month assessments were younger, more often born outside Sweden, had a lower level of education, reported tobacco use more often but less alcohol use, had more anxiety and depressive symptoms and were more often using antidepressant treatment. In addition, they had more often had a previous abortion and had less often received counselling before the abortion (Table 1), and they also had higher rates of lifetime PTSD, ongoing PTSD and PTSS at the baseline assessment than the responders (Table 2). Dropouts at the six-month assessment had lower levels of education and had more often had a previous induced abortion (Table 1), but did not differ from responders in rates of lifetime PTSD, ongoing PTSD or PTSS (Table 2).
The prevalence of lifetime PTSD at baseline was 7.2%, at three months 2.9% and at six months 2.3%. The prevalence of PTSS at baseline was 23.5%, at three months 4.6% and at six months 6.1%. The prevalence of ongoing PTSD at baseline was 4.3%, at three months 2% and at six months 1.9% (Table 2).
Table 3 displays the demographic characteristics of women who developed (n = 51), recovered (n = 145) or remained unchanged (n = 25) in their PTSD or PTSS status during the observation period in comparison with the comparison group (n = 499) (see also Figure 2). Women who developed PTSD or PTSS were to a greater extent younger, more often students, less often working full-time, had a lower level of education, did not have children, and had more often received counselling before the abortion. However, the abortion method or the place of abortion was not associated with development of PTSD or PTSS (Table 3). The comparison group had lower levels of anxiety and depressive symptoms throughout the study than those who developed, recovered or remained unchanged in their state of PTSD or PTSS. Women who remained unchanged in their PTSD or PTSS during the observation period had the highest rates of depression and anxiety at all three assessment points (Table 4).
Trauma experiences during the period between the induced abortion and the three months assessment were reported by 57/720 women, or every 12 woman. The most commonly reported traumas were physical and psychological threats from a partner or from other persons, followed by traumatic events in the family and accidents. Among the 57 women, 14 reported trauma experiences that were related to the abortion, without giving any examples of what kind of trauma they had experienced. Eleven of these developed PTSD or PTSS. Of the 14 women who reported trauma experiences related to the abortion, nine had had a medical and three had had a surgical abortion. Six women had their abortion performed at the clinic and six at home. Two had missing data of abortion method and place of abortion.
Results
Of 1457 women who were qualified responders at baseline, 76 were never reported to the study centre and consequently never received the follow-up questionnaire. Response rates were 742/1381 (54%) at the three-month follow-up and 641/1381 (46%) at the six-month assessment (Figure 1).
Dropouts at the three-month assessments were younger, more often born outside Sweden, had a lower level of education, reported tobacco use more often but less alcohol use, had more anxiety and depressive symptoms and were more often using antidepressant treatment. In addition, they had more often had a previous abortion and had less often received counselling before the abortion (Table 1), and they also had higher rates of lifetime PTSD, ongoing PTSD and PTSS at the baseline assessment than the responders (Table 2). Dropouts at the six-month assessment had lower levels of education and had more often had a previous induced abortion (Table 1), but did not differ from responders in rates of lifetime PTSD, ongoing PTSD or PTSS (Table 2).
The prevalence of lifetime PTSD at baseline was 7.2%, at three months 2.9% and at six months 2.3%. The prevalence of PTSS at baseline was 23.5%, at three months 4.6% and at six months 6.1%. The prevalence of ongoing PTSD at baseline was 4.3%, at three months 2% and at six months 1.9% (Table 2).
Table 3 displays the demographic characteristics of women who developed (n = 51), recovered (n = 145) or remained unchanged (n = 25) in their PTSD or PTSS status during the observation period in comparison with the comparison group (n = 499) (see also Figure 2). Women who developed PTSD or PTSS were to a greater extent younger, more often students, less often working full-time, had a lower level of education, did not have children, and had more often received counselling before the abortion. However, the abortion method or the place of abortion was not associated with development of PTSD or PTSS (Table 3). The comparison group had lower levels of anxiety and depressive symptoms throughout the study than those who developed, recovered or remained unchanged in their state of PTSD or PTSS. Women who remained unchanged in their PTSD or PTSS during the observation period had the highest rates of depression and anxiety at all three assessment points (Table 4).
Trauma experiences during the period between the induced abortion and the three months assessment were reported by 57/720 women, or every 12 woman. The most commonly reported traumas were physical and psychological threats from a partner or from other persons, followed by traumatic events in the family and accidents. Among the 57 women, 14 reported trauma experiences that were related to the abortion, without giving any examples of what kind of trauma they had experienced. Eleven of these developed PTSD or PTSS. Of the 14 women who reported trauma experiences related to the abortion, nine had had a medical and three had had a surgical abortion. Six women had their abortion performed at the clinic and six at home. Two had missing data of abortion method and place of abortion.
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