Risk of developing depression after an abortion
An abortion is a procedure in which a pregnancy is interrupted. There are two different types of abortions: miscarriage, where a pregnancy ends on its own, and induced abortion, where a woman decides to end her pregnancy by taking medication or undertaking surgery. Generally, abortion is conducted during the first trimester of pregnancy; this way, there is less risk of complications and it is carried out by a doctor or a health professional on a hospital or a health clinic.
An abortion through surgery is common; there are two types of procedures: vacuum aspiration, consisting of extracting the embryo from the uterus with a suction instrument and it can be performed before 14 weeks of pregnancy, and dilatation and evacuation (D&E), which can be performed after 14 weeks of pregnancy. The latter takes longer and it can require more than one visit to the doctor.
Laws regarding abortion are varied. In some places, women under 18 are required to let her parents know or let a court rule a decision. In other places, it is enough to wait between consultancy and the conduction of an abortion. Within Mexico, Mexico City is the only federal entity to allow a Legal Interruption of Pregnancy (ILE).
Two different criteria for induced abortions are considered; for it to be medically safe when performed by trained professionals, and when methods recommended by the World Health Organization are used. It is less safe when only one of these criteria is fulfilled and considered not safe when none of the criteria is met.
Risks and complications depend on when the procedures and methods are used. Less than 1 woman in every 100 presents complications on an abortion undertaken under 14 weeks of pregnancy. In abortions performed on advance stages, 2 in every 100 present complications.
According to data from the Guttmacher Institute, it is estimated that between 2010 and 2014, 56 million induced abortions occurred globally. The highest abortion annual rate occurred during that period on the Caribbean, estimated in 59 in every thousand women of reproductive age, followed by South America with 48. Lowest rates occurred in North America with 17, and West and North Europe with 16 and 18, respectively.
Attended women in services of Legal Pregnancy Interruption in Mexico City reach a total of 195,375 patients during April, 2007 and June 6, 2018. This figure includes those women who traveled to Mexico City to undertake an induced abortion. Patients came mainly from Mexico City, Puebla, Hidalgo, Morelos, Querétaro, and Michoacán.
A study performed to women 3 years after seeking an abortion in the United States, evaluated the occurrence with new depression anxiety diagnoses. Biannual interviews were conducted to 956 women who looked for an abortion on 30 facilities. Results showed that women who undertook abortion and women who gave birth had more probabilities to report self-diagnosis of depression during the first year after seeking an abortion than at the end of the year; that is, the study found that self-diagnosed depression is more common closer to the moment of seeking an abortion than after 3 years.
The experience of going through an unwanted pregnancy or the circumstances of a woman wanting to interrupt her pregnancy put women at risk of developing depression after seeking an abortion. These circumstances can be related to having reasons to undertake an abortion; for example, economy, age, sentimental relationships, amongst others.
The decision to give birth or interrupt a pregnancy can be difficult. It is necessary to seek help and talk about emotions, feelings, and receive pertinent counselling. Psychological services are crucial for proper orientation and to take a decision considering various factors like age, values, beliefs, future goals, and specially health.
Reviewers: Brenda Giselle Álvarez Rodríguez (Public Health Research Unit) and Cassandra Saldaña Pineda (Knowledge Management Unit).
Article: “Mental Health Diagnoses 3 Years After Receiving or Being Denied an Abortion in the United States”. American Journal of Public Health (AJPH). December, 2015.
American College of Obstetricians and Gynecologists.
Ministry of Health, Mexico City.