Emotional distress among couples involved in first-trimester induced abortions

OBJECTIVE To establish the prevalence of clinically significant psychological distress in women and men involved in first-trimester abortions and to identify related risk factors. DESIGN Prospective cohort study. SETTING A downtown Montreal public abortion clinic and the Montreal metropolitan area. PARTICIPANTS We recruited 197 women and 113 men involved in first-trimester abortions and compared them with control groups composed of 728 women and 630 men 15 to 35 years old who had taken part in a previous public health survey (Enquete Santi Quebec 1987). One hundred twenty-seven women and 69 men completed the follow-up questionnaire. MAIN OUTCOME MEASURES Level of distress as measured by the Ilfeld Psychological Symptom Index. RESULTS Before the abortion, 56.9% of women and 39.69% of men were much more distressed than their respective controls. Three weeks after the abortion, 41.7% of women and 30.9% of men were still highly distressed. Predictors of distress for women were fear of negative effects on the relationship, unsatisfactory relationships, relationships of less than 1 year, ambivalence about the decision to abort, not having a previous child, and suicidal ideation (this association was weaker than in controls). Predictors. For men were fear of negative effects on the relationship, relationships of less than 1 year, preoccupation with the abortion and anxiety about its accompanying pain, negative perceptions of their own health, suicidal gestures in the past, and suicidal ideation in the past year (only the association with suicidal gestures was marginally stronger than in controls). CONCLUSION Being involved in a first-trimester abortion can be highly distressing for both women and men.