Twenty-six million legal abortions occur each year worldwide. Of these an unknown percentage of women have adverse psychological sequelae. This article reports on interviews with a nonrandom sample of fifty women regarding reproductive history, abortion experiences and emotional responses in the former Soviet Union country of Belarus, where abortions are often used as a primary form of birth control. Both positive and negative responses were queried but emphasis was on cross-cultural comparisons with western samples regarding posttraumatic sequelae, depression, grief and guilt, and using an objective measure of trauma symptoms, the Impact of Events Scale-Revised (IES-R). Comparisons with existing Western literature allowed the question of: Similar to the cross-cultural concept of posttraumatic stress disorder are their possibly universal responses to abortion as well? As in western samples, attachment and recognition of life during pregnancy were present for many women despite choosing abortion, and eightytwo percent of the sample reported posttraumatic sequelae, which is high. Grief, guilt, dissociation, depression, anxiety and psychosomatic responses were also in common across cultures. The authors conclude that despite disparate circumstances and abortion use, women who have adverse responses are very similar across these two divergent cultures. They call for more research using representative samples to learn what percentage of women are likely to have adverse responses and which variables predict negative responses.
Alan Guttmacher Institute (1999). Sharing responsibility: Women, society and abortion worldwide, (pp 25-27). New York: AGI.
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author.
Bagarozzi, D. (1994). Identification, assessment and treatment of women suffering from posttraumatic stress after abortion. Journal of Family Psychotherapy, 5(3), 25-55.
Barnard, C. (1990). The long-term psychosocial effects of abortion. Dissertation Abstracts International 51/08-B: 4038.
Butterfield, L (1988). Incidence of complicated grief and posttraumatic stress in a Postabortion population. Dissertation Abstracts International 49/08-B: 3431.
Centers for Disease Control (2001). Morbidity and Mortality Weekly Report, January 07, 2000/48(51);1171-1174, 1191.
Donovan, D. M (1991). Traumatology: A field whose time has come. Journal of Traumatic Stress, (4)3:433-436.
Forst, J. G. (1992). The psychosocial aftermath of abortion. M.S.W. thesis; Masters Abstracts 31/01: 151.
Gilligan, C. (1993). In a different voice: Psychological theory and women's development. Harvard University Press: Cambridge, MA.
Karlin, E. (1997). Affidavit of Elizabeth Karlin in Karlin, et al. v. Foust et al. (Case Number 96-C-0374-C) in the United States District Court for the Western District of Wisconsin.
Leifer, M (1980). Psychological effects of motherhood: A study of first pregnancy. New York: Praeger Special Studies.
Major, B. N.; Cozzarelli, C.; Sciacchitano, A. M.; Cooper, M. L.; Testa, M.; & Mueller, P. M. (1990). Perceived social support, self-efficacy, and adjustment to abortion. Journal of Personality and Social Psychology (ISSN: 0022-3514), v. 59, no. 3, pp. 452-463.
Major, B. N.; Cozzarelli, C.; Cooper, M. L.; Zubek, J. Richards, C; Wilhite, M.; & Gramzow, R. H. (2000). Psychological responses of women after first-trimester abortion. Archives of General Psychiatry (ISSN: 0003-990X), v. 57, no. 8, pp. 777-784.
Mufel, N. (2000a). Changes in self-image after abortion, Health and Living Scientific Journal #4.
Mufel, N. (2000b). Decision-making about abortion in adolescents, Health and Living Scientific Journal #3.
Mufel, N. Speckhard, A. C. & Sivuha, S. (2002). Predictors of posttraumatic stress disorder following abortion in a former Soviet Union country. Journal of Prenatal & Perinatal Psychology & Health, 17(1), pp. 41-61.
Ney, P. G. (1982). A consideration of abortion survivors. Child Psychiatry in Human Development, 13, pp. 168-179.
Pope, L., Adler, N. & Tschann, J. (1999). "Post-abortion psychological adjustment: Are minors at increased risk?" Unpublished paper. Exhibit 2, Affidavit of Nancy E. Adler, Ph.D. in North Florida Women's Health et al. v. Florida, et al.
Romans-Clarkson, S. E. (1989). Psychological sequelae of induced abortion Australian and New Zealand Journal of Psychiatry (ISSN: 0004-8674), v. 23, no. 4, 555-565.
Rue, V. & Speckhard, A. (1996). Getting Beyond Traumatic Pregnancy Loss: Research Findings and Clinical Applications. Master Class presentation at the Georgetown University Medical Center's Trauma, Loss & Dissociation: Foundations of 21st Century Traumatology 2nd Annual Conference, Alexandria, VA.
Rue, V. & Speckhard, A. C. (1992a). Informed consent & abortion: Issues in medicine and counseling, Medicine & Mind, (invited article), 7, 75-94.
Rue, V. & Speckhard, A.C. (1992b). Post abortion trauma: Incidence and diagnostic considerations, Medicine & Mind, (invited article) 6(1-2), 57-73.
Speckhard, A. C. (1987). Psycho-social stress following abortion. Sheed & Ward Publishers, Kansas City, MO.
Speckhard, A. & Rue, V. (1992). Post abortion syndrome: An emerging public health concern, Journal of Social Issues 48(3), pp. 95-119.
Speckhard, A & Rue, V. (1993). Complicated mourning: Dynamics of impacted post abortion grief, Journal of Pre- and Peri-Natal Psychology, 8(1), 5-32.
Speckhard, A. (1996). Traumatic death in pregnancy: The significance of meaning & attachment. In Death & Trauma: The Traumatology of Surviving, Charles Figley, Brian Bride, & Nicholas Mazza (Eds.), Taylor & Francis.
Tarabrina, N. V., Lazebnaya, E. O., Zelonova, M. E., Lasko, N. B., Orr, S. P. & Pitman, R.K. (1993). Psychophysiological responses of Chernobyl liquidators during script-driven imagery. International Society for Traumatic Stress Studies Annual Meeting, San Antonio, Texas.
Weiss, D. S. & Marmar, C.R. (1995). "The impact of event scale-revised." In Assessing psychological trauma and PTSD: A practitioner's handbook, J.P. Wilson & T. M. Keane (Eds.), New York: Guilford.
Anne Speckhard, Ph.D. and Natalia Mufel
Anne Speckhard, Ph.D. is Adjunct Associate Professor of Psychiatry, Georgetown University Medical School, Washington, D.C. and Psychological Consultant for Advances in Health, Mclean VA. She is also Professor of Psychology, Vesalius College, Free University of Brussels. She lived in Belarus with her husband the U.S. Ambassador to Belarus, from 1997 to 2000 during which time this research was conducted at the Belarusian/American Women's Center. Likewise, Dr. Speckhard has conducted research interviews with women regarding their psychological responses to abortion in Romania, Netherlands, Belgium, Belarus, Russia and the United States. Belgian address: 3 Avenue des Fleurs, 1150 Brussels, Belgium. U.S. address: PSC 81, Box 135, APO AE 09724. E-mail: Aspeckhard@brutele.be or Speckhardl@aol.com
Natalia Mufel is Assistant Programme Officer for Early Childhood Development, UNICEF, in Minsk, Belarus. She is a Ph.D. aspirant in Belarusian State University, lectured gender-oriented courses in European Humanities University and wrote the chapter "Women's Health" for the United Nations' report about the state of women in Belarus (2003). She served as psychologist for the Women's Wellness Center, Minsk, Belarus during the time of research. E-mail: email@example.com
Editor's Note: Collaboration and travel between the researchers was supported by a grant from the NATO Science Programme, Collaborative Linkage Grant No 978603.