title: Later abortions and mental health: psychological experiences of women having later abortions--a critical review of research.
abstract: BACKGROUND
  Some abortion policies in the U.S. are based on the notion that abortion harms women's mental health. The American Psychological Association (APA) Task Force on Abortion and Mental Health concluded that first-trimester abortions do not harm women's mental health. However, the APA task force does not make conclusions regarding later abortions (second trimester or beyond) and mental health. This paper critically evaluates studies on later abortion and mental health in order to inform both policy and practice.
  
  
  METHODS
  Using guidelines outlined by Steinberg and Russo (2009), post 1989 quantitative studies on later abortion and mental health were evaluated on the following qualities: 1) composition of comparison groups, 2) how prior mental health was assessed, and 3) whether common risk factors were controlled for in analyses if a significant relationship between abortion and mental health was found. Studies were evaluated with respect to the claim that later abortions harm women's mental health.
  
  
  RESULTS
  Eleven quantitative studies that compared the mental health of women having later abortions (for reasons of fetal anomaly) with other groups were evaluated. Findings differed depending on the comparison group. No studies considered the role of prepregnancy mental health, and one study considered whether factors common among women having later abortions and mental health problems drove the association between later abortion and mental health.
  
  
  CONCLUSIONS
  Policies based on the notion that later abortions (because of fetal anomaly) harm women's mental health are unwarranted. Because research suggests that most women who have later abortions do so for reasons other than fetal anomaly, future investigations should examine women's psychological experiences around later abortions.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, California 94143, USA. julia.steinberg@ucsf.edu
authors.forename: Julia R
authors.initials: JR
authors.lastname: Steinberg
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects / Q000523:psychology*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008603:Mental Health; D011247:Pregnancy / Q000523:psychology*; D011262:Pregnancy Trimester, Second; D013997:Time Factors