title: The impact of psychiatric history on women's pre- and postabortion experiences.
abstract: OBJECTIVE
  The objective of this study is to investigate to what extent psychiatric history affects preabortion decision difficulty, experienced burden, and postabortion emotions and coping. Women with and without a history of mental disorders might respond differently to unwanted pregnancy and subsequent abortion.
  
  
  METHODS
  Women who had an abortion (n=325) were classified as either with or without a history of mental disorders, using the Composite International Diagnostic Interview version 3.0. The two groups were compared on preabortion doubt, postabortion decision uncertainty, experienced pressure, experienced burden of unwanted pregnancy and abortion, and postabortion emotions, self-efficacy and coping. The study was conducted in the Netherlands. Data were collected using structured face-to-face interviews and analyzed with regression analyses.
  
  
  RESULTS
  Compared to women without prior mental disorders, women with a psychiatric history were more likely to report higher levels of doubt [odds ratio (OR)=2.30; confidence interval (CI)=1.29-4.09], more burden of the pregnancy (OR=2.23; CI=1.34-3.70) and the abortion (OR=1.93; CI=1.12-3.34) and more negative postabortion emotions (β=.16; CI=.05-.28). They also scored lower on abortion-specific self-efficacy (β=-.11; CI=-.22 to .00) and higher on emotion-oriented (β=.22; .11-.33) and avoidance-oriented coping (β=.12; CI=.01-.24). The two groups did not differ significantly in terms of experienced pressure, decision uncertainty and positive postabortion emotions.
  
  
  CONCLUSIONS
  Psychiatric history strongly affects women's pre- and postabortion experiences. Women with a history of mental disorders experience a more stressful pre- and postabortion period in terms of preabortion doubt, burden of pregnancy and abortion, and postabortion emotions, self-efficacy and coping.
  
  
  CONCLUSIONS
  Negative abortion experiences may, at least partially, stem from prior or underlying mental health problems.
authors.affiliation: Utrecht University, Faculty of Social and Behavioral Sciences, Utrecht, the Netherlands. Electronic address: j.m.vanditzhuijzen@uu.nl.
authors.forename: Jenneke
authors.initials: J
authors.lastname: van Ditzhuijzen
authors.affiliation: Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, the Netherlands.
authors.forename: Margreet
authors.initials: M
authors.lastname: Ten Have
authors.affiliation: Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, the Netherlands.
authors.forename: Ron
authors.initials: R
authors.lastname: de Graaf
authors.affiliation: Utrecht University, Faculty of Social and Behavioral Sciences, Utrecht, the Netherlands.
authors.forename: Carolus H C J
authors.initials: CH
authors.lastname: van Nijnatten
authors.affiliation: Utrecht University, Faculty of Social and Behavioral Sciences, Utrecht, the Netherlands.
authors.forename: Wilma A M
authors.initials: WA
authors.lastname: Vollebergh
mesh_terms: D000028:Abortion, Induced / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000359:Aftercare / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000150:complications*; D009426:Netherlands; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000523:psychology*; D012044:Regression Analysis; D020377:Self Efficacy; D055815:Young Adult
keywords: Abortion; Coping; Doubt; Emotions; Mental health; Self-efficacy