title: Psychosocial factors and pre-abortion psychological health: The significance of stigma.
abstract: BACKGROUND
  Most research in mental health and abortion has examined factors associated with post-abortion psychological health. However, research that follows women from before to after their abortion consistently finds that depressive, anxiety, and stress symptoms are highest just before an abortion compared to any time afterwards.
  
  
  OBJECTIVE
  This finding suggests that studies investigating psychosocial factors related to pre-abortion mental health are warranted.
  
  
  METHODS
  The current study uses data from 353 women seeking abortions at three community reproductive health clinics to examine predictors of pre-abortion psychological health. Drawing from three perspectives in the abortion and mental health literature, common risks, stress and coping, and sociocultural context, we conducted multivariable analyses to examine the contribution of important factors on depressive, anxiety, and stress symptoms just before an abortion, including sociodemographics, abortion characteristics, childhood adversities, recent adversities with an intimate partner, relationship context, future pregnancy desires, and perceived abortion stigma.
  
  
  RESULTS
  Childhood and partner adversities, including reproductive coercion, were associated with negative mental health symptoms, as was perceived abortion stigma. Before perceived abortion stigma was entered into the model, 18.6%, 20.7%, and 16.8% of the variance in depressive, anxiety, and stress symptoms respectively, was explained. Perceived abortion stigma explained an additional 13.2%, 9.7%, and 10.7% of the variance in depressive, anxiety, and stress symptoms pre-abortion.
  
  
  CONCLUSIONS
  This study, one of the first to focus on pre-abortion mental health as an outcome, suggests that addressing stigma among women seeking abortions may significantly lower their psychological distress.
authors.affiliation: Department of Family Science, University of Maryland College Park, USA. Electronic address: jrsteinb@umd.edu.
authors.forename: Julia R
authors.initials: JR
authors.lastname: Steinberg
authors.affiliation: Department of Psychiatry, University of California, San Francisco, USA.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Tschann
authors.affiliation: Planned Parenthood Mar Monte, San Jose, CA, USA.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Furgerson
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA.
authors.forename: Cynthia C
authors.initials: CC
authors.lastname: Harper
mesh_terms: D000028:Abortion, Induced / Q000523:psychology*; D000022:Abortion, Spontaneous / Q000523:psychology; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008603:Mental Health / Q000592:standards; D011247:Pregnancy; D011584:Psychology; D057545:Social Stigma; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology* / Q000523:psychology
keywords: Adverse experiences; Pre-abortion psychological health; Stigma