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Psychiatric aspects of pregnancy termination

Uta Landy, PhD
Philip D Darney, MD, MSc
Section Editors
Jody Steinauer, MD, MAS
Jonathan M Silver, MD
Deputy Editors
Sandy J Falk, MD, FACOG
David Solomon, MD


In the United States in 2011, approximately 1 million pregnancies were terminated [1]. Approximately half of all pregnancies were unintended and 40 percent of these were terminated, meaning that 21 percent of all pregnancies were aborted. The number of induced abortions declined by 13 percent between 2008 and 2011, but the number of terminations of intended pregnancies has increased due to advances in prenatal testing for fetal abnormalities [1-3]. Although the psychological impact of pregnancy termination is controversial, most studies, especially higher-quality studies, suggest that induced abortion is not associated with an increased risk of serious mental health disorders [4-10]. It is important to note that the psychological context of pregnancy termination varies depending upon whether the reason is an unwanted pregnancy, multiple gestation, or fetal anomalies.

The psychiatric aspects of pregnancy termination are reviewed here. Other issues regarding pregnancy termination are discussed separately. (See "Overview of pregnancy termination".)


Most reviews have concluded that abortion does not harm a women’s mental health [4,5,11-13]. However, some of the evidence regarding the psychiatric aspects of pregnancy termination is of low quality, and study designs are inconsistent [11]. Many studies do not use validated mental health measures or control for pre-abortion mental status and whether the pregnancy is planned, and the presence and type of comparison group varies [4]. Specifically, many studies compare women with unplanned pregnancies to women planning an ongoing pregnancy. The circumstance of an unwanted pregnancy involves factors that are likely to be associated with emotional distress, such as impaired relationships and financial difficulties.

In addition, psychological responses to pregnancy termination often vary by social, cultural, religious, or legal context, so generalizations across populations are difficult to make [14,15]. Emotional responses to abortion would be expected to differ between environments where induced abortion is permissible and where abortion is disapproved. If abortion poses risks such as injury, financial ruin, or incarceration, it is difficult to distinguish psychological responses to abortion from fears of the consequences.

The following sections focus upon mental health outcomes following pregnancy termination for unintended pregnancy. Psychiatric outcomes of pregnancy termination due to fetal abnormalities are discussed in a separate section. (See 'Termination for fetal anomalies' below.)

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Literature review current through: Dec 2017. | This topic last updated: Sep 14, 2016.
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