Post-abortion syndrome

Post-abortion syndrome (PAS), also known as post-traumatic abortion syndrome and abortion trauma syndrome, is a term used to describe a set of psychopathological characteristics that have been observed in women following an elective abortion. There is no agreement within the medical community as to whether these characteristics constitute a separate nosological category. PAS is not included in the DSM-IV-TR or ICD-10 list of psychiatric conditions.

Although no formal definition exists, PAS is characterized as being similar to post-traumatic stress disorder (PTSD). The term "abortion trauma syndrome" has been used by abortion opponents to imply that connection. A 2005 study showed that the criteria for PTSD were met in all ten cases of alleged PAS that were looked at. Apart from the PTSD-specific symptoms, other symptoms noted were "repeated and persistent dreams and nightmares related with the abortion, intense feelings of guilt and the 'need to repair'."

The U.S. Surgeon General, C Everett Koop, conducted a review in 1989 of over 250 studies pertaining to the psychological impact of abortion, but wrote that it was not possible to reach any conclusions, and recommended setting up a five-year, $100 million study.

Most likely to be affected
According to a 2005 report of the American Psychological Association (APA), prior research indicated that adverse emotional reactions to the procedure are most strongly influenced by pre-existing psychological conditions and other negative factors.

A recent longitudinal study of 630 young women in New Zealand found results that conflict with the conclusions of the 2005 APA report. Women who had an abortion between the ages of 15 and 25 were significantly more likely to develop mental health problems post-abortion, including depression, suicidal behaviors and substance use disorders. This was the case even when accounting for confounding variables, including pre-existing psychological conditions.

Empirical research suggests that some women are more likely than others to develop post-abortion psychological problems. The risk-factors include:
 * low self-efficacy for coping with the abortion
 * low self-esteem
 * external locus of control
 * difficulty with the decision
 * when there is emotional investment in the pregnancy
 * perceptions of one's partner, family members, or friends as non-supportive
 * timing during adolescence, being unmarried, or poor
 * pre-existing emotional problems or unresolved traumatization
 * a poor or insecure attachment relationship with one's mother or a childhood history of separation from one's mother for a year or more before age 16
 * involvement in violent relationships
 * traditional sex-role orientations
 * conservative views of abortion and/or religious affiliation
 * when a pregnancy is initially intended
 * abortion during the second trimester
 * when woman is in an unstable partner relationship
 * being forced into abortion by one's partner, others, or by life circumstances