A growing number of women with major psychiatric disorders frequently consider the choice of abortion or relinquishment of the custody of children. Psychological reactions to abortion and relinquishment of custody were assessed and contrasted among 119 hospitalized women of M age 40 yr. and psychiatric patients. An original questionnaire was developed to assess emotional symptoms, psychiatric signs, attitudes, and satisfaction with the decision regarding the loss of a fetus or child. As hypothesized, reported sequelae of relinquishments of custody were rated as significantly more severe than sequelae of abortion. Dissatisfaction with choice, negative attitudes, religious affiliation, and involuntary removal of a child from custody were predictive of distress following abortion or relinquishment. The findings show that increased efforts are needed to help women with psychiatric difficulties cope with reproductive planning and losses.
Get full access to this article
View all access options for this article.
References
1.
AdlerN. E. (1975) Emotional response of women following therapeutic abortion. American Journal of Orthopsychiatry, 45, 446–454.
2.
AdlerN. E.DavidH. P.MajorB. N.RothS. H.RussoN. F.WyattG. E. (1990) Psychological responses after abortion. Science, 248, 41–44.
3.
AdlerN. E.DavidH. P.MajorB. N.RothS. H.RussoN. F.WyattG. E. (1992) Psychological factors in abortion. American Psychologist, 47, 1194–1204.
4.
BachrachC. A. (1986) Adoption plans, adopted children and adoptive mothers. Journal of Marriage and the Family, 48, 243–253.
5.
BachrachL. (1988) Chronically mentally ill women: an overview of service delivery issues. In BachrachL.NadelsonC. (Eds.), Treating chronically mentally ill women. Washington, DC: American Psychiatric Press. Pp. 3–17.
6.
BlantonT. L.DeschnerJ. (1990) Biological mothers' grief: the postadoptive experience in open versus confidential adoption. Child Welfare, 69, 525–535.
7.
BonavolgliaA. (Eds) (1991) Introduction. In The choices we made. New York: Random House. Pp. 19–33.
8.
BurnellG. M.NorfleetM. A. (1979) Women who place their infant for adoption: a pilot study. Patient Counseling Health Education, 1, 169–172.
9.
CavenarJ. O.MaltbieA. A.SullivanJ. L. (1978) Aftermath of abortion. Bulletin of the Menninger Clinic, 42, 433–438.
10.
CoverdaleJ.AruffoJ.GrunebaumH. (1992) Developing family planning services for female chronic mentally ill outpatients. Hospital and Community Psychiatry, 43, 475–478.
11.
CoverdaleJ. H.AruffoJ. A. (1989) Family planning needs of female chronic psychiatric outpatients. American Journal of Psychiatry, 146, 1489–1491.
12.
CoverdaleJ. H.BayerT. L.McCulloughL. B.ChervenakF. A. (1993) Respecting the autonomy of chronic mentally ill women in decisions about contraception. Hospital and Community Psychiatry, 44, 671–674.
13.
DaggP. K. (1991) The psychological sequelae of therapeutic abortion—denied and completed. American Journal of Psychiatry, 148, 578–585.
14.
DavidH. P.MorgallJ. M. (1990) Family planning for the mentally disordered and retarded. Journal of Nervous and Mental Disease, 178, 385–391.
15.
DeykinE. Y.CampbellL.PathP. (1984) The postadoption experience of surrendering parents. American Journal of Orthopsychiatry, 54, 271–280.
16.
EdwardsH. (1989) How could you?Freedom, CA: Crossing Press.
17.
EwingJ. A.RouseB. A. (1973) Therapeutic abortion and a prior psychiatric history. American Journal of Psychiatry, 130, 37–40.
18.
FialkovM. J. (1988) Fostering permanency of children in out-of-home care: psycholegal aspects. Bulletin of the American Academy of Psychiatry and the Law, 16, 343–355.
19.
FordC. V.Castelnuovo-TedescoP.LongK. D. (1971) Abortion: is it a therapeutic procedure in psychiatry?Journal of the American Medical Association, 218, 1173–1178.
20.
GilchristA. C.HannafordP. C.FrankP.KayC. R. (1995) Termination of pregnancy and psychiatric morbidity. British Journal of Psychiatry, 167, 243–248.
21.
HenshawS. K.KostK. (1996) Abortion patients in 1994–1995: characteristics and contraceptive use. Family Planning Perspectives. 28140–147, 158.
22.
HenshawS. K.Van VortJ. (1994) Abortion services in the United States, 1991 and 1992. Family Planning Perspectives, 26, 100–106, 112.
HowellD. C. (1998) Fundamental statistics for the behavioral sciences. Pacific Grove, CA: Duxbury.
25.
KnightM. R. (1985) Termination visits in closed adoptions. Child Welfare, 64, 37–45.
26.
LukerK. (1984) Abortion and the politics of motherhood. Berkeley, CA: Univer. of California Press.
27.
McEvoyJ. P.HatcherA.AppelbaumP. S.AbernethyV. (1983) Chronic schizophrenic women's attitudes toward sex, pregnancy, birth control, and childrearing. Hospital and Community Psychiatry, 34, 536–539.
28.
McLoughlinS. D.ManninenD. L.WincesL. D. (1988) Do adolescents who relinquish their children fare better or worse than those who raise them?Family Planning Perspectives, 20, 23–32.
29.
McNeilT. F.KaijL.Malmquist-LarssonA. M. (1984) Women with nonorganic psychosis: pregnancy's effect on mental health during pregnancy. Acta Psychiatrica Scandinavica, 70, 140–148.
30.
MillenL.RollS. (1985) Solomon's mothers: a special case of pathological bereavement. American Journal of Orthopsychiatry, 55, 411–418.
31.
MillerL. J. (1990) Psychotic denial of pregnancy: phenomenology and clinical management. Hospital and Community Psychiatry, 41, 1233–1237.
32.
MillerW. H.ResnickM. P.WilliamsM. H.BloomJ. D. (1990) The pregnant psychiatric inpatient: a missed opportunity. General Hospital Psychiatry, 12, 373–378.
33.
MoseleyD. T.FollingstadD. R.HarleyH. (1981) Psychological factors that predict reaction to abortion. Journal of Clinical Psychology. 37. 276–279.
34.
MuqtadirS.HamannJ.MolnarG. (1986) Management of psychotic pregnant patients in a medical-psychiatric unit. Psychosomatics, 27, 31–33.
35.
NeyP. G.WickettA. R. (1989) Mental health and abortion: review and analysis. Psychiatric Journal of the University of Ottawa, 14, 506–516.
36.
NicholsonJ.GellerJ. L.FisherW. H.DionG. L. (1993) State policies and programs that address the needs of mentally ill mothers in the public sector. Hospital and Community Psychiatry, 44, 484–489.
37.
PackerS. (1992) Family planning for women with bipolar disorder. Hospital and Community Psychiatry, 43, 479–485.
38.
PayneE. C.KravitzA. R.NotmanM. T.AndersonJ. V. (1976) Outcome following therapeutic abortion. Archives of General Psychiatry, 33, 725–733.
39.
RaskinV. D. (1992) Maternal bereavement in the perinatal substance abuser. Journal of Substance Abuse Treatment, 9, 149–152.
40.
RosenfeldJ. A. (1992) Emotional responses to therapeutic abortion. American Family Physician, 45, 137–140.
41.
RudolphB.LarsonG. L.SweenyS.HoughE. E.ArorianK. (1990) Hospitalized pregnant psychotic women: characteristics and treatment issues. Hospital and Community Psychiatry, 41, 159–163.
42.
RussoN. F.ZierkK. L. (1992) Abortion, childbearing, and women's well-being. Professional Psychology: Research and Practice, 23, 269–280.
43.
RynearsonE. K. (1982) Relinquishment and its maternal complications: a preliminary study. American Journal of Psychiatry, 139, 338–340.
44.
SameroffA. J.SeiferR.BarocasR. (1983) Impact of parental psychopathology: diagnosis, severity, or social status effects?Infant Mental Health Journal, 4, 236–249.
45.
Schreiner-EngelP.WaltherV. N.MindesJ.LynchL.BerkowitzR. L. (1995) First-trimester multifetal pregnancy reduction: acute and persistent psychologic reactions. American Journal of Obstetrics Gynecology, 172, 541–547.
46.
SpielvogelA.WileJ. (1992) Treatment and outcomes of psychotic patients during pregnancy and childbirth. Birth, 19, 131–137.
47.
TestM. A.BerlinS. (1981) Issues of special concern to chronic mentally ill women. Professional Psychology, 12, 136–145.
48.
ThomasT.ToriC. D.WileJ. R.ScheidtS. D. (1996) Psychosocial characteristics of psychiatric inpatients with reproductive losses. Journal of Health Care for the Poor and Underserved, 7(1), 15–23.
49.
WeinrebM. L.MurphyB. C. (1988) The birth mother: a feminist perspective for the helping professional. Women and Therapy, 7, 23–36.
