Degrees of grief and complicated grief self-attributed to natural and induced pregnancy losses in a national population of 41–45-year-old females

BACKGROUND: Pregnancy loss may trigger complicated grief. Self-judgment and pressure to abort contrary to one's preferences may increase the risk and severity of complicated grief reactions. METHOD: A topic-blind survey was offered to a random panel of 41- to 45-year-old American females. Of 2361 eligible respondents, 1925 (82%) usable surveys were collected. RESULTS: The highest levels of grief were associated women whose abortions were self-reported as inconsistent with their values and preferences. The grief scores of women who had natural pregnancy losses were most similar to those of the women who had unwanted abortions. Higher levels of grief were associated with self-judgement, intrusion, pressure to abort, immediate or persistent negative reactions, and reactions that interfered more with work, relationships and other activities. Nearly 40% reported that the worst of their negative feelings attributed to their pregnancy losses continue and persist today. CONCLUSIONS: Compared to a natural pregnancy loss, persistent and complicated grief following an induced abortion may be more or less common depending on the degree that the abortion was consistent, or inconsistent, with a woman's own values and preferences. With 40% reporting persistent negative emotions, even 20 years later, more interventions and resources are warranted.