Is relief the most common reaction to abortion? Self-assessed intensity of emotions attributed to abortion in a national sample of women aged 41 to 45

Background It is widely reported that the most prominent emotion following abortions is relief. This claim primarily rests on two studies of abortion clinic patients which had methodological and self-censure bias. Other studies have indicated that negative emotions are more common than positive emotions. The objective of this study is to obtain self-assessed data on the intensity of emotional responses to abortion and pregnancy loss in a random national sample. Methods Using visual analog scales, a random sample of 1,925 women aged 41 to 45 completed a survey in which respondents rated the degree to which they experienced emotional responses to their first abortion or natural pregnancy loss. The emotions assessed included relief, grief, depression, anxiety, guilt, emptiness, anger, regret, shame, unforgiveness of self, uncontrollable weeping, frequent thoughts of the child they could have had, and difficulty completing the grief process. Women were categorized into five groups based on pregnancy outcomes, and four abortion decision types: Wanted, Inconsistent, Unwanted, or Coerced. Results Among women with a history of abortion (n=409), negative emotions were reported more intensely than relief. Relief was the predominant emotion only among the 29.8% of women whose abortions were freely wanted and consistent with their own values and preferences. For all other groups, relief was low and negative emotions were more prominent. Emotions following natural pregnancy losses were similar to those following abortion, but less severe following wanted abortions and more severe following coerced abortions. Conclusions Relief is only common after freely wanted abortions. Most abortions are inconsistent or contrary to women’s own values. In these cases, strong negative emotions are far more dominant than relief. These results should inform pre-abortion screening, counseling supportive of women’s own values and preferences, and mental health support post-abortion.