Short-term Psychiatric Sequelae to Therapeutic Termination of Pregnancy

¹ Registrar, Maudsley Hospital; Senior Registrar, Dept. of Psychological Medicine, The Hospital for Sick Children, Great Ormond Street, London, W.C.1

A prospective study is described of the shortterm psychiatric sequelae to therapeutic termination of pregnancy. Of 44 women interviewed six months after operation, the outcome was favourable for 30 patients (68 per cent) and unfavourable for 14 patients (32 per cent). The psychiatric status of 39 patients (89 per cent) was improved or unchanged and only seven (16 per cent) regretted the termination. It is argued that in the majority of cases with an adverse outcome this was related to the patient's environment since operation rather than the termination. Factors which put patients at risk for an unfavourable outcome include multi-parity, desertion by partner, being foreign-born, falling within the age group 21-30, a past history of psychiatric illness, the existence of psychiatric illness at the time of termination, and moderate or strong ambivalence to termination.

In determining the outcome of termination, emphasis is placed on the importance of the attitudes of those associated with the patient. An arbitrary scale is devised for predicting the `at-risk patient', and ways of avoiding or reducing adverse sequelae are discussed.