Degrees of grief and complicated grief self-attributed to natural and induced pregnancy losses in a national population of 41–45-year-old females
CLI Summary
This study screened women who had had abortions or pregnancy losses for complicated or prolonged grief. Over half the women who felt that their abortions were coerced were at the highest risk on the scale. Overall, nearly 40% of women who had an abortion or miscarriage reported that the worst of their negative emotions and poor mental health persisted even today.
Abstract
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.

