Psychiatric morbidity and acceptability following medical and surgical methods of induced abortion.

Ninety-one women were asked to complete a standardized multiple choice questionnaire (modified from the Edinburgh Postnatal Depression Scale) to screen for anxiety and depression before and after legal abortion in early pregnancy achieved either by using mifepristone in combination with a prostaglandin (n = 54) or by vacuum aspiration under general anaesthesia (n = 37). Before abortion over 60% in both groups had high scores (compatible with psychiatric morbidity), but after the abortion there was a significant and equal fall in scores so that by 1 month less than 10% of either group had high scores. There was no difference between the two groups. Both methods of abortion were acceptable to the majority of women, although only 75% of the medical group indicated they would have the same method if a future termination was ever required, compared with 94% in the surgical group. However, in 13 women who had experience of both methods, the medical approach was preferred by 10 (77%). Thus, medical abortion is acceptable to the majority of women and is associated with the same low rate of short term psychiatric morbidity as has been recorded with surgical methods of termination, despite greater patient involvement and awareness of the abortion process.