Uncorrected Proof
Shiraz E-Med J. In Press(In Press):e111809.
Published online 2021 August 17.
doi: 10.5812/semj.111809.
Research Article
Short-Term Physical and Psychological Health Consequences of
Induced and Spontaneous Abortion: A Cross-Sectional Study
Sedigh Alipanahpour
1
, Naeimeh Tayebi
2
, Mahnaz Zarshenas
3
and Marzieh Akbarzadeh
4, *
1
Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
2
Department of Midwifery, School of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran
3
Community Based Psychiatric Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
4
Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
*
Corresponding author: Department of Midwifery, Maternal-Fetal Medicine Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz,
Iran. Email: akbarzadm@sums.ac.ir
Received 2020 December 27; Revised 2021 February 20; Accepted 2021 May 03.
Abstract
Background: Abortion is an important pregnancy complication with short-term and long-term adverse physical and psychological
effects on women.
Objectives: The present study aimed to investigate the short-term physical and psychological effects of various types of medical
abortion in pregnant women referring to educational and medical centers in Shiraz, Iran.
Methods: In this cross-sectional study, among 5176 deliveries by the women referring to Shiraz Educational and Forensic Medicine
Centers during a 4-month period, 437 pregnancies ended in abortion and thus were included in this study. A questionnaire was
completed for each of the abortions, recording demographic characteristics and midwifery information. As well, the Mississippi
Post Traumatic Stress Disorder Scale (M-PTSD) was filled. Data were analyzed by SPSS software using appropriate statistical tests.
Results: The most common physical complications of induced and spontaneous abortion were fever (10.3%) and the need for trans-
fusion of blood products (4.6%). Among the patients who received abortion therapy, 73.1% had moderate stress due to psychological
complications.
Conclusions: Since the most common complications after abortion are fever, the need for blood transfusion, and bleeding, it is
recommended to prepare a protocol to standardize post-abortion care. Most women in both induced and spontaneous abortion
groups had moderate levels of stress. Due to the lack of attention to the mental health of the women experiencing abortion, it is
necessary for these women to receive adequate supportive counseling, in addition to other medical services, after abortion.
Keywords: Abortion, Physical, Complication, Termination, Pregnancy, Psychological Women, Medical, Spontaneous, Induced
1. Background
It is estimated that 42 million abortions occur every
year; 20 million of which are unsafe. The complications
of unsafe abortion result in 70,000 maternal deaths and
5 million temporary or permanent maternal disabilities
each year. It has also been mentioned that both sponta-
neous and induced abortion are recorded as spontaneous
in medical centers in order to receive post-abortion care (1).
Various studies have reported that early vaginal bleeding
(a risk factor for miscarriage) has been associated with ad-
verse pregnancy outcomes such as preterm delivery, pre-
mature rupture of membranes (PPROM), low birth weight
(LBW), intrauterine growth retardation (IUGR), small in-
fants for gestational age (SGA), placental abruption, man-
ual placental abruption, and pregnancy-induced hyper-
tension (PIH) (2-4). Bleeding and infection (endometritis,
infectious abortion) are also common following abortion
(5). Some studies have reported that miscarriage is a risk
factor for breast cancer (6, 7). Job loss, divorce, instability
in emotional relationships, and delayed gestational care
have also been reported to commonly occur after abortion
(8). Vaginal bleeding is a usual problem in pregnancy and
is considered an adverse pregnancy outcome and an omi-
nous complication.
Women’s reproductive history determines their health
outcomes. The women experiencing pregnancy complica-
tions and recurrent miscarriages are more prone to bleed-
ing and infection, which are the leading causes of mater-
nal mortality, as well as other adverse outcomes (9). Re-
garding the psychological effects of abortion, the num-
ber and types of distress response symptoms are grouped
into four classes: psychological, emotional, physical, and
cognitive/behavioral (10). For some women, abortion can
Copyright © 2021, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License
(http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly
cited.