Negative Abortion Experiences: Predictors and Development of the Post-Abortion Psychological and Relational Adjustment Scale 

Associations between several personal and contextual predictors of negative post-abortion mental health outcomes were explored using a large national sample of U.S. women who sought out post-abortion care from a crisis pregnancy center. The predictors examined included decisional regret, pregnancy wantedness, various forms of pressure, understanding of the procedure, and satisfaction with counseling provided by the abortion facility. Well-established measures of depression, anxiety, and substance abuse in addition to a newly developed assessment of abortion-related outcomes, the Post-Abortion Psychological and Relational Adjustment Scale (PAPRAS) were employed as the criteria in regression models. All analyses included controls for pre-abortion psychological adjustment and various forms of abuse in addition to a number of demographic variables. When the PAPRAS served as the outcome measure, the abortion context variables as a group accounted for 45.8% of the variance in women’s post-abortion psychological and relational adjustment scores. Using the same sets of predictors in a series of regression models and employing established measures of general anxiety, depression, PTSD, alcohol abuse, and substance abuse, 3.5% to 8.8% of the variance was explained. Based on psychometric analysis of the PAPRAS, there is evidence that this newly developed instrument holds promise for addressing the unique post-abortion mental health and relational concerns of women.