Medical abortion for adolescentsBMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d2185 (Published 20 April 2011) Cite this as: BMJ 2011;342:d2185
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Professor Grimes comments that medical abortion is a viable option
for adolescents wishing to terminate a pregnancy (1). The basis for
determining success, however, appears to be judged upon short term
outcome, namely the need for post-procedure hospital treatment. The
possibility of long term psychological sequelae is not fully considered.
Grimes cites one small retrospective study which shows that women aged 14-
17 undergoing early abortion with mifepristone and misoprostol had "no
medical and psychological complications" (2). This retrospective study
uses a follow-up period of just four weeks. Grimes' conclusion is
challenged by several other studies which show a higher incidence of
mental health disorders in women who have had an abortion (3). In one
large longitudinal study, Fergusson et al. found that women aged 15-18,
who underwent an abortion, had a significantly higher incidence of major
depression, anxiety and suicidal ideation than both their non-pregnant
peers and pregnant peers who opted to continue with the pregnancy (4). A
full consideration of the long term psychological effects should be made,
therefore, before making any judgment on the apparent "success rate" of a
particular abortion method.
1)Grimes DA, Raymond EG. Medical abortion for adolescents. British
Medical Journal 2011; 342: 935-936.
2)Phelps RH, Schaff EA, Fielding SL. Mifepristone abortion in minors.
Contraception 2001; 64:339-43.
(3)Coleman PK, Coyle CT, Shuping M. et al. Induced Abortion and
Anxiety, Mood, and Substance Abuse Disorders: Isolating the Effects of
Abortion in the National Comorbidity Survey. Journal of Psychiatric
Research 2009;43: 770- 776.
(4) Fergusson, DM. Horwood LJ, Ridder, EM. Abortion in young women
and subsequent mental health. Journal of Child Psychology and Psychiatry
2006; 47: 16-24.
Competing interests: No competing interests