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Contraceptive Barriers and Psychological Well-Being After Repeat Induced Abortion: A Systematic Review
Bogdan Dumitriu1,2, Alina Dumitriu1, Flavius George Socol1,2
1Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Behavioral Sciences (Basel, Switzerland)
|October 29, 2025
Summary
Psychological distress after repeat abortions is linked to restrictive policies and socioeconomic factors, not just the number of procedures. Access to contraception and mental health support is crucial for women's well-being.
Area of Science:
- Reproductive Health
- Mental Health Research
- Public Health Policy
Background:
- Repeat induced abortions are increasing globally.
- Their impact on women's psychological health is debated, especially with limited contraceptive access.
Purpose of the Study:
- To assess psychological outcomes (depression, anxiety, stress, quality of life) in women with repeat abortions.
- To examine how contraceptive access barriers influence these outcomes.
Main Methods:
- Systematic review of PubMed, Embase, and Scopus databases.
- Analysis of eight studies with over 262,000 participants.
- Preregistered under the PRISMA-2020 protocol.
Main Results:
- Prevalence of depression (5.5–24.8%), anxiety (8.3–31.2%), and stress (18.8–27%) varied widely.
- Three or more abortions increased depression odds by ~37%.
- Socioeconomic reasons, unwanted disclosure, and low partner support significantly worsened mental health outcomes.
- Restrictive abortion legislation and legal hostility correlated with higher mental distress.
Conclusions:
- Psychological distress after abortion is more strongly associated with legal hostility, financial hardship, and coercion than the number of procedures.
- Integrated interventions offering mental health support and accessible contraception are vital.
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