Priyanka H. Krishnaswamy 1, Sujatha Prabhu2, Achal Shetty3
BACKGROUND
India is a country where people are dependent on each other for psychological support. Traditional Indian culture follows a collectivist pattern where the woman cares more about her family and society than herself. An unmarried woman who is pregnant poses a problem for both herself and her baby here, where traditional values are held high and pregnancy without marriage is almost always a taboo.
AIMS
To find the impact of Termination of Pregnancy (TOP) on the anxiety and depression levels among pregnant women, correlation with period of gestation and the impact of perceived social support on anxiety and depression levels of these women.
SETTING
One hundred women who attended the outpatient department of ESICMC- PGIMSR, Bengaluru, India, requesting for Termination of Pregnancy, between August 2011 and December 2014 were studied.
DESIGN
A Prospective Observational study.
METHODS AND MATERIAL
Hospital Anxiety and Depression Scale (HADS) and Multidimensional Scale of Perceived Social Support (Zimet, 1988) were measured both pre-TOP and Hospital Anxiety and Depression Scale (HADS) was measured post TOP in women fulfilling the Inclusion and Exclusion criteria.
STATISTICAL ANALYSIS
Averages and proportions were calculated for the study and appropriate statistical tests like Wilcoxon Signed Ranks Test and Spearman’s Correlation Coefficient were done using MiniTab version 16.
RESULTS
1) There is a reduction of depression and anxiety after Termination of pregnancy (p <0.05) more so among unmarried women with an unwanted pregnancy.
2) The higher the period of gestation, the higher the levels of HADS anxiety levels were observed (p value of <0.05).
3) The lower the social support scores, the higher the levels of HADS anxiety and depression (p value of <0.05).
CONCLUSIONS
There is a need for larger number of abortion care providers in India with increased contraception awareness and education regarding the need for Termination of Pregnancy in medical professionals. Women undergoing termination of pregnancy, especially when recognized as having social issues like a pregnancy without a husband, should be provided with counseling for not only the women, but also the family to improve the mental status of the woman especially in a country with a collectivist culture like India.
