Depression and associated psychosocial factors following a legal abortion in Mexico

Introduction: Scientific evidence from the United States and European countries shows that women who have had an induced abortion are not more likely to become depressed and several factors may confound this outcome. In contrast, in the case of Latin America, there are practically no studies in this regard due to restrictive legislation prevailing in the region. This paper aims to determine the prevalence of a probable major depressive episode (PMDE) in women who have legally terminated a pregnancy by way of public service in Mexico City and whether there are any psychosocial factors reported by the international literature associated with this outcome. Method: In a cross-sectional study, 274 women aged 15 years or older were interviewed two weeks after undergoing a medical abortion between November 2018 and November 2019. The Center for Epidemiological Studies Depression Scale 35-item version (CESD-R35) was used to measure the PMDE in a structured interview. Results: The prevalence of a PMDE was 15.8%. Multivariate logistic regression was used for adjusted analysis. Perceived abortion stigma (OR = 6.74, 95% CI = 3.29-13.82), child sexual abuse (OR = 2.23, 95% CI = 1.01-4.93), and previous childless pregnancies (OR = 6.07, 95% CI = 1.52-24.21) were associated with PMDE. Conclusions: The prevalence of PMDE is similar to or lower than that reported in studies with women who continued a pregnancy; post-abortion counseling and clinical considerations should include the impact that stigma and gender-based violence have on women’s mental health.