Ann Lalos

Legal abortion: a painful necessity.

This study was conducted to increase knowledge about the psychosocial background and current living conditions of Swedish women seeking abortion, along with their motives for abortion and their feelings towards pregnancy and abortion. Two hundred and eleven women answered a questionnaire when they consulted the gynaecologist for the first time. The study indicates that legal abortion may be sought by women in many circumstances and is not confined to those in special risk groups. For example, most women in the sample were living in stable relationships with adequate finances. The motives behind a decision to postpone or limit the number of children revealed a wish to have children with the right partner and at the right time in order to combine good parenting with professional career. The study shows that prevailing expectations about lifestyle render abortion a necessity in family planning. One-third of the women had had a previous abortion(s) and 12% had become pregnant in a situation where they had felt pressured or threatened by the man. Two-thirds of the women characterised their initial feelings towards the pregnancy solely in painful words while nearly all the others reported contradictory feelings. Concerning feelings towards the coming abortion, more than half expressed both positive and painful feelings such as anxiety, relief, grief, guilt, anguish, emptiness and responsibility, while one-third expressed only painful feelings. However, almost 70% stated that nothing could change their decision to have an abortion. Thus, this study highlights that contradictory feelings in relation to both pregnancy and the coming abortion are common but are very seldom associated with doubts about the decision to have an abortion.

Ambivalence : a logical response to legal abortion : a prospective study among women and men

The aim of the study was to elucidate ambivalence in relation to legal abortion by studying emotions, attitudes, motives for abortion and ethical reasoning in a-strategic sample of women and men who, 1 year after abortion, expressed both positive and painful feelings in relation to the abortion. The study shows that social perspectives legitimate the decision to have an abortion whilst ethical perspectives complicate the decision. Nearly all women and men described having the abortion as an expression of responsibility. Almost one-half also had parallel feelings of guilt, as they regarded the abortion as a violation of their ethical values. The majority of the sample expressed relief while simultaneously experiencing the termination of the pregnancy as a loss coupled with feelings of grief/emptiness, in spite of the ambivalence, only one woman regretted the abortion. For the vast majority, the impact of the abortion had led to increased maturity and deepened self-knowledge. Thus, ambivalence might be regarded not only as problematic but also as indicating openness to the complexity of the abortion issue. Since incompatible values clash in connection with abortion, experiences of ambivalence become both logical and understandable.

Psychological Reactions to the Medical Investigation and Surgical Treatment of Infertility

The psychological effects of the medical investigation and surgical treatment of infertility were investigated. For 2 years 30 women with a diagnosis of tubal damage and 29 men were followed with repeated interviews. Negative effects on sexual life were recorded in all individuals and were associated with the planning of intercourse. Semen analysis was psychologically difficult to half of the men and feelings of shame and degradation were common. Fear and anxiety were increased before reconstructive tubal surgery and postoperative depression was observed in 10 women. Most couples overestimated their chances of having a child and half of them expected pregnancy to occur within a few months. After 2 years the need for professional support and counseling had increased. The medical procedure has psychological side effects in the infertile couple and may provoke anxiety. The investigation should be comprehensive and short, and psychologically traumatic investigations like basal body temperature records should be used with caution. During the period of somatic investigation and treatment repeated discussions about the marital relationship and sexual life should be initiated and psychosocial counseling should be offered to all couples.

“Keeping Up a Front”: Narratives About Intimate Partner Violence, Pregnancy, and Antenatal Care

Nine women who had been subjected to severe intimate partner violence during pregnancy narrated their ambiguous and contradictory feelings and the various balancing strategies they used to overcome their complex and difficult situations. Because allowing anyone to come close posed a threat, the women mostly denied the situation and kept up a front to hide the violence from others. Three women disclosed ongoing violence to the midwives, but only one said such disclosure was helpful. This article highlights the complexity of being pregnant when living with an abusive partner and challenges antenatal care policies from the perspective of pregnant women.

Depression, Guilt and Isolation among Infertile Women and their Partners

The crisis of infertility has been studied in 30 women with tubal damage and the manner in which it affected their partners over a period of 2 years. Altogether, 4 interviews were carried out with ...

How do urinary incontinence and urgency affect women's sexual life?

Objective. To investigate the impact of urinary incontinence and urgency on womens sexual life and the prevalence of urinary leakage during sexual activity. A further aim was to explore factors affecting sexual desire and satisfaction with sexual life. Design. A semi‐structured questionnaire study. Setting and Sample. Sexually active women (n=147) aged 18–74years with urinary incontinence and urgency were recruited from four outpatient clinics. Methods. The women completed questionnaires concerning medical history, psychosocial situation, partner relationship and sexual life, and answered the Bristol Female Lower Urinary Tract Symptoms questionnaire. All underwent clinical evaluation. Main Outcome Measures. Prevalence of urinary leakage during sexual activity, factors affecting sexual desire and sexual satisfaction. Results. The vast majority considered sexuality to be important in their lives. One‐third of the women had urinary leakage during sexual activity. Half reported that sexual life was more or less spoiled due to their urinary incontinence or urgency and they were worried about having urinary leakage during intercourse, and almost two‐thirds worried about odor and felt unattractive. The womens dissatisfaction with sexual life was strongly correlated to unsatisfying psychological health, orgasmic disability and worry about urinary leakage during intercourse. Insufficient vaginal lubrication, unsatisfying psychological health and their partners’ ill health were significantly correlated with decreased sexual desire. Conclusions. Urinary incontinence and urgency have a negative impact on womens sexual life. Thus, a dialogue about sexual function in women with urinary symptoms should become an integral component in clinical management.

Psychosocial determinants of well-being in gynecologic cancer patients

The purpose of this study was to investigate the well-being of women with endometrial versus cervical cancer before treatment, and its determinants at 12 to 15 months follow-up. The subjects were interviewed before treatment, then 6 and 12 to 15 months after initiation of treatment. Simultaneously, they completed questionnaires on psychological symptoms and social support. It appeared that well-being at baseline and at the follow-ups were highly correlated. Furthermore, cervical cancer patients reported significantly more symptoms on all occasions. After discriminant function analysis, the following three variables remained in the analysis: (a) well-being before treatment, (b) diagnosis, and (c) children at home. This allowed 81% of the patients to be classified as having a favorable versus an unfavorable outcome. The results of this study highlight the importance of well-being before treatment as a predictor of well-being after treatment. The necessity of individualized intervention measures is warranted.

Social adjustment and spouse relationships among women with stress incontinence before and after surgical treatment

Forty-five women with stress urinary incontinence (SUI) and their partners have been interviewed three months before and one year after surgical treatment to investigate the social consequences of their impairment. One year after surgery 76% of the women reported that they were cured (group A, n = 34) and 24% that they were improved (group B, n = 11). The cured women were significantly younger than the improved women. The duration of urinary leakage before the operation was significantly shorter in group A than in group B. One year post surgery group A reported a significantly decrease in impediments to exert certain tasks due to urine leakage. As concerns leisure time, group A reported a higher level of overall activities before surgery than group B, whereas postsurgery both groups obtained about the same level of activities. Regarding social support, no differences between the groups occurred as concerns attachment. Furthermore, group A women showed a significantly higher degree of adequacy of social integration compared with group B. The majority of the couples could openly discuss sexual matters with their partners and were satisfied with their sexual life. More than half of the interviewed men reported an increase in sexual desire one year after their partners operation. Whereas about every third woman in both groups reported an increase in sexual desire. However, the frequency of intercourse did not change in any groups. In conclusion, this study underlines the importance of social factors in the assessment of the consequences of stress urinary incontinence and its treatment.

The wish to have a child : a pilot-study of infertile couples

ABSTRACT– All women (n= 30) who were to undergo microsurgical treatment for tubal infertility, and their partners (n= 29), were subject to individual interviews just before and 2 years after the tubal surgery. Initially, they answered an open question concerning their wish to have a child and then were asked to choose from a list of 36 alternatives, a maximum of five motives for having a child. The infertile couples’ motives were compared with those of three reference groups: one group of 30 who had decided to continue their pregnancy, another group of 101 women who also planned to continue pregnancy and a third group of 459 women applying for legal abortion. All motives on the list were categorized as “philosophical”, “social/cultural”, “interpersonal” and “intrapsychic” motives. The interpersonal and intrapsychic motives dominated both the infertile women and their partners. A central motive was that a child is an ultimate expression of love between a man and a woman. The motives of the infertile couples, generally, did not differ from those of the reference groups.

Experiences of the Male Partner in Cervical and Endometrial Cancer – a Prospective Interview Study

This article focuses on social, psychological and sexual experiences of 47 men before their partner was treated for cervical or endometrial cancer and 1 year later. As a complement to the interviews the men completed a symptom check-list. Before initiation of treatment, a great majority of the men were in psychological crisis. The number of psychological symptoms decreased from the first to the last interview. Symptoms with psychosomatic character increased, however, considerably. In the endometrial group, several had intrapsychic problems, while interpersonal problems were more common in the cervical group. Both groups found it difficult to know how to behave and how to communicate with their partner, friends and acquaintances. A majority had nobody to whom they could speak honestly, and most did not obtain basic information about their partners disease. The experiences of intercourse were much more negative after completed treatment and a majority described impaired sexual desire. Provided that the woman herself desires it, the coping and rehabilitation of the woman, the man and the couple would improve if the male were integrated in the care program from the moment the diagnosis of cancer is made.