Research Projects: Literature review of the emotional and psycho-social affects of abortion on women Research Proposal
28 June 2004

Crisis Pregnancy Programme Research Brief

Literature review of the emotional and psycho-social affects of abortion on women.

Background to this research:

The Crisis Pregnancy Programme, established by Statutory Instrument No.446 of 2001, is tasked with three functions that are specified in the Establishment Order. The functions of the Crisis Pregnancy Programme are as follows:
“to provide for:

1)a reduction in the number of crisis pregnancies by the provision of education, advice and contraceptive services
2)a reduction in the number of women with crisis pregnancies who opt for abortion by offering services and supports which make other options more attractive
3)the provision of counselling and medical services after crisis pregnancy".

In November 2003 the Crisis Pregnancy Programme published its “Strategy to Address the Issue of Crisis Pregnancy”. One of the aims of the strategy is to establish standards of best practice for post abortion care and counselling. One of the knowledge gaps in our evidence base is a comprehensive understanding of what reliable and valid research literature concludes about the range of emotional and psycho-social effects of abortion. The CPA wishes to commission a systematic literature review addressing these areas so as to feed findings into service planning and development.

This literature review will not need to address the physical effects of abortion as these aspects are reviewed and updated by expert medical associations (e.g. Royal College of Obstetricians and Gynecologists (RCOG) in the U.K.).

Research Aim:
The aim of this research is to critically review published and peer reviewed research relating to the range of emotional and psycho-social affects women may experience after abortion. This may include direct effects of the procedure and/or indirect contextual effects e.g. reaction of significant other’s/family support. The review will also outline significant risk factors contributing to adverse outcomes (e.g. pre-existing psychological problems).

A systematic identification and in-depth analysis of all relevant literature is required which critiques primary research relating to this topic.

Research Objectives:
1.To identify all peer reviewed published literature both in Ireland and internationally which explores the emotional and psycho-social affects of abortion.
2.To highlight the main issues addressed in international literature in relation to this topic and to place this data within an Irish context for comparison purposes.
3.To critique the literature found on the subject matter and to examine the feasibility of developing recommendations from research that would feed into the development of standards of best practice for post abortion care and counselling.
4.To explore the level and range of risk factors such as age, relationship status, socio-economic factors, pre-existing psychological problems, drug/alcohol addiction etc. related to adverse outcomes.
5.To fully address methodological issues arising, including limitations with respect to the reliability, validity and generalisability of research findings and recommendations for how research findings can be further tested, supported and validated.

Outputs of the research:
Expected outputs from this literature review include:

A systematic review of literature relating to the emotional, psychological and social effects of abortion. This may include direct effects of the procedure and/or indirect effects e.g. of other’s reactions or family support.

A series of recommendations with respect to the psycho-social needs of women and her family/partner after an abortion and how this relates to service development.

An understanding of what methodological approaches (e.g. longitudinal designs versus case study approach) have been used to increase knowledge within this area and the pros and cons of these approaches.

A clear understanding of the topic in an international context and an understanding of the complexities of the field.

An understanding of the limitations involved in carrying out this kind of research and a clear understanding of the reliability and validity of research data and implications for developing understanding in the research area.

Methodology
Full outline of literature review approach needs to be submitted in tender documents.

The objectiveness and integrity of the review approach needs to be described and ensured by the researcher.

The proposal should outline clearly the criteria used by the researcher for the inclusion/exclusion of research material.

It is important that prospective tenderers have not previously published on either side of the abortion debate.

Budget guidance:
The budget allocated for this piece of research is in the region of €10,000 inclusive of VAT.

Timetable for reporting process:
The suggested timeframe for this study is three months. An outline of the structure and content of the literature review should be submitted to the CPA at the end of the first month.

Closing date for receipt of tenders is Monday July 26th