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After-Effects of Abortion

• Abortion does not raise risk of depression

Depression and unwanted first pregnancy: longitudinal cohort study
Department of Psychology, Arizona State University
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38623.532384.55

Claims that terminating an unwanted first pregnancy raises the risk of depression is called into question in a study published online by the BMJ.

In fact, the authors suggest that abortion may be linked to a lower risk of depression through beneficial effects on education, income, and family size. The study involved 1,247 US women who aborted or delivered an unwanted first pregnancy between 1970 and 1992.

The women were interviewed over several years to examine the relation between pregnancy outcome and later depression.

Terminating compared with delivering an unwanted first pregnancy was not directly related to risk of depression. Instead, women who delivered before 1980 had a significantly higher risk of depression than all other groups. The abortion group also had a significantly higher mean education and income and lower total family size, all of which were associated with a lower risk of depression.

These results cannot be explained by underreporting of abortion, say the authors, because findings did not vary in groups known to vary in underreporting. Furthermore, women with higher depression scores were more willing to provide confidential abortion card information. Despite some study limitations, they conclude that there is no credible evidence that choosing to terminate an unwanted first pregnancy puts women at higher risk of subsequent depression.

They suggest that if the goal is to reduce women’s risk for depression, research should focus on how to prevent and ameliorate the effect of unwanted childbearing, particularly for younger women.

Contact:
Professor Nancy Russo, Department of Psychology, Arizona State University, AZ, USA Email: nancy.russo@asu.edu

• Motherhood

In the UK, a substantial proportion of new mothers suffer from post-natal depression. There is as yet no universally agreed definition of this, except that  it is a depressive condition which can affect a mother in the weeks and months  after childbirth. It is generally thought to affect between 10 and 15 per cent of  all new mothers.

• Denial of access to abortion services

Safe, legal abortion rarely has negative psychological effects. The denial of access  to abortion, however, can have serious consequences for the woman and for the resultant child.Several research studies have compared the effects on women and their children of those granted abortion and those forced to continue with their pregnancy. The evidence shows that the psychological and social consequences of refused abortion are frequently more serious than the consequences of abortion.

• Psychological problems

The consensus of all authoritative psychiatric and medical opinion is that, for the large majority of women, the effects on psychological health of having an abortion are neither major nor long-lasting.Most women report feeling a sense of relief. They suggest that the most stressful thing is coming to the decision to terminate, particularly when the circumstances  are difficult. Some women may experience feelings of sadness and loss; this is not  a mental illness, it is just a normal reaction to what can be a negative event.

Anti-choice organisations claim that abortion causes women to suffer severe psychological effects which they call “Post-Abortion Syndrome” (PAS). They liken  PAS to post traumatic stress disorder, a real syndrome sometimes experienced by people who have suffered a terrible trauma. However, research in the UK and the USA shows that there is no evidence of such a mental illness. To describe the possible emotional problems that women may experience after an abortion in  this way is a distortion of the facts.

Very few women suffer prolonged emotional distress following an abortion. However, distress may be triggered if the circumstances surrounding the abortion were especially stressful, e.g. if it had been illegal and was frightening/degrading;  if secrecy had been essential due to family/cultural/religious disapproval; if the woman had been unsure about her decision to have an abortion or if she had wanted to continue the pregnancy, but, for medical reasons, had had to have  an abortion.

Only a small minority of women experience any long term, adverse psychological after-effects following an abortion. …  [Risk factors are ambivalence before the abortion, lack of  a supportive partner, a psychiatric history or membership of  a cultural group that considers abortion wrong.] …    Early distress, although common, is usually a continuation  of symptoms present before abortion.

• Physical complications

Pregnancy is not without physical risk: carrying a pregnancy to term and giving birth can cause complications and subsequent health problems or even death. Even if a woman is in good physical health continuing a pregnancy is more risky than an abortion. Complications after an abortion such as serious bleeding, internal damage to the uterus or cervix and infection are possible but very rare when, as in the UK, abortions are performed by trained, experienced professionals in sterile conditions.Infertility

There is no link between abortion and infertility, miscarriage and stillbirth.

Breast cancer

The largest study looking at a possible link between abortion and breast cancer followed 1.5 million women in Denmark. It found that women who had abortions had no greater risk of breast cancer than those who had not. Research showing  a link between breast cancer and abortion has been discredited. A collaborative analysis of data from 53 studies reported in the Lancet stated that “worldwide epidemiological evidence indicates that pregnancies ending as either spontaneous  or induced abortions do not have adverse effects on women’s subsequent risk of developing breast cancer.”

• General After-Effects of Abortion

Anti-choice activists have encouraged publicity suggesting abortion harms women. On average one in three women in the UK will have an abortion in their lifetime – to suggest that they all suffer serious after-effects of abortion is a clear exaggeration.  A great deal of research has been undertaken over several decades to establish whether there is any link between abortion and damage to a woman’s physical and/or psychological health. The findings demonstrate that these anti-choice  claims are untrue.