Many earlier studies on abortion focused on complications, techniques and maternal mortality, with later studies concentrating on long-term health consequences that were driven by a political agenda. Some studies noted that a woman who terminates her pregnancy under circumstances of duress and coercion is likely to experience adverse psychological problems. Although this may be a valid concern with induced abortions, not many clinical studies have been done regarding psychological aftereffects. In some cases, psychiatric disorders such as depression and anxiety are seen following an elective abortion. However, the most common psychological response to abortion was depression and regret.
“Induced Abortion, Facts in Brief”
This fact sheet was a typical example of politically generated information made available to the general public. The information released by the Alan Guttmacher Institute showed that risk of death is eleven times higher during childbirth than abortions, and major complications are “minimal” acquiring for less than 1% of abortions. They reported fourteen percent of all abortions were paid with state public funds, while some were paid from federal Medicaid funding in cases of rape, incest, and endangerment to the woman’s health. Some states paid for the abortions of indigent women to help curb the estimated 1.3 million unplanned pregnancies that occurred.
To their credit, they briefly mentioned that death following an abortive procedure was possible. They stated, “the risk of death associated with abortion increases with the length of pregnancy.” They explained that an abortion at 8 weeks or less yielded 1 death in every 500,000 abortions, while a 16-20 week abortion resulted in 1 out of 27, 000. For someone seeking an abortion at 21 weeks or more, the possibility of death increased to 1 out of 8, 000 procedures.
The problem with this fact sheet was that abortion was portrayed as being a better alternative than childbirth because the procedure was endorsed by the federal government and gladly paid for by individual states. It never mentioned the possibility of psychological complications or any long-term physical effects following induced abortions. In fact, the data showed that an early abortion using the vacuum aspiration method (noted as the “most common procedure”) was harmless simply because they claimed it caused “no childbearing problems.”
The fact sheet also presented the 1992 court decision (Planned Parenthood vs. Casey) in a negative light—citing that the ruling “significantly weakened” the “legal protections” of women by granting states the ability to impose certain abortion restrictions, thus creating an “undue burden” for women who sought an abortion. They insinuated that the enforcement of parental consent or notification in thirty-two states was an illustration of “undue burden.”
“Long-Term Physical and Psychological Health Consequences of Induced Abortion”
Thorp et al. published a report in the January 2003 issue of Obstetrical & Gynecological Survey. The research indicated that the ratio for elective abortions in 1996 were 23 out of 1,000 women. They also indicated that a person having an induced abortion was more likely to have complications in later pregnancies and to suffer from severe mood disorders. Psychological effects of induced abortion include depression and emotional problems that sometimes result in suicide or suicide attempt (although long-term mental health effects could not be established due to the lack of a proper control group). Physical complications included breast cancer, placenta previa and the likelihood of preterm births or early deliveries (20-30 weeks of gestation), especially with an increased number of abortions.
Based on the findings, Thorp et al. believed clinicians are “obligated to inform” a young first-time pregnant woman of the added risk of breast cancer if she decided to abort. Informed consent should also “caution” women that having elective abortions lead to higher instances of depression and suicidal ideation.
There were several problems with this study. Only data from legal surgical abortions were considered (data from medical abortions were not used), and a true experimental design could not be established due “inappropriate comparison groups of women without a history of abortion.” The research results were compiled from published articles and not from actual subjects. Obtaining information “scientifically” was not possible since cases of induced abortion and breast cancer or other problems are usually acquired during self-disclosure in adverse medical situations.
Long-term studies cannot be conducted because many women do not report induced abortions during routine exams. Thorp et al. realized that more research needs to be done of women in “unintended or crisis pregnancies.” Without a longitudinal study on lifetime effects of elective abortions, the authors summed, “Women are making important health decisions with incomplete information.”
“Psychiatric Admissions of Low-Income Women Following Abortion and Childbirth”
A study conducted by Reardon et al. revealed that women who were separated, widowed or divorced during the abortion procedure were at higher risk for psychiatric admission. They also found that “depression, negative emotions and dissatisfaction with the abortion decision increased with time.” A small number of women experienced symptoms of post-traumatic stress disorder following an abortive procedure.
They determined that women who had abortions were more likely to suffer from depression than those who had unintended pregnancies and carried to term. The concluding interpretation of the study was: “Subsequent psychiatric admissions are more common among low-income women who have an induced abortion than among those who carry a pregnancy to term, both in the short and longer term.”
Reardon et al. sited several limitations of their study. Their research only contained data received from the “lowest socioeconomic group in the United States,” and complete medical histories of patients (including psychiatric diagnosis and previous pregnancies) were unavailable. They were unable to use marital status/social support as a determiner for post-abortive adjustment.
Psychological Responses of Women After First-Trimester Abortion
The study by Major et al. conducted a two-year study of emotional responses of women who aborted during their first trimester of pregnancy. The data was collected an hour before the procedure, an hour after, one month later, and two years post-abortion. They discovered that women who were initially satisfied with their decision to abort eventually became dissatisfied with their decision, resulting in increased negative emotions (sadness and regret two years after the procedure). Even though negative emotions increased over time, “severe psychological distress” was rare, and symptoms of post-traumatic stress disorder was less than the percentage found in the general population. Major et al. believed that the best predictor for post-abortion feelings and mental health was the evaluation of pre-abortion mental health.
One of the problems Major et al. found with their results was that responses were based on self-report, yielding a possibility that feelings may have been over or underestimated; and the sample results of the two-year follow-up had diminished to 50% of the original respondents (from 882 to 442). Also, there was an absence of a “good baseline measure of mental health prior to the discovery of the pregnancy,” in other words, they had no data to show that certain women may have been depressive before they became pregnant.
All studies that were examined showed that depression was an innate emotional reaction to abortion. The fact sheet, produced by the Alan Guttmacher Institute, gave no indication that extreme emotional or physical aftereffects existed following an abortion, only that the risk of death increased with a late term abortion. The truth is that most women will survive an abortive procedure, but will be plagued with the emotional aftereffects for many years following an abortion. Not only will the women experience grief and loss, they will carry the enormous burden of guilt.
Although the research findings indicated that “severe psychological distress” and post-traumatic stress disorder were rare, the realization that a woman was responsible for the termination of her own baby’s life was devastating enough to create an immediate sense of distress. Due to recent research findings, women now face an increased risk of breast cancer, in addition to the looming feeling of remorse they will feel for the rest of their lives.
When asked how the church might help someone who is contemplating abortion, someone suggested, “Make sure there are pamphlets available with the physical addresses of pro-life centers within a 30 mile radius of the church. Provide a 24-hour telephone number of a pro-life hotline and get a volunteer to be a designated driver for anyone who needs transportation to one of these facilities.” When questioned how the church might help someone emotionally heal from an abortion, another person commented, “Just love them.”
Allen Guttmacher Institute. Facts in Brief: Induced Abortion. New York: The Alllen Guttmacker Institute, 2002 [on-line]. Accessed 25 October 2003. Available from http://www.guttmacher.org; Internet.
Major, Brenda, Catherine Cozzarelli, M. Lynne Cooper, Josephine Z ubek, Caroline Richards, Michael Wilhite, and Richard H. Gramzow. Psychological Responses of Women After First-Trimester Abortion. Archives of General Psychiatry, Vol. 57 (8), August 2000 [on-line]. Accessed 27 October 2003. Available from http://archpsyc.ama-assn.org/cgi/ content/abstract/57/8/777; Internet.
Reardon, David C., Jesse R. Cougle, Vincent M. Rue, Martha W. Shuping, Priscilla K. Coleman and Philip G. Ney. Psychiatric Admissions of Low-Income Women Following Abortion and Childbirth. Canadian Medical Association Journal, May 2003 [on-line]. Accessed 25 October 2003. Available from http://www.cmaj.ca/cgi/content/full/168/10/1253; Internet.
Stotland, Nada L. Assessing the Mental Health Impact of Induced Abortion. Medline Review. Medscape Women’s Health 1(8), 1996 [on-line]. Accessed 25 October 2003. Available from http://eileen.250x.com/Main/Pass/MntlHlthImpct.htm; Internet.
Thorp, John M. Jr., Katherine E. Hartmann, and Elizabeth Shadigian. Long-Term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence. Obstetrical & Gynecological Survey, Vol. 58 (1), January 2003 [on-line]. Accessed 26 October 2003. Available from http://www.ncrtl.org/images/concept/evidencereview.pdf; Internet.
John M. ThorpJr., Katherine E. Hartmann, and Elizabeth Shadigian, Long-Term Physical and Psychological Health Consequences of Induced Abortion, Obstetrical & Gynecological Survey, Vol. 58 (1) [on-line], accessed 26 October 2003, available from http://www.ncrtl.org/images/concept/ evidencereview.pdf, internet.
Nada L. Stotland, Assessing the Mental Health Impact of Induced Abortion, Medline Review, Medscape Women’s Health 1(8), 1996 [on-line], accessed 25 October 2003, available from http://eileen.250x.com/Main/Pass/ MntlHlthImpct.htm, internet.
Copyright © 2007 M. Teresa Trascritti