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| ===Journal of the American Medical Association=== | ===Journal of the American Medical Association=== | ||
| Psychiatrist Nada Stotland of the ], current vice president of the American Psychiatric Association, argued in a 1992 commentary published in the '']'' (JAMA): "There is no evidence of an abortion-trauma syndrome.”<ref name=stotland_1404747 /> In 2003, Stotland wrote, "Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae."<ref name=stotland_15985924 /> | Psychiatrist Nada Stotland of the ], current vice president of the American Psychiatric Association, argued in a 1992 commentary published in the '']'' (JAMA): "There is no evidence of an abortion-trauma syndrome.”<ref name=stotland_1404747 /> In 2003, Stotland wrote, "Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae."<ref name=stotland_15985924 /> | ||
| ===Studies Relating to Reactions at One Year Post-Abortion=== | |||
| Interviews with of 854 women one year after they had abortions at a hospital in Sweden, found that approximately 60 percent of the women had experienced some level of emotional distress from their abortions and in 30% of the cases the reactions were classified as "severe."<ref>Söderberg, H., Janzon, L., & Sjöberg, N-O. (1998). European Journal of Obstetrics & Gynecology and Reproductive Biology, 79:173-178.</ref> | |||
| The research also compared pre-operative data on the women who agreed to participate in the one year followup and data on women who refused to participate, who represented approximately one-third of all women who had abortions at the hospital. Based on socio-demographic factors, reproductive history and reasons given for the abortion, the researchers concluded that women who are most likely to experience negative post-abortion reactions are also least likely to participate in post-abortion research, stating that "for many of the women, the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer very often given was: ‘I do not want to talk about it. I just want to forget'." <ref>Söderberg, H., Andersson, C., Janzon, L., & Sjöberg, N-O. (1998). European Journal of Obstetrics & Gynecology and Reproductive Biology, 77:67-70.</ref> | |||
| A record-based study of ] women found that in the year following a pregnancy outcome the rate of suicide following abortion was 34.7 per 100,000 compared to 5.9 per 100,000 for women who gave birth, 18.1 per 100,000 for women who had miscarriages, and 11.4 per 100,000 for women who had not been pregnant in the prior year. <ref>Gissler M, Hemminki E, Lonnqvist J. BMJ 1996;313:1431-4)</ref> | |||
| ======= TEMP ====== | |||
| For discussion and eventual inclusion in the section on abortion and mental health: | |||
| :According to the task force, "Case studies have established that some women experience severe distress or psychopathology after abortion" but "severe negative reactions are infrequent in the immediate and short-term aftermath, particularly for first-trimester abortions. Women who are terminating pregnancies that are wanted and personally meaningful, who lack support from their partner or parents for the abortion, or who have more conflicting feelings or are less sure of their decision before hand may be a relatively higher risk for negative consequences." <ref name="APA89">Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. "Psychological responses after abortion." Science, April 1990, 248: 41-44. </ref> | |||
| :In 1992, the <i>Journal of Social Issues</i> dedicated an entire issue to research relating to the psychological effects of elective abortion. In an overview of the contributors papers the editor, Dr. Gregory Wilmoth, concluded: "There is now virtually no disagreement among researchers that some women experience negative psychological reactions postabortion. Instead the disagreement concerns the following: (1) The prevalence of women who have these experiences . . . , (2) The severity of these negative reactions . . . , (3) The definition of what severity of negative reactions constitutes a public health or mental health problem . . . , (4) The classification of severe reactions . . . "<ref>Wilmoth G. Abortion, Public Health Policy, and Informed Consent Legislation. J Social Issues, 48(3):1-17 (1992).</ref> | |||
| :Interviews with of 854 women one year after they had abortions at a hospital in Sweden, found that approximately 60 percent of the women had experienced some level of emotional distress from their abortions and in 30% of the cases the reactions were classified as "severe."<ref>Söderberg, H., Janzon, L., & Sjöberg, N-O. (1998). European Journal of Obstetrics & Gynecology and Reproductive Biology, 79:173-178.</ref> | |||
| :The research also compared pre-operative data on the women who agreed to participate in the one year followup and data on women who refused to participate, who represented approximately one-third of all women who had abortions at the hospital. Based on socio-demographic factors, reproductive history and reasons given for the abortion, the researchers concluded that women who are most likely to experience negative post-abortion reactions are also least likely to participate in post-abortion research, stating that "for many of the women, the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer very often given was: ‘I do not want to talk about it. I just want to forget'." <ref>Söderberg, H., Andersson, C., Janzon, L., & Sjöberg, N-O. (1998). European Journal of Obstetrics & Gynecology and Reproductive Biology, 77:67-70.</ref> | |||
| :A record-based study of ] women found that in the year following a pregnancy outcome the rate of suicide following abortion was 34.7 per 100,000 compared to 5.9 per 100,000 for women who gave birth, 18.1 per 100,000 for women who had miscarriages, and 11.4 per 100,000 for women who had not been pregnant in the prior year. <ref>Gissler M, Hemminki E, Lonnqvist J. BMJ 1996;313:1431-4)</ref> | |||
| :In 2006, a team of researchers at the ] in New Zealand, published results relating to abortion reactions from a longitudinal study tracking approximately 500 women from birth to 25 years of age. The study found that compared to other women in the group those who had an abortion were significantly more likely to experience subsequent "mental health problems including depression, anxiety, suicidal behaviours and substance use disorders. This association persisted after adjustment for confounding factors." The authors wrote, "The findings suggest that abortion in young women may be associated with increased risks of mental health problems." <ref name="NZ">Fergusson, D.M., Horwood, L.J., & Ridden, E.M. (2006. . ''Journal of Child Psychology and Psychiatry, 47''(1), 16-24.</ref> | |||
| ==References== | ==References== | ||
Revision as of 23:19, 8 February 2008
Research on the relationship between abortion and mental health indicates that abortion is associated with positive or neutral effects on mental health. Some pro-life advocates claim that there is evidence of a "post-abortion syndrome", where negative psychological effects are purported to follow abortion. No major medical association recognizes such a syndrome. The validity of the claim is disputed by physicians, researchers, and pro-choice advocates.
Neutral or positive psychological effects
Studies have indicated that those who have undergone abortion have experienced positive or no change to their mental health and well-being. A 1989 study of teenagers who sought pregnancy tests found that counting from the beginning of pregnancy until two years later, the level of stress and anxiety of those who had an abortion did not differ from that of those who had not been pregnant or who had carried their pregnancy to term. A study done in Washington State University found no correlation between abortion and suicide.
Another study in 1992 found that having one abortion was positively associated with higher global self-esteem, particularly feelings of self-worth, capableness, and not feeling one is a failure. It also noted that adverse emotional reactions to the abortion are influenced by pre-existing psychological conditions and other negative factors and, furthermore, that well-being was separately and positively related to employment, income, and education, but negatively related to total number of children. In a 2005 US study, the evidence was inconclusive as to whether abortion as compared to completion of an undesired first pregnancy was related to increased risk of depression.
Potential negative psychological effects
No causal link has been established between abortion and mental illness. Emotional distress may occur in a minority of women who are contemplating or have had an abortion because of pre-existing mental health problems, the status of the woman's relationship, a poor economic status, a poor social network, or any conservative views on abortion she may have. These situations and abortion do correlate in a small minority of women with emotions such as guilt, anxiety, depression, and anniversary reactions.
Post-abortion syndrome
Post-abortion syndrome (PAS) is a term used to describe a set of adverse psychopathological characteristics, with possible connections to post-traumatic stress disorder, which are proposed to occur in a small percentage of those who undergo an induced abortion, following the procedure. Primarily a term used by pro-life advocates, PAS is not a medically recognized syndrome; PAS is not listed in the Diagnostic and Statistical Manual of Mental Disorders, and neither the American Psychological Association nor American Psychiatric Association recognize it. Some physicians and pro-choice advocates have argued that attempts to popularize the term "post-abortion syndrome" are a tactic used by pro-life advocates for political purposes.
A few studies suggest that abortion can be associated with short-term negative psychological effects in a minority of people.
While some studies have shown a correlation between abortion and clinical depression, anxiety, suicidal behaviors, or adverse effects on sexual functions for a small number of people, these correlations may be explained by pre-existing social circumstances and emotional health. According to the American Psychological Association, various factors, such as emotional attachment to the pregnancy, lack of support, and conservative views on abortion, may increase the likelihood of experiencing negative reactions. Studies have either failed to establish a causal relationship between abortion and negative psychological symptoms, or been inconclusive.
Studies
United States Surgeon General
American Surgeon General C. Everett Koop, who describes himself as pro-life, conducted a study of the medical and psychological impact of abortion on the patient, while he was in office. Koop summarized his findings in a letter to Ronald Reagan by saying that the psychological effects were "minuscule". Koop refused to publish the study, which was later found to have to have concluded that the procedure has no long-term mental health effects.
1987-1990 APA Task Force Review
When Koop was assigned to review information on abortion, he invited input from any individuals and organizations with material to present." The American Psychological Association Division on Population and Environmental Psychology prepared and presented to Koop their own summary of the literature and recommendations for his report. After Koop refused to issue the findings, division members published a synthesis of their own findings in which they concluded that "The weight of the evidence does not pose a psychological hazard for most women."
According to the task force, "Case studies have established that some women experience severe distress or psychopathology after abortion" but "severe negative reactions are infrequent in the immediate and short-term aftermath, particularly for first-trimester abortions. Women who are terminating pregnancies that are wanted and personally meaningful, who lack support from their partner or parents for the abortion, or who have more conflicting feelings or are less sure of their decision before hand may be a relatively higher risk for negative consequences."
The task force concluded that "research with diverse samples, different measures of response, and different times of assessment have come to similar conclusions. The time of greatest distress is likely to be before the abortion. Severe negative reactions after abortions are rare and can best be understood in the framework of coping with normal life stress."
Nancy Adler, professor of psychology at the University of California, San Francisco, has testified on behalf of the APA that "severe negative reactions are rare and are in line with those following other normal life stresses."
In 2007, APA established a new task force to review studies on abortion published since 1989. The new task force report is expected to be published in 2008.
Journal of the American Medical Association
Psychiatrist Nada Stotland of the University of Chicago, current vice president of the American Psychiatric Association, argued in a 1992 commentary published in the Journal of the American Medical Association (JAMA): "There is no evidence of an abortion-trauma syndrome.” In 2003, Stotland wrote, "Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae."
Studies Relating to Reactions at One Year Post-Abortion
Interviews with of 854 women one year after they had abortions at a hospital in Sweden, found that approximately 60 percent of the women had experienced some level of emotional distress from their abortions and in 30% of the cases the reactions were classified as "severe."
The research also compared pre-operative data on the women who agreed to participate in the one year followup and data on women who refused to participate, who represented approximately one-third of all women who had abortions at the hospital. Based on socio-demographic factors, reproductive history and reasons given for the abortion, the researchers concluded that women who are most likely to experience negative post-abortion reactions are also least likely to participate in post-abortion research, stating that "for many of the women, the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer very often given was: ‘I do not want to talk about it. I just want to forget'."
A record-based study of Finnish women found that in the year following a pregnancy outcome the rate of suicide following abortion was 34.7 per 100,000 compared to 5.9 per 100,000 for women who gave birth, 18.1 per 100,000 for women who had miscarriages, and 11.4 per 100,000 for women who had not been pregnant in the prior year.
= TEMP
For discussion and eventual inclusion in the section on abortion and mental health:
- According to the task force, "Case studies have established that some women experience severe distress or psychopathology after abortion" but "severe negative reactions are infrequent in the immediate and short-term aftermath, particularly for first-trimester abortions. Women who are terminating pregnancies that are wanted and personally meaningful, who lack support from their partner or parents for the abortion, or who have more conflicting feelings or are less sure of their decision before hand may be a relatively higher risk for negative consequences."
- In 1992, the Journal of Social Issues dedicated an entire issue to research relating to the psychological effects of elective abortion. In an overview of the contributors papers the editor, Dr. Gregory Wilmoth, concluded: "There is now virtually no disagreement among researchers that some women experience negative psychological reactions postabortion. Instead the disagreement concerns the following: (1) The prevalence of women who have these experiences . . . , (2) The severity of these negative reactions . . . , (3) The definition of what severity of negative reactions constitutes a public health or mental health problem . . . , (4) The classification of severe reactions . . . "
- Interviews with of 854 women one year after they had abortions at a hospital in Sweden, found that approximately 60 percent of the women had experienced some level of emotional distress from their abortions and in 30% of the cases the reactions were classified as "severe."
- The research also compared pre-operative data on the women who agreed to participate in the one year followup and data on women who refused to participate, who represented approximately one-third of all women who had abortions at the hospital. Based on socio-demographic factors, reproductive history and reasons given for the abortion, the researchers concluded that women who are most likely to experience negative post-abortion reactions are also least likely to participate in post-abortion research, stating that "for many of the women, the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer very often given was: ‘I do not want to talk about it. I just want to forget'."
- A record-based study of Finnish women found that in the year following a pregnancy outcome the rate of suicide following abortion was 34.7 per 100,000 compared to 5.9 per 100,000 for women who gave birth, 18.1 per 100,000 for women who had miscarriages, and 11.4 per 100,000 for women who had not been pregnant in the prior year.
- In 2006, a team of researchers at the University of Otago Christchurch School of Medicine in New Zealand, published results relating to abortion reactions from a longitudinal study tracking approximately 500 women from birth to 25 years of age. The study found that compared to other women in the group those who had an abortion were significantly more likely to experience subsequent "mental health problems including depression, anxiety, suicidal behaviours and substance use disorders. This association persisted after adjustment for confounding factors." The authors wrote, "The findings suggest that abortion in young women may be associated with increased risks of mental health problems."
References
- ^ Zabin, L.S., Hirsch, M.B., Emerson, M.R. (1989). When urban adolescents choose abortion: effects on education, psychological status and subsequent pregnancy. Family Planning Perspectives, 21 (6), 248-55. Retrieved September 8, 2006.
- ^ Russo, N. F., & Zierk, K.L. (1992). Abortion, childbearing, and women. Professional Psychology: Research and Practice, 23(4), 269-280. Retrieved September 8, 2006.
- ^ Schmiege, S. & Russo, N.F. (2005). Depression and unwanted first pregnancy: longitudinal cohort study Electronic version. British Medical Journal, 331 (7528), 1303. Retrieved 2006-01-11.
- ^ Stotland NL. The myth of the abortion trauma syndrome. JAMA. 1992 Oct 21;268(15):2078-9. PMID 1404747.
- Legal abortion: a painful necessity - Sweden
- Psychological effects of abortion Portugal
- Predictors of anxiety and depression following pregnancy termination: a longitudinal five-year follow-up study, Norway
- Anniversary reactions and due date responses following abortion.
- Gómez Lavín C, Zapata García R (2005). "Diagnostic categorization of post-abortion syndrome". Actas Esp Psiquiatr. 33 (4): 267–72. PMID 15999304.
- Research and Destroy, by Chris Mooney. Published in Washington Monthly, October 2004.
- Is There a Post-Abortion Syndrome? By Emily Bazelon. Published in the New York Times Magazine, January 21 2007. Accessed January 11 2008.
- Science in support of a cause: the new research, by Michael Kranish. Published in the Boston Globe on July 31 2005; accessed November 27 2007.
- ^ Stotland NL (2003). "Abortion and psychiatric practice". J Psychiatr Pract. 9 (2): 139–49. PMID 15985924.
- Grimes DA, Creinin MD (2004). "Induced abortion: an overview for internists". Ann. Intern. Med. 140 (8): 620–6. PMID 15096333. Key summary points: "Abortion does not lead to an increased risk for breast cancer or other late psychiatric or medical sequelae." On p. 624, the authors state: "The alleged 'postabortion trauma syndrome' does not exist."
- Cooper, Cynthia L. Abortion Under Attack
- Russo NF, Denious JE (2005). "Controlling birth: science, politics, and public policy". J Soc Issues. 61 (1): 181–91. PMID 17073030.
- TIME. Abortion on Demand
- ^ Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. "Psychological responses after abortion." Science, April 1990, 248: 41-44.
- American Psychological Association. "APA research review finds no evidence of 'post-abortion syndrome' but research studies on psychological effects of abortion inconclusive." Press release, January 18, 1989.
- ^ "Dr. Koop's Abortion Advice" New York Times
- "Reagan's officials 'suppressed' research on abortion" New Scientist
- Family Planning and Perspectives by Nancy Adler
- Abortion and American Psychology Warren Throckmorton, PhD
- Söderberg, H., Janzon, L., & Sjöberg, N-O. (1998). Emotional distress following induced abortion: A study of its incidence and determinants among abortees in Malmo, Sweden. European Journal of Obstetrics & Gynecology and Reproductive Biology, 79:173-178.
- Söderberg, H., Andersson, C., Janzon, L., & Sjöberg, N-O. (1998). Selection bias in a study on how women experienced induced abortion. European Journal of Obstetrics & Gynecology and Reproductive Biology, 77:67-70.
- Gissler M, Hemminki E, Lonnqvist J. Suicides after pregnancy in Finland: 1987-94: register linkage study. BMJ 1996;313:1431-4)
- Wilmoth G. Abortion, Public Health Policy, and Informed Consent Legislation. J Social Issues, 48(3):1-17 (1992).
- Söderberg, H., Janzon, L., & Sjöberg, N-O. (1998). Emotional distress following induced abortion: A study of its incidence and determinants among abortees in Malmo, Sweden. European Journal of Obstetrics & Gynecology and Reproductive Biology, 79:173-178.
- Söderberg, H., Andersson, C., Janzon, L., & Sjöberg, N-O. (1998). Selection bias in a study on how women experienced induced abortion. European Journal of Obstetrics & Gynecology and Reproductive Biology, 77:67-70.
- Gissler M, Hemminki E, Lonnqvist J. Suicides after pregnancy in Finland: 1987-94: register linkage study. BMJ 1996;313:1431-4)
- Fergusson, D.M., Horwood, L.J., & Ridden, E.M. (2006. Abortion in young women and subsequent mental health. Journal of Child Psychology and Psychiatry, 47(1), 16-24.
External links
- Major media coverage
- Is There a Post-Abortion Syndrome? By Emily Bazelon; published in The New York Times Magazine
- Post-Abortion Politics: a 2007 video investigation by PBS.
- Pro-choice sources
- The Emotional Effects of Induced Abortion, from the Planned Parenthood website.
- Pro-life sources