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Abortion and mental health

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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.

Potential neutral or positive psychological effects of abortion

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.

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 of abortion

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."

References

  1. ^ 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.
  2. ^ Russo, N. F., & Zierk, K.L. (1992). Abortion, childbearing, and women. Professional Psychology: Research and Practice, 23(4), 269-280. Retrieved September 8, 2006.
  3. ^ 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.
  4. Gómez Lavín C, Zapata García R (2005). "Diagnostic categorization of post-abortion syndrome". Actas Esp Psiquiatr. 33 (4): 267–72. PMID 15999304.
  5. Research and Destroy, by Chris Mooney. Published in Washington Monthly, October 2004.
  6. Is There a Post-Abortion Syndrome? By Emily Bazelon. Published in the New York Times Magazine, January 21 2007. Accessed January 11 2008.
  7. 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.
  8. ^ Stotland NL (2003). "Abortion and psychiatric practice". J Psychiatr Pract. 9 (2): 139–49. PMID 15985924.
  9. 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."
  10. ^ Stotland NL. The myth of the abortion trauma syndrome. JAMA. 1992 Oct 21;268(15):2078-9. PMID 1404747.
  11. Cooper, Cynthia L. Abortion Under Attack
  12. Russo NF, Denious JE (2005). "Controlling birth: science, politics, and public policy". J Soc Issues. 61 (1): 181–91. PMID 17073030.
  13. TIME. Abortion on Demand
  14. ^ Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. "Psychological responses after abortion." Science, April 1990, 248: 41-44.
  15. 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.
  16. ^ "Dr. Koop's Abortion Advice" New York Times
  17. "Reagan's officials 'suppressed' research on abortion" New Scientist
  18. Family Planning and Perspectives by Nancy Adler
  19. Abortion and American Psychology Warren Throckmorton, PhD

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