Psychological Risks
For many women abortion is indeed a life changing event with significant emotional, physical, and spiritual consequences. Most women who struggle with past abortions say that they wish they had been told all of the facts about abortion and its risks. The following research articles indicates it is not just a simple medical procedure and can lead to mental illness.
In 2011 the British Journal of Psychiatry published the peer reviewed research findings of Priscilla K Coleman Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009 . The findings clearly showed the mental health risks associated with abortion.
Synopsis of this article:
Background: Given the methodological limitations of recently published qualitative reviews of abortion and mental health, a quantitative synthesis was deemed necessary to represent more accurately the published literature and to provide clarity to clinicians.
Aims: To measure the association between abortion and indicators of adverse mental health, with subgroup effects calculated based on comparison groups (no abortion, unintended pregnancy delivered, pregnancy delivered) and particular outcomes. A secondary objective was to calculate population-attributable risk (PAR) statistics for each outcome.
Method: After the application of methodologically based selection criteria and extraction rules to minimise bias, the sample comprised 22 studies, 36 measures of effect and 877,181 participants (163,831 experienced an abortion). Random effects pooled odds ratios were computed using adjusted odds ratios from the original studies and PAR statistics were derived from the pooled odds ratios.
Results: Women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be attributable to abortion. The strongest subgroup estimates of increased risk occurred when abortion was compared with term pregnancy and when the outcomes pertained to substance use and suicidal behaviour.
Conclusions: This review offers the largest quantitative estimate of mental health risks associated with abortion available in the world literature. Calling into question the conclusions from traditional reviews, the results revealed a moderate to highly increased risk of mental health problems after abortion. Consistent with the tenets of evidence-based medicine, this information should inform the delivery of abortion services.
Read Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009
The Royal College of Psychiatrists in the UK
According to the TimesOnline March 16, 2008: The Royal College of Psychiatrists in the UK recommended updating abortion information leaflets to include details of the risks of depression. It said, “Consent cannot be informed without the provision of adequate and appropriate information.” This overturned the consensus that stood for decades which held the view it was better for a woman’s mental health to have an abortion than continue with an unwanted pregnancy.
Further studies indicate abortion linked to mental health problems
The above findings are backed by a large body of independent studies, such as the following 4 examples:
1. A large Finnish study published in the British Medical Journal in 1996 found a six-fold increased risk of suicide rates among women who had abortions.
2. A study published in the American Journal of Orthopsychiatry in 2002 examined 173,000 California state health records and found that women were 63% more likely to receive mental care in the 90 days following an abortion than giving birth. They are also significantly more likely to be treated in the four years the study followed for mental illness, including neurotic depression, bipolar disorder and schizophrenia.
3. A major longitudinal study in 2006 at the Christchurch School of Medicine in New Zealand found that women at 25 years of age who had an abortion were subsequently more likely to suffer “depression, anxiety, suicidal behaviours and substance use disorder.”
4. Research published in the Journal of Child Psychology and Psychiatry in 2006, concluded that abortion in young women might be associated with risks of mental health problems.
A Real Life Story
The Royal College of Psychiatry’s findings came after the most public and controversial case against abortion in Britain, when an inquest in Cornwall, in 2008, heard that a talented artist hanged herself because she was overcome with grief after aborting her twins. Emma Beck, 30, left a note saying:
"Living is hell for me. I never should have had an abortion. I see now that I would have been a good Mum. I told everyone that I didn’t want to do it, even at the Hospital. I was frightened, now it is too late. I died when my babies died. I want to be with my babies; they need me, no-one else does."
Psychological Problem Associated With Abortion
The following information is from: Traumatic After-effects of Abortion
Elliot Institute © www.afterabortion.org
Suicide
6-7 times higher suicide rate. Two national studies from Finland, based on medical records, revealed that aborting women were six-seven times more likely to commit suicide in the following year than were delivering women. 1
Up to 60% have suicidal thoughts. According to a recent study in a major scientific journal, 31% had thoughts of suicide after abortion. In another survey, approximately 60% of women with post-abortion problems reported suicidal thoughts, with 28% attempting suicide and half of those attempting suicide two or more times. 2
154% higher risk of suicide. Another study of more than 173,000 American women who had abortions or carried to term found that, during the eight years after the pregnancy ended, women who aborted had a 154% higher risk of suicide than women who carried to term. 3
Higher suicide risks for teens. Teen girls are 10 times more likely to attempt suicide if they have had an abortion in the last six months than girls who have not had an abortion, and 2-4 times more likely to commit suicide after abortion compared to adult women. 4
Depression
65% higher risk of clinical depression. A longitudinal study of American women revealed that those who aborted were 65% more likely to be at risk of long-term clinical depression after controlling for age, race, education, marital status, history of divorce, income, and prior psychiatric state. 5
Depression risk remained high, even when pregnancies were unplanned. Among a national sample of women with unintended first pregnancies, aborting women were at significantly higher risk of long-term clinical depression compared to delivering women. 6
Trauma
65% report symptoms of post-traumatic stress disorder (PTSD). In a study of U.S. and Russian women who had abortions, 65% of U.S. women experienced multiple symptoms of PTSD, which they attributed to their abortions. Slightly over 14% reported all the symptoms necessary for a clinical diagnosis of abortion-induced PTSD, and 25% said they did not receive adequate counselling. 64% said they felt pressured by others to abort. 7
60% said they felt “part of me died”. In the above study, 60% of American women reported that they felt “part of me died” after their abortions. 7
Twice as likely to be hospitalized. Compared to women who deliver, women who abort are more than twice as likely to be subsequently hospitalized for psychiatric illness within six months. 8
More outpatient psychiatric care. Analysis of California Medicaid records shows that women who have abortions subsequently require significantly more treatments for psychiatric illness through outpatient care. 9
Multiple disorders and regrets. A study of post-abortion patients only 8 weeks after their abortions found that 44% reported nervous disorders, 36% experienced sleep disturbances, 31% had regrets about their decision, and 11% had been prescribed psychotropic medicine by their family doctor. 10
Generalised anxiety disorder. Among women with no previous history of anxiety, women who aborted a first, unplanned pregnancy were 30% more likely to subsequently report all the symptoms associated with a diagnosis for generalized anxiety disorder, compared to women who carried to term. 11
Sleep disorders. In a study of women with no known history of sleep disorders, women were more likely to be treated for sleep disorders after having an abortion compared to giving birth (nearly twice as likely in the first 180 days afterwards). Numerous studies have shown that trauma victims often experience sleep difficulties. 12
Disorders not pre-existing. In a New Zealand study, women had higher rates of suicidal behaviour, depression, anxiety, substance abuse, and other disorders after abortion. The study found that these were not pre-existing problems. 13
Eating disorders & substance abuse
39% had eating disorders. In a survey of women with post-abortion problems, 39% reported subsequent eating disorders. 14
Five-fold higher risk of drug and alcohol abuse. Excluding women with a prior history of substance abuse, those who abort their first pregnancy are 5 times more likely to report subsequent drug and alcohol abuse vs. those who give birth. 15
Substance abuse during subsequent pregnancies. Among women giving birth for the first time, women with a history of abortion are five times more likely to use drugs, twice as likely to use alcohol, and ten times more likely to use marijuana during their pregnancy, compared to women who have not had an abortion. 16
Alcohol abuse linked to other problems. Alcohol abuse after abortion has been linked to violent behaviour, divorce or separation, auto accidents, and job loss. 17
Coercion, guilt, repressed grief
Coerced to violate their beliefs, values and conscience. The “decision” to abort is often based on the demands or threats of others – even when it violates the woman’s own moral beliefs and desire to keep the baby.18 This is a known risk factor for psychological complications after abortion. 19
64% of abortions involve coercion. A recent study of women who had abortions found that 64% of American women reported that they felt pressured by others to abort. 7
Common negative reactions. In a survey of women reporting post-abortion problems, 80% experienced guilt, 83% regret, 79% loss, 62% anger and 70% depression. 2
Forbidden grief. After abortion, societal expectation, personal shame and public and professional denial result in repressed grief, causing serious problems including clinical depression, eating disorders, self-destructive lifestyles and suicide. 20
Divorce and chronic relationship problems
Women with a history of abortion are significantly more likely to subsequently have shorter relationships and more divorces. This may be due to lowered self-esteem, greater distrust of males, sexual dysfunction, substance abuse, and increased levels of depression, anxiety, and volatile anger. 21
More poverty and single parenthood after repeat abortions. Women who have more than one abortion (nearly half of those seeking abortions each year) 22 are more likely to become single parents and to require public assistance. 23
30-50% of post-abortive women report experiencing sexual dysfunctions such as promiscuity, loss of pleasure from intercourse, increased pain, and aversion to sex and/or men. 23
Not counselled before or after the abortion, many wanted alternatives
In a study of American and Russian women who experienced abortion:
67% of American women reported that they received no counselling beforehand
84% reported they received inadequate counselling beforehand
79% were not counselled about alternatives
54% were not sure about their decision at the time. 7
Unresolved trauma and child abuse
144 % more likely to abuse their children. One study found that women with a history of induced abortion were 144% more likely to physically abuse their children than women who had not had an abortion. 24
Child abuse linked to unresolved trauma. Abortion is linked with increased violent behaviour, alcohol and drug abuse, replacement pregnancies, depression, and poor maternal bonding with later children. These factors are closely associated with child abuse and would appear to confirm a link between unresolved post-abortion trauma and subsequent child abuse. 25
Repeat abortions, self-punishment and risk factors
48% of aborting women have had a previous abortion. 22 Women who have had an abortion are 4 times more likely to abort a current pregnancy than those with no prior abortion history. 21 This may reflect aspects of self-punishment. 26
Studies have identified factors that put women at risk for negative reactions to abortion, including feeling pressured into unwanted abortions, lack of support, being more religious, prior emotional or psychological problems, adolescence, being unsure of her decision, and receiving little or no counselling prior to abortion. An analysis of 63 medical studies that identify risk factors concluded that the number of women suffering from negative emotional reactions could be dramatically reduced if abortion clinics screened women for these risk factors . 19
Recommended reading Forbidden Grief: The Unspoken Pain of Abortion (Burke & Reardon: Acorn Books, 2002)
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References
http://bjp.rcpsych.org/content/199/3/180.abstract
1 Gissler, Hemminki & Lonnqvist, “Suicides after pregnancy in Finland, 1987-94: register linkage study,” British Journal of Medicine 313:1431-4, 1996; and M. Gissler, “Injury deaths, suicides and homicides associated with pregnancy, Finland 1987-2000,” European J. Public Health 15(5):459-63,2005.
2 D. Reardon, Aborted Women, Silent No More (Springfield, IL: Acorn Books, 2002).
3 DC Reardon et. al., “Deaths Associated With Pregnancy Outcome: A Record Linkage Study of Low Income Women,” Southern Medical Journal 95(8):834-41, Aug. 2002.
4 B. Garfinkel, et al., “Stress, Depression and Suicide: A Study of Adolescents in Minnesota,” Responding to High Risk Youth (University of Minnesota: Minnesota Extension Service, 1986); M. Gissler, et. al., “Suicides After Pregnancy in Finland: 1987-94: register linkage study,” British Medical Journal, 313: 1431-1434, 1996; and N. Campbell, et. al., “Abortion in Adolescence,” Adolescence, 23:813-823, 1988. See the “Teen Abortion Risks” Fact Sheet at www.unfairchoice.info/resources.htm for more information.
5 JR Cougle, DC Reardon & PK Coleman, “Depression Associated With Abortion and Childbirth: A Long-Term Analysis of the NLSY Cohort,” Medical Science Monitor 9(4):CR105-112, 2003.
6 DC Reardon, JR Cougle, “Depression and unintended pregnancy in the National Longitudinal Study of Youth: a cohort study,” British Medical Journal 324:151-2, 2002.
7 VM Rue et. al., “Induced abortion and traumatic stress: A preliminary comparison of American and Russian women,” Medical Science Monitor 10(10): SR5-16, 2004.
8 DC Reardon et. al., “Psychiatric admissions of low-income women following abortions and childbirth,” Canadian Medical Association Journal 168(10): May 13, 2003
9 PK Coleman et. al., “State-Funded Abortions Versus Deliveries: A Comparison of Outpatient Mental Health Claims Over Four Years,” American Journal of Orthopsychiatry 72(1):141-152, 2002.
10 Ashton,”The Psychosocial Outcome of Induced Abortion”, British Journal of Ob & Gyn. 87:1115-1122, 1980.
11 JR Cougle, DC Reardon, PK Coleman, “Generalized Anxiety Following Unintended Pregnancies Resolved Through Childbirth and Abortion: A Cohort Study of the 1995 National Survey of Family Growth,” Journal of Anxiety Disorders 19:137-142 (2005).
12 DC Reardon and PK Coleman, “Relative Treatment Rates for Sleep Disorders and Sleep Disturbances Following Abortion and Childbirth: A Prospective Record Based-Study,” Sleep 29(1):105-106, 2006.
13 DM Fergusson et. al., “Abortion in young women and subsequent mental health,” Journal of Child Psychology and Psychiatry 47(1): 16-24, 2006.
14 T. Burke with D. Reardon, Forbidden Grief: The Unspoken Pain of Abortion (Springfield, IL: Acorn Books, 2002) 189, 293
15 DC Reardon, PG Ney, “Abortion and Subsequent Substance Abuse,” American Journal of Drug and Alcohol Abuse 26(1):61-75, 2000.
16 PK Coleman et. al., “A history of induced abortion in relation to substance abuse during subsequent pregnancies carried to term,” American Journal of Obstetrics and Gynaecology 1673-8, Dec. 2002.
17 Benedict, et al., “Maternal Perinatal Risk Factors and Child Abuse,” Child Abuse and Neglect 9:217-224, 1985; P.G. Ney, “Relationship between Abortion and Child Abuse,” Canadian Journal of Psychiatry, 24:610-620, 1979; Shepard, et al., “Contraceptive Practice and Repeat Induced Abortion: An Epidemiological Investigation,” J. Biosocial Science 11:289-302, 1979; M. Bracken, “First and Repeated Abortions: A Study of Decision-Making and Delay,” J. Biosocial Science 7:473-491, 1975; S. Henshaw, “The Characteristics and Prior Contraceptive Use of U.S. Abortion Patients,” Family Planning Perspectives, 20(4):158-168, 1988; D. Sherman, et al., “The Abortion Experience in Private Practice,” Women and Loss: Psychobiological Perspectives, ed. W.F. Finn, et al., (New York: Praeger Publishers, 1985) 98-107; E.M. Belsey, et al., “Predictive Factors in Emotional Response to Abortion: King’s Termination Study – IV,” Social Science and Medicine 11:71-82, 1977; E. Freeman, et al., “Emotional Distress Patterns Among Women Having First or Repeat Abortions,” Obstetrics and Gynaecology 55(5):630-636, 1980; C. Berger, et al., “Repeat Abortion: Is it a Problem?” Family Planning Perspectives 16(2):70-75 (1984).
18 George Skelton, “Many in Survey Who Had Abortion Cite Guilt Feelings,” Los Angeles Times, March 19, 1989, p. 28 (question 76). See also Mary K. Zimmerman, Passage Through Abortion (New York, Prager Publishers, 1977).
19 David C. Reardon, “The Duty to Screen: Clinical, Legal, and Ethical Implications of Predictive Risk Factors of Post-Abortion Maladjustment,” The Journal of Contemporary Health Law and Policy 20(2):33-114, Spring 2004.
20 For more on this topic, see T. Burke, Forbidden Grief: The Unspoken Pain of Abortion (Springfield, IL: Acorn Books, 2002).
21 Shepard, et al., “Contraceptive Practice and Repeat Induced Abortion: An Epidemiological Investigation,” J. Biosocial Science 11:289-302, 1979; M. Bracken, “First and Repeated Abortions: A Study of Decision-Making and Delay,” J. Biosocial Science 7:473-491, 1975; S. Henshaw, “The Characteristics and Prior Contraceptive Use of U.S. Abortion Patients,” Family Planning Perspectives, 20(4):158-168, 1988; D. Sherman, et al., “The Abortion Experience in Private Practice,” Women and Loss: Psychobiological Perspectives, ed. W.F. Finn, et al., (New York: Praeger Publishers, 1985) 98-107; E.M. Belsey, et al., “Predictive Factors in Emotional Response to Abortion: King’s Termination Study – IV,” Social Science and Medicine 11:71-82, 1977; E. Freeman, et al., “Emotional Distress Patterns Among Women Having First or Repeat Abortions,” Obstetrics and Gynaecology 55(5):630-636, 1980; C. Berger, et al., “Repeat Abortion: Is it a Problem?” Family Planning Perspectives 16(2):70-75 (1984).
22 Facts in Brief: Induced Abortion,” The Alan Guttmacher Institute (www.agi-usa.org), 2002.
23 Speckhard, Psycho-social Stress Following Abortion, (Kansas City, MO: Sheed & Ward, 1987); and Belsey, et al., “Predictive Factors in Emotional Response to Abortion: King’s Termination Study – IV,” Social Science & Medicine 11:71-82, 1977.
24 Priscilla K. Coleman, et. al., “Associations between voluntary and involuntary forms of peri natal loss and child maltreatment among low-income mothers,” Acta Paediatrica 94, 2005
25 Benedict, et al., “Maternal Perinatal Risk Factors and Child Abuse,” Child Abuse and Neglect 9:217-224, 1985; P.G. Ney, “Relationship between Abortion and Child Abuse,” Canadian Journal of Psychiatry, 24:610-620, 1979. See also Reardon, Aborted Women, Silent No More (Springfield, IL: Acorn Books, 2002) 129-30, which describes a case of woman who beat her three year old son to death shortly after an abortion which triggered a “psychotic episode” of grief, guilt, and misplaced anger.
26 The Repeat Abortion Patient,” Family Planning Perspectives 9(1):37-39, 1977; S. Fischer, “Reflection on Repeated Abortions: The meanings and motivations,” Journal of Social Work Practice 2(2):70-87, 1986; B. Howe, et al., “Repeat Abortion, Blaming the Victims,” Am. J. of Public Health 69(12):1242-1246, 1979.21. David C. Reardon, “The Duty to Screen: Clinical, Legal, and Ethical Implications of Predictive Risk Factors of Post-Abortion Maladjustment,” The Journal of Contemporary Health Law and Policy 20(2):33-114, Spring 2004.
Text from the booklet – published research:
Psychological Risks Fact Sheet, 2006
Elliot Institute
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Additional material is posted at www.afterabortion.org
Used with permission