With uncanny timing, in the light of a Parliamentary debate next week on pre-abortion counselling, the prestigious British Journal of Psychiatry has today published the findings of one of the largest studies of its kind on abortion, showing that almost 10% of all mental health problems are directly linked to abortion.
Overall, women with an abortion history were found to experience nearly double the risk of mental health problems when compared with women who had not had an abortion (81% increased risk).
More specifically, when calculating the effect of abortion on different mental health outcomes, the findings reveal that, post-abortion, the increased risk for anxiety disorders was 34%; for depression it was 37%; for alcohol use/abuse it was 110%; for marijuana use/abuse it was as high as 220% and for suicide behaviors it was 155%.
Even when compared to women delivering an unintended pregnancy, post-abortion women still had a 55% increased risk of experiencing a mental health problem. Overall, when compared to all women who carried to term, the increased risk of experiencing mental health problems ranged from 55% to 138%.
The simple but unequivocal conclusion of the author is that:
“This review offers the largest estimate of mental health risks associated with abortion available in the world literature. The results revealed moderate to high increased risk of mental health problems after abortion.“
But why should we believe these latest findings, considering the considerable debate among academics regarding the extent to which abortion poses serious mental health risks to women?
First, the paper is published in a prestigious journal, the British Journal of Psychiatry, which is considered one of the top psychiatry journals in the world. This means the paper has been extensively scrutinised by well-respected scientists and the results of its studies are trusted by practitioners throughout the world.
Second, this new meta-analysis (a synthesis of data from many previously published studies) conducted by Priscilla Coleman from Bowling Green State University, USA, is based on 22 published studies but only including the strongest, most rigorous studies in order to avoid any allegations of bias. It analyses 36 effects and brings together data on 877,181 participants, of whom 163,831 experienced an abortion.
As the author says: “In an effort to provide a long overdue, dispassionate analysis of the literature on abortion and mental health, the primary objective of this review was to conduct meta-analyses of associations between induced abortion and adverse mental health outcomes (depression, anxiety, substance use and suicidal behaviour) with sensitivity to the use of distinct control groups employed in the various studies (no abortion, unintended pregnancy delivered, pregnancy delivered).”
So will this research paper have any impact on the debate on abortion and mental health?
Along with the findings already cited above, which should speak for themselves, there are two other interesting points to be drawn from this research. First, Coleman highlights the deficiency in the academic literature regarding any benefits, or positive effects, from abortion. Yet, she says, over 90% of abortions are carried out on the presumption that abortion reduces the mental health risks associated with continuing the pregnancy. Clinicians, she sys, should therefore “convey the current state of uncertainty related to benefits of abortion in addition to sharing the most accurate information pertaining to statistically validated risks.” This understated language is effectively saying that most abortion assessments cannot be justified by the research evidence, and are doing more harm than good.
Second, Coleman draws attention to the particularly strong link between abortion and substance misuse and suicidal behaviour. She queries what the cause of this might be, suggesting that substance misuse and suicidal behaviour may result from efforts to block or avoid any psychological pain associated with abortion and may be construed as faster, easier remedies for personal suffering than seeking professional help. As is normal with journal papers, this question is left open for future research but she certainly makes some interesting and persuasive suggestions that would be of real interest to post-abortion counsellors.
Coleman says that her findings – that there are some real risks associated with abortion – should be shared with women as they are counselled prior to an abortion decision. In less highly charged and politicised debates than abortion, research findings would usually be used to inform practitioners and disseminate information to patients and the public. Perhaps this effort to produce an unbiased, quantitative analysis of the best available evidence will eventually filter through to patients.
However, for once, the politicising of the abortion debate may actually generate some more immediate benefits from this research paper. As I noted above, the timing of publication of this paper is remarkably prescient (although undoubtedly unplanned by the British Journal of Psychiatry!), coming just a few days before a high profile debate in Parliament on the need for independent counselling to be offered to women considering abortion. [http://righttoknow.org.uk/] The proposed amendments for debate aim to ensure that woman considering abortion have access to proper advice, information and counselling.
This latest research summary is exactly the kind of information women need to know about when considering abortion. It’s called informed consent.