11 Aug One of the lies in the present abortion narrative, is that there are no long term adverse effects on women who choose an elective abortion. The attached overview of the germane literature indicates that this narrative is a lie at the tragic expense of women
Brief Overview of the Abortion and Mental Health Professional Literature Priscilla K. Coleman, PhD, Professor of Human Development and Family Studies, Bowling Green State University, Bowling Green, OH 43403, USA.
For a significant number of women, abortion initiates powerful negative feelings and alienation from others (Kero, Hogberg, & Lalos, 2004; Kero & Lalos, 2000; Kero, Wulff, & Lalos, 2009; Kimport, 2012; Kimport, Foster, & Weitz, 2011; Söderberg, Janzon, & Sjöberg, 1998). A Clinician’s Guide to Medical and Surgical Abortion is a textbook written by leading abortion providers (Paul, et al., 1999) for training purposes. The chapter on counseling in this text outlines several negative reactions that women may experience after abortion, including depression, severe guilt, shame, and unresolved grief (Baker et al., 1999). According to the Clinician’s Guide, symptoms of depression include the following: crying, suicidal ideation, poor performance in school or work, loss of interest in enjoyable activities, and feelings of worthlessness.
Symptoms of severe guilt entail the following:
1) self-punishing behaviors such as substance abuse or indiscriminate sex;
2) nightmares about killing or saving babies;
3) blocking out the experience;
4) avoiding anything that triggers memories of the event;
5) fearing God’s punishment; and
6) interpreting misfortune, illness, or accident as signs of God’s punishment.
Symptoms of shame include the following:
1) relentless thoughts of being a bad person;
2) engaging in self-destructive behaviors;
3) fear of anyone finding out about the abortion.
Finally, symptoms of unresolved grief, according to the authors of the abortion text involve engaging in thoughts and behaviors that perpetuate a strong emotional investment in the pregnancy, or that prevent the redirection of emotional energy into moving forward with life. Over the past several decades, the number of peer-reviewed studies identifying adverse mental health outcomes associated with abortion have increased dramatically, as has the scientific rigor of research on this topic.
The literature base, comprised of hundreds of studies, has revealed that women who choose abortion experience increased risk of mental health problems, including substance abuse, anxiety, depression, suicidal ideation and suicide, among other conditions and symptoms (e.g., Bradshaw & Slade, 2003; Coleman et al., 2002a, 2002b; Coleman, 2005, 2006; Cougle et al., 2003, 2005; Dingle, 2008; Fergusson et al., 2006, 2008; Gissler et al., 2005; 2015; Mccarthy, 2015; Mota et al., 2010; Pedersen, 2007, 2008; Rees & Sabia, 2007; Sullins, 2016).
In a 2013 narrative review of literature published between 1995 and 2011, incorporating 30 peer-reviewed journal articles by Italian researchers Bellieni and Buonocore, the authors concluded, “The studies analyzed here show that abortion is a risk factor for mental illness when compared to childbirth.”
In 2011, I published a meta-analysis titled “Abortion and Mental Health: A Quantitative Synthesis and Analysis of Research Published from 1995-2009” in the British Journal of Psychiatry. A meta-analysis is a specific form of systematic literature review wherein quantitative data from multiple published studies are converted to a common metric and combined statistically to derive an overall measure of the effect of an exposure such as abortion. This methodology gives the results more statistical power and much more credibility than the results of any individual empirical study or narrative review. In a meta-analysis, the contribution or weighting of any particular study to the final result is based on objective scientific criteria (sample size and strength of effect), as opposed to an individual’s opinion of what constitutes a strong study.
My review offers the largest quantitative estimate of mental health risks associated with abortion available in the world. After applying methodologically-based selection criteria and extraction rules to minimize bias, the sample consisted of 22 studies, 36 measures of effect, and 877,297 participants (163,880 of whom experienced an abortion). Results revealed that women who aborted compared to women who had not, experienced an 81% increased risk for mental health problems. When compared specifically to unintended pregnancies delivered, abortions were associated with a 55% increased risk of mental health problems.
Separate effects were calculated based on the type of mental health outcome, with the results revealing the following increased risks: anxiety disorders 34%; depression 37%; alcohol use/abuse 110%; marijuana use/abuse 220%; and suicide behaviors 155%. Calculation of a composite Population Attributable Risk (PAR) statistic revealed that nearly 10% of the incidence of mental health problems was directly attributable to abortion.
The scientific evidence linking abortion to increased rates of mental health problems is published in leading peer-reviewed journals in psychology and medicine. There are now dozens of large-scale prospective studies with 1000’s of participants incorporating different types of comparison groups and other control techniques, effectively fortifying the level of confidence in the results derived. Potentially confounding variables, controlled in the various studies, include prior mental health, reproductive history, experience of abuse of various forms, and several demographic variables thereby increasing the reliability and validity of the findings.
- Baker, A., Beresford, T., Halvorson-Boyd, G., & Garrity, J. (1999). Informed consent, counseling, and patient preparation. In M. Paul, E. S. Lichtenberg, L. Borgatta, D. A. Grimes, & P. G. Stubblefield (Eds.). A Clinician’s Guide to Medical and Surgical Abortion (pp. 25-37). New York: Churchill Livingstone.
- Bellieni, C., & Buonocore, G. (2013). Abortion and subsequent mental health: Review of the literature. Psychiatry and Clinical Neurosciences, 67(5), 301–310.
- Bradshaw, Z. & Slade, P. (2003). The effects of induced abortion on emotional experiences and relationships: A critical review of the literature. Clinical Psychology Review, 23, (7), 929-958.
- Coleman, P. K. (2006). Induced Abortion and increased risk of substance use: A review of the evidence. Current Women’s Health Reviews 1, 21-34.
- Coleman, P.K. (2011). Abortion and Mental Health: A Quantitative Synthesis and Analysis of Research Published from 1995-2009. British Journal of Psychiatry, 199, 180-186.
- Coleman, P. K., Reardon, D. C., Rue, V., & Cougle, J. (2002a). History of induced abortion in relation to substance use during subsequent pregnancies carried to term. American Journal of Obstetrics and Gynecology, 187, pp. 1673-1678.
- Coleman, P. K., Reardon, D. C., Rue, V., & Cougle, J. (2002b). State-funded abortions vs. deliveries: A comparison of outpatient mental health claims over four years. The American Journal of Orthopsychiatry, 72, 141-152.
- Coleman, P. K., Reardon, D. C., Strahan, T., & Cougle, J. (2005). The psychology of abortion: A review and suggestions for future research. Psychology & Health, 20, 237-271.
- Cougle, J.R., Reardon, D.C. & Coleman, P.K. (2003). Depression associated with abortion and childbirth: A long-term analysis of the NLSY cohort. Medical Science Monitor, 9 (4), CR 105-112.
- Cougle, J., Reardon, D. C., & Coleman, P. K. (2005). Generalized anxiety associated with unintended pregnancy: A cohort study of the 1995 National Survey of Family Growth. Journal of Anxiety Disorders, 19 (10), 137-142.
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- Kero, A., Wulff, M., Lalos, A. (2009). Home abortion implies radical changes for women. The European Journal Of Contraception & Reproductive Health Care, 14, 324–333.
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- Kimport, K., Foster, K., & Weitz, T. A. (2011). Social sources of women’s emotional difficulty after abortion: Lessons from women’s abortion narratives. Perspectives on Sexual and Reproductive Health, 43(2), 103–109.
- Mccarthy, F. P., Moss-Morris, R., Khashan, A. S., et al. (2015). Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy. BJOG, 122, 1757-1764.
- Media Research Center (2014). Warren Buffett: The billion-dollar king of abortion.” June 05, https://www.mrc.org/articles/warren-buffett-billion-dollar-king abortion.
- Mota, N.P. et al (2010). Associations between abortion, mental disorders, and suicidal behaviors in a nationally representative sample. The Canadian Journal of Psychiatry, 55 (4), 239-246.
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- Reardon, D. C., Cougle, J., Rue, V. M., Shuping, M., Coleman, P. K., & Ney, P. G. (2003). Psychiatric admissions of low-income women following abortion and childbirth. Canadian Medical Association Journal, 168, 1253-1256.
- Rees, D. I. & Sabia, J. J. (2007). The relationship between abortion and depression: New evidence from the Fragile Families and Child Wellbeing Study. Medical Science Monitor, 13(10), 430-36.
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- Sullins, P. D. (2016). Abortion, substance abuse and mental health in early adulthood: thirteen-year longitudinal evidence from the United States. Sage Open Medicine, 4.
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