Among the strategies employed by anti-abortion forces is an effort, apparently quite a successful effort, to convince the public, as well as legislators and the judiciary, that abortion damages women psychologically. The scientific evidence does not support this assertion.
First, some words about words. As a medical term, "abortion" includes miscarriage, or "spontaneous abortion," and abortions performed for narrowly defined medical reasons. Other abortions are sometimes referred to as "elective." To the women who undergo these procedures, an abortion is not elective like a college course. An abortion is a procedure performed because a pregnant woman considers that her situation would not allow her to take adequate care of a baby. It is a procedure performed because women take motherhood seriously.
Some other words: Those of us who study and advocate for legal, safe and accessible abortion services are not pro-abortion, nor do we endorse the idea that those who oppose those services are pro-life. We believe we have to consider, first, the lives of families and of women and the children they may already have or may want to have in the future.
Abortion often occurs in the context of stressful, even traumatic, circumstances: sexual coercion, domestic violence, economic and educational disadvantage, overwhelming responsibilities. These situations are highly correlated with depression and with anxiety disorders. Over one-third of the women in the United States have an abortion during their lives. The scientific evidence from studies of large populations of women indicates that having an abortion neither alleviates nor causes psychiatric disorders. Women have a variety of normal emotional reactions after abortion, including sadness as well as relief, and those reactions vary over days, weeks and years. As with any life decision, some women regret having had abortions, although, when they recall the circumstances that led them to the decision at the time, they often say that, faced with the same circumstances, they would make the same decision. Braving a crowd of screaming agitators at an abortion clinic increases the emotional stress of abortion. So does misinformation about the procedure. But regret and emotional reactions are not disorders.
Studies and policies aimed at preventing abortions often fail to take into account the fact that the outcomes of abortion must be compared with those of carrying a pregnancy to term; that is the only alternative for a pregnant woman. Pregnancy and childbirth are associated with clinical depression in at least 10 percent of women, and with more tragic outcomes in a small fraction.
There is no evidence that adolescents are less able to make decisions about pregnancy, or more vulnerable to adverse effects of abortion, than adult women, or that requiring that their parents be informed or give consent improves outcomes. On the other hand, having a baby as a teenager is associated with quitting school and being unable to get a job providing a living wage. Being forced to marry the father of the baby doesn't help and usually doesn't last.
Misinformation about the psychological impact of abortion is generated and used to support legislation and judicial decisions, up to and including those of the United States Supreme Court, restricting access to abortion. Several states now have laws requiring that women contemplating abortions be informed that abortion causes serious psychiatric problems. The Oklahoma law even requires the physician to attest that his or her patient understands this incorrect and anxiety-provoking information. The possibility that an individual may regret a decision has never before been used to justify preventing her from making that decision, nor has medical evidence been so ignored, nor the doctor-patient relationship been so disrupted, as by legislatures and judges opposed to abortion.
I am a psychiatrist. I trained in medicine at a time when abortion was illegal and hospital wards -- and morgues -- were filled with women who, in desperation, had resorted to the terror, pain and dangers of back-alley abortions. My career focus has been on women's mental health issues, with particular focus on issues related to reproduction.
I was reluctantly drawn into the abortion debate when the American Psychiatric Association was asked to provide testimony before the then United States Surgeon General C. Everett Koop, M.D., while I chaired the organization's Committee on Women. Since that time, I have testified against restrictive abortion laws in several state courts and before committees of the United States Senate and House of Representatives. I have served on the Board of Physicians for Reproductive Choice and Health -- an organization that has seen several member physicians murdered. I have edited one book and written another about the psychiatric aspects of abortion.
I am also the mother of four daughters and the grandmother of their four children. Mothering and grandmothering have been the most sublime experiences of my life. I can understand, and I respect, those who oppose abortion on religious grounds. It is immoral, however, to mislead and frighten women, and to make public policy, on the basis of fabricated evidence.
1. Russo NE, Robinson GE, Stotland, NL. "Is there an "Abortion Trauma
Syndrome"?: Critiquing the Evidence," Harvard Review of Psychiatry, July/August
2. Stotland N, Robinson G. "Abortion Trauma Syndrome" Revisited. Psychiatric Times. P 23, Jan 2010.