Abortion and mental health

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Abortion has been shown in various studies to have conflicting effects on the mental health of the patient undergoing the procedure.

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 women following an induced abortion.[1] Primarily a term used by pro-life advocates,[2][3][4] PAS is not a medically recognized syndrome;[5][6] 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.[6][7][8][9]

While some studies have shown a correlation between abortion and clinical depression, anxiety, suicidal behaviors, or adverse effects on women's sexual functions for a small number of women, these correlations may be explained by pre-existing social circumstances and emotional health.[10] 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 experienced by women, or been inconclusive.[11] On the other hand, a number of researchers have concluded that abortion has positive or neutral effects on women's psychological well-being.

Neutral and positive effects of abortion

A number of studies have indicated that women 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.[12] 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 women's well-being was separately and positively related to employment, income, and education, but negatively related to total number of children.[13] 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.[14]

Feelings experienced after miscarriage or abortion

Various studies suggest that some women experience stress after a miscarriage or abortion. The kind of stress and the amount of stress women experience varies from culture to culture. Studies also suggest that an individual woman's stress level is influenced by her economic status, family situation and the status of her mental health before the pregnancy. Although no studies have been able to find a causal relationship between abortion and depression or stress, many studies cite the pre-existence of depression and stress in many women who seek abortions. Some women may experience some or all of the following feelings after an abortion.

Some empirical research suggests that some women are more likely than others to develop stress after after a miscarriage or abortion. The risk factors found in some clinical studies include:

  • Low self-efficacy for coping with the abortion[22]
  • Low self-esteem[23]
  • External locus of control[24]
  • Difficulty with the decision to have an abortion[25][26]
  • When there is emotional investment in the pregnancy [27][28]
  • Perceptions of one's partner, family members, or friends as non-supportive[29][30]
  • Timing during adolescence, being unmarried, or poor[31][32][33]
  • A poor or insecure attachment relationship with one's mother or a childhood history of separation from one's mother for a year or more before age 16[34][35][36]
  • Involvement in violent relationships[37][38]
  • Traditional sex-role orientations[39]
  • Conservative views of abortion and/or religious affiliation[40][41][42]
  • When a pregnancy is initially intended[43][44][45][46][47]
  • Abortion during the second trimester[48]
  • When the woman is in an unstable partner relationship[49][50]
  • Being forced into abortion by one's partner, others, or by life circumstances[51]

References

  1. ^ a b Gómez Lavín C, Zapata García R (2005). "Diagnostic categorization of post-abortion syndrome". Actas Esp Psiquiatr. 33 (4): 267–72. PMID 15999304.
  2. ^ Research and Destroy, by Chris Mooney. Published in Washington Monthly, October 2004.
  3. ^ Is There a Post-Abortion Syndrome? By Emily Bazelon. Published in the New York Times Magazine, January 21 2007. Accessed January 11 2008.
  4. ^ 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.
  5. ^ 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."
  6. ^ a b Stotland NL (2003). "Abortion and psychiatric practice". J Psychiatr Pract. 9 (2): 139–49. PMID 15985924. "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."
  7. ^ Stotland NL. The myth of the abortion trauma syndrome. JAMA. 1992 Oct 21;268(15):2078-9. PMID 1404747.
  8. ^ Cooper, Cynthia L. Abortion Under Attack
  9. ^ Russo NF, Denious JE (2005). "Controlling birth: science, politics, and public policy". J Soc Issues. 61 (1): 181–91. PMID 17073030.
  10. ^ TIME. Abortion on Demand
  11. ^ 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.
  12. ^ 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.
  13. ^ Russo, N. F., & Zierk, K.L. (1992). Abortion, childbearing, and women. Professional Psychology: Research and Practice, 23(4), 269-280. Retrieved September 8, 2006.
  14. ^ 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.
  15. ^ a b Cite error: The named reference Broen was invoked but never defined (see the help page).
  16. ^ a b Sexual behavior during the first eight weeks after legal termination of pregnancy
  17. ^ a b Legal abortion: a painful necessity - Sweden
  18. ^ Abortion and guilt, France
  19. ^ a b c Psychological effects of abortion Portugal
  20. ^ Predictors of anxiety and depression following pregnancy termination: a longitudinal five-year follow-up study, Norway
  21. ^ Anniversary reactions and due date responses following abortion.
  22. ^ Major, B., Cozzarelli, C., Sciacchitano, A.M., Cooper, M.L., Testa, M., & Mueller, P.M. (1990). Perceived social support, self-efficacy, and adjustment to abortion. Journal of Personality and Social Psychology, 59, 186-197.
  23. ^ Cozzarelli, C., Karrasch, A., Sumer, N., & Major, B. (1994). The meaning and impact of partner's accompaniment on women's adjustment to abortion. Journal of Applied Social Psychology, 24, 2028-2056.
  24. ^ Cozzarelli, C. (1993). Personality and self-efficacy as predictors of coping with abortion. Journal of Personality and Social Psychology, 65, 1224-1236.
  25. ^ Bracken, M.B. (1978). A causal model of psychosomatic reactions to vacuum aspiration abortion. Social Psychiatry, 13, 135-145.
  26. ^ Osofsky, J.D., & Osofsky, H.J. (1972). The psychological reaction of patients to legalized abortion. American Journal of Orthopsychiatry, 42, 48-60.
  27. ^ Lyndon, J., Dunkel-Schetter, C., Cohan, C.L., & Pierce, T. (1996). Pregnancy decision making as a significant life event: A commitment approach. Journal of Personality and Social Psychology, 71, 141-151.
  28. ^ Remennick, L.I., & Segal, R. (2001). Sociocultural context and women's experiences of abortion: Israeli women and Russian immigrants compared. Culture, Health, and Sexuality, 3, 49-66.
  29. ^ Major et al. (1990).
  30. ^ Major, B., & Cozzarelli, C. (1992). Psychological predictors of adjustment to abortion. Journal of Social Issues, 48, 121-142.
  31. ^ Adler, N.E. (1975). Emotional responses of women following therapeutic abortion: How great a problem? Journal of Applied Social Psychology, 6, 240-259.
  32. ^ Bracken, M.B., Hachamovitch, M., & Grossman, G. (1974). The decision to abort and psychological sequelae. Journal of Nervous and Mental Disease, 158, 155-161.
  33. ^ Campbell, N., Franco, K., & Jurs, S. (1988). Abortion in adolescence. Adolescence, 23, 813-823.
  34. ^ Cozzarelli, C., Sumer, N., & Major, B. (1998). Mental models of attachment and coping with abortion. Journal of Personality and Social Psychology, 74, 453-467.
  35. ^ Kitamura, T., Toda, M.A., Shima, S., & Sugawara, M. (1998). Single and repeated elective abortions in Japan: A psychosocial study. Psychosomatic Obstetrics and Gynecology, 19, 126-134.
  36. ^ Payne, E., Kravitz, A., Notman, M., & Anderson, J. (1976). Outcome following therapeutic abortion. Archives of General Psychiatry, 33, 725-733.
  37. ^ Allanson, S., & Astbury, J. (2001). Attachment style and broken attachments: Violence, pregnancy, and abortion. Australian Journal of Psychology, 53, 146-151.
  38. ^ Russo, N., & Denious, J.E. (2001). Violence in the lives of women having abortions: Implications for policy and practice. Professional Psychology Research and Practice, 32, 142-150.
  39. ^ Gold, D., Berger, C., & Andres, D. (1979). The abortion choice: Psychological determinants and consequences. Concordia University, Department of Psychology, Montreal.
  40. ^ Bogen, I. (1974). Attitudes of women who have had abortions. Journal of Sex Research, 10, 97-109.
  41. ^ Osofsky & Osofsky (1972)
  42. ^ Soderberg, H., Janzon, L., & Slosberg, N.-O. (1998). Emotional distress following induced abortion: A study of its incidence and determinants among adoptees in Malmo, Sweden. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 79, 173-178.
  43. ^ Ashton, J. (1980). The psychosocial outcome of induced abortion. British Journal of Obstetrics and Gynecology, 87, 1115-1122.
  44. ^ Friedman, C., Greenspan, R., & Mittleman, F. (1974). The decision-making process and the outcome of therapeutic abortion. American Journal of Psychiatry, 131, 1332-1337.
  45. ^ Lazarus, A. (1985). Psychiatric sequelae of legalized first trimester abortion. Journal of Psychosomatic Obstetrics and Gynecology, 4, 141-150.
  46. ^ Major, B., Mueller, P., & Hildebrandt, K. (1985). Attributions, expectations, and coping with abortion. Journal of Personality and Social Psychology, 48, 585-599.
  47. ^ Miller, W.B. (1992). An empirical study of the psychological antecedents and consequenes of induced abortion. Journal of Social Issues, 48, 67-93.
  48. ^ Anthanasiou, R., Oppel, W., Michelson, L., Unger, T., & Yager, M. (1973). Psychiatric sequelae to term birth and induced early and late abortion: A longitudinal study. Family Planning Perspectives, 5, 227-231.
  49. ^ Llewellyn, S.P., & Pytches, R. (1988). An investigation of anxiety following termination of pregnancy. Journal of Advanced Nursing, 51, 468-471.
  50. ^ Soderberg, H., Andersson, C., Janzon, L., & Slosberg, N.-O. (1997). Continued pregnancy among abortion applicants. A study of women having a change of mind. Act Obstetrica Gynecologica Scandinavia, 76, 942-947.
  51. ^ Friedman, et. al (1974)

External links

Major media coverage

Articles from pro-choice sources

Articles from pro-life sources

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