Post abortion syndrome

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With the expression Post-Abortion-Syndrome (PAS, from English "post abortion" - "after the termination of pregnancy"), as well as with the synonyms Post-Abortion-Stress (PAS) or Post-Abortion-Stress-Syndrome (PASS), an alleged psycho-emotional syndrome as a result of an abortion is alleged.

Post-Abortion Syndrome is not classified as a disorder on either the World Health Organization's ICD or the American Psychiatric Association's DSM . The existence of post-abortion syndrome is not recognized in science .

Origin of the term and described symptoms

The term post-abortion syndrome was first used by Vincent Rue in 1981 in a testimony to the United States Congress . Rue is a life rights activist who was working for the pro-life organization Ramah-International at the time. In 1992, together with the psychologist Anne Speckhard, he conceptualized the "post-abortion syndrome" as a variant of the post-traumatic stress disorder that develops as a result of an abortion. Speckhard had previously developed a description of the syndrome in her dissertation . To this end, she interviewed 30 women who were recruited because they rated an abortion between one and 25 years ago as "extremely stressful". The sample was atypical in its composition: 46% of the women interviewed had abortions in the second trimester , 4% in the third trimester and some of the women had had illegal abortions.

The symptoms are similar to those of war veterans , according to Rue and Speckhard . The women affected experience depression , feelings of guilt , grief , shame and anger. There are also flashbacks , denials and substance abuse , so Rue and Speckhard.

The term post-abortion syndrome is used primarily in the political debate surrounding abortion in the United States. Rights activists and adherents of the religious right use the term to attribute a number of negative reactions to abortion. In the 1980s, anti-abortion opponents in the United States increasingly claimed the existence of the PAS. In this climate, then President of the United States Ronald Reagan had his Surgeon General of the United States , C. Everett Koop , compile data and submit an official report that abortion poses a threat to women's health. Koop, who had been named Surgeon General for being a noted anti-abortionist, conducted a systematic study of the psychological consequences of abortion but found that there was not enough scientific evidence to suggest a link between abortion and mental disorders.

In many so-called Crisis Pregnancy Centers , which were founded by religious and life rights activists in the USA, the "post-abortion syndrome" is presented as a risk of abortion, along with breast cancer and infertility.

Scientific status

Neither the medical diagnosis scheme ICD-10 nor the psychological-psychiatric diagnosis scheme DSM-5 recognize a "post-abortion syndrome". It is not recognized as a true syndrome by any medical or psychiatric association . The American Psychiatric Association also does not list abortion in the description of the triggers for post-traumatic stress disorder .

A working group of the American Psychological Association examined all studies published in English on abortion and possible consequences since 1989. The results were published in a report in 2008 and updated in 2009. The group concluded that among adult women who are unwantedly pregnant, the relative risk of mental health problems is no greater if they have a single abortion performed within the first three months or if they have the baby. Risk factors for the development of mental disorders after an abortion are not the intervention itself, but the perceived stigmatization , the need to keep the abortion a secret, low social support for the decision, a low self-esteem, denial and avoidant coping strategies and, above all, previous psychological ones Problems. In a systematic review in December 2011 , experts from the National Collaborating Center for Mental Health , a center belonging to the UK National Health Service , also came to the conclusion that abortion does not increase the risk of developing mental disorders. According to these results, the risk of developing mental disorders for an unwantedly pregnant woman does not depend on whether she ultimately chooses to have an abortion or to carry the child to term.
An American study came to the conclusion that an abortion in affected women causes less strong feelings than is often assumed. At first, positive feelings dominate after such an intervention, but like the negative feelings, these quickly subside.

Further review articles confirm that there is insufficient evidence for a causal relationship between mental disorders and abortion. Overall, the quality of individual studies was rated as below average. High-quality studies are rare and consistently show that termination of pregnancy has no or very few consequences. In contrast, studies with the greatest methodological deficiencies report negative consequences. Methodological deficiencies include poor sample and comparison group selection, insufficient control of confounding variables , inadequate statistical analysis, and errors in interpretation, including incorrect attribution of causal effects. Moreover disinformation widely about abortion: data is manipulated, misquoted or ignored and citation of non- peer-reviewed articles is common.

Some researchers believe that "post-abortion syndrome" and the claim that abortion has negative consequences for the mental health of women is a new strategy used by life rights activists to criminalize abortion. Sociologists concluded that the syndrome enables life rights activists to psychologize the abortion experience of women and undermine alternative constructions of the experience.

It is sometimes suggested that, despite objections from medical professionals and researchers, the PAS is increasingly being considered in federal and state political decisions in the United States. For example, in some states in the United States , e.g. For example, in South Dakota , doctors are legally required to tell their patients that abortion increases the risk of depression and suicide , although a lot of research does not confirm these risks. This law, according to critics, would encourage medical personnel to spread misinformation; it forces doctors to violate their duty to obtain genuinely informed consent . However, such laws are not based primarily on claims by the PAS, but z. B. on a long-term study from the USA, which came to the conclusion over a period of 13 years that the risk of depression, suicidal thoughts, as well as addictive illnesses is significantly increased after an abortion. The final report of the American Psychological Association from 2008, in which the majority of all studies carried out since 1989 up to that point were examined, comes to the conclusion that there is no noticeably increased risk of psychological distress for voluntary termination of pregnancy. However, the researchers identified 17 risk factors that favor psychological distress in connection with an abortion.

See also

Individual evidence

  1. ↑ a b c d e f B. Major u. a .: Abortion and mental health: Evaluating the evidence . ( Memento of the original from October 4, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. (PDF; 194 kB). In: American Psychologist . 64, No. 9, 2009, pp. 863-890. doi: 10.1037 / a0017497 . PMID 19968372 . @1@ 2Template: Webachiv / IABot / alranz.org
  2. ↑ a b c G. E. Robinson et al. a .: Is there an “Abortion Trauma Syndrome”? Critiquing the Evidence. In: Harvard Review of Psychiatry. 17, No. 4, 2009, pp. 268-290. doi: 10.1080 / 10673220903149119 . PMID 19637075 .
  3. ^ A b c E. M. Dadlez, WL Andrews: Post-Abortion Syndrome: Creating an Affliction. In: Bioethics. 24, No. 9, 2009, pp. 445-452. doi: 10.1111 / j.1467-8519.2009.01739.x . PMID 19594725 .
  4. ↑ a b c S. Rowlands: Misinformation on abortion. In: The European Journal of Contraception and Reproductive Health Care. 16, No. 4, 2011, pp. 233-240. doi: 10.3109 / 13625187.2011.570883 . PMID 21557713 .
  5. ↑ a b c N. L. Stotland: Abortion and psychiatric practice. In: Journal of psychiatric practice. 9, No. 2, 2003, pp. 139-149. PMID 15985924 .
  6. ↑ a b c D. A. Grimes, MD Creinin: Induced abortion, an overview for internists. In: Annals of internal medicine . 140, No. 8, 2004, pp. 620-626. PMID 15096333 . ISSN  0003-4819 .
  7. ^ Vincent Rue: Abortion and Family Relations . Testimony before the Subcommittee on the Constitution of the US Senate Judiciary Committee, US Senate, 97th Congress, Washington, DC (1981).
  8. ↑ Irin Carmon: Who is Vincent Rue? . In: MSNBC . June 11, 2014.
  9. ↑ a b A. C. Speckhard, VM Rue: Postabortion Syndrome: An Emerging Public Health Concern. In: Journal of Social Issues. 48, No. 3, 1992, pp. 95-119. doi: 10.1111 / j.1540-4560.1992.tb00899.x .
  10. ↑ Emily Bazelon : Is There a Post-Abortion Syndrome? In: The New York Times . January 21, 2007.
  11. ↑ AJ Trumpy: Woman vs. Fetus: Frame Transformation and Intramovement Dynamics in the Pro-Life Movement. In: Sociological Spectrum. 34, No. 2, 2014, pp. 163-184. doi: 10.1080 / 02732173.2014.878624 .
  12. ↑ Michael Kranish: Science in support of a cause: the new research . In: The Boston Globe . July 31, 2005.
  13. ^ Diana DeGette, Daniel Paisner: Sex, Science, and Stem Cells: Inside the Right Wing Assault on Reason . Lyons Press, Guilford (Conn.) 2008, ISBN 978-1-59921-431-3 , e.g. B. S. 207th .
  14. ^ RB Siegel: The Right's Reasons: Constitutional Conflict and the Spread of Woman-Protective Antiabortion Argument . In: Duke Law Journal. 57, No. 6, 2008, pp. 1641-1692. PMID 19108356 .
  15. ^ Chris Mooney: Research and Destroy: How the religious right promotes its own "experts" to combat mainstream science . ( Memento of the original from April 4, 2008 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. In: Washington Monthly. October 2004. @1@ 2Template: Webachiv / IABot / www.washingtonmonthly.com
  16. ↑ Bryant AG, EE Levi: Abortion misinformation from crisis pregnancy centers in North Carolina. In: Contraception. 86, No. 6, December 2012, pp. 752-756. doi: 10.1016 / j.contraception.2012.06.001 .
  17. ^ A. Bryant, E. Levi, S. Narasimhan: Abortion misinformation provided by crisis pregnancy center websites listed on states' Department of Health Web sites as resources for pregnant women: a systematic review. In: Contraception. 86, No. 3, September 2012. doi: 10.1016 / j.contraception.2012.05.058 .
  18. ↑ Ben Quinn: Abortion: Pregnancy counseling centers found wanting . In: The Guardian . August 2, 2011.
  19. ^ AG Bryant, S. Narasimhan, K. Bryant-Comstock, EE Levia: Crisis pregnancy center websites: Information, misinformation and disinformation. In: Contraception. 90, No. 6, December 2014, pp. 601-605. doi: 10.1016 / j.contraception.2014.07.003 .
  20. ^ A b APA Task Force on Mental Health and Abortion: Report of the APA Task Force on Mental Health and Abortion . American Psychological Association , Washington, DC, 2008.
  21. ↑ Lynn Harris: APA report: Abortion is not a threat to women's mental health . In: Salon , August 13, 2008.
  22. ↑ Induced Abortion and Mental Health: A systematic review of the evidence ( Memento of September 27, 2015 in the Internet Archive ). National Collaborating Center for Mental Health, National Health Service , December 2011.
  23. ↑ Jane Dreaper: Abortion 'does not raise' mental health risk . BBC , December 9, 2011.
  24. ↑ Quotation: “ Overall, we have […] largely confirmed the APA and Charles reviews, both through our narrative review and meta-analysis. When a woman has an unwanted pregrancy, rates of mental health problems will be largely unaffected whether she has an abortion or goes on to give birth. " Induced Abortion and Mental Health: A systematic review of the evidence ( Memento September 27, 2015 in the Internet Archive ). National Collaborating Center for Mental Health, National Health Service, December 2011, p. 125.
  25. ↑ Corinne H. Rocca, Goleen Samari, Diana G. Foster, Heather Gould, Katrina Kimport: Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion Stigma. Social Science & Medicine, January 13, 2020, DOI: 10.1016 / j.socscimed.2019.112704
  26. ↑ a b c d V. E. Charles u. a .: Abortion and long-term mental health outcomes: a systematic review of the evidence. In: Contraception. 78, No. 6, 2008, pp. 436-450. doi: 10.1016 / j.contraception.2008.07.005 . PMID 19014789 .
  27. ↑ NE Adler u. a .: Psychological responses after abortion. In: Science . 248, No. 4951, 1990, pp. 41-44. doi: 10.1126 / science.2181664 . PMID 2181664 .
  28. ↑ a b S. Cameron: Induced abortion and psychological sequelae. In: Best Practice & Research: Clinical Obstetrics & Gynaecology . 24, No. 5, October 2010, pp. 657-665. doi: 10.1016 / j.bpobgyn.2010.02.001 . PMID 20303831 .
  29. ↑ NL Stotland: The myth of the abortion trauma syndrome. In: JAMA . 268, No. 15, 1992, pp. 2078-1079. PMID 1404747 .
  30. ^ NF Russo, JE Denious: Controlling Birth: Science, Politics, and Public Policy. In: Journal of Social Issues. 61, No. 1, 2005, pp. 181-191. doi: 10.1111 / j.0022-4537.2005.00400.x . PMID 17073030 .
  31. ↑ N. Hopkins, S. Reicher, J. Saleem: Constructing women's psychological health in anti-abortion rhetoric. In: The Sociological Review . 44, No. 3, 1996, pp. 539-564. doi: 10.1111 / j.1467-954X.1996.tb00436.x .
  32. ^ R. Alta Charo: Physicians and the (Woman's) Body Politic . In: The New England Journal of Medicine . 370, No. 3, pp. 193-195, January 2014. doi: 10.1056 / NEJMp1313499 . PMID 24382001 .
  33. ↑ Kelly Kimberly: The spread of 'Post Abortion Syndrome' as social diagnosis. In: Social Science & Medicine. 102, No. 1, February 2014, pp. 18-25. doi: 10.1016 / j.socscimed.2013.11.030 . PMID 24565137 .
  34. ↑ CM Corbin: Abortion Distortions . In: Washington and Lee Law Review. 2014.
  35. ^ A b Z. Lazzarini: South Dakota's Abortion Script - Threatening the Physician - Patient Relationship . In: The New England Journal of Medicine. 359, No. 21, 2008, pp. 2189-2191. doi: 10.1056 / NEJMp0806742 . PMID 19020321 .
  36. ↑ Donald Paul Sullins: Abortion, substance abuse and mental health in early adulthood: Thirteen-year longitudinal evidence from the United States . Sage Open Medicine, 2016.
  37. ↑ APATask Force onMental Health and Abortion (ed.): Report of the APA Task Force on Mental Health and Abortion . Washington DC 2008, p. 13 f .

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