Can abortions lead to mental illness?

The debate continues about the procedure's risk to a woman's sanity.

By Carol Lloyd
Published March 27, 2008 9:10PM (EDT)

A story last week headlined "Royal College Warns Abortions Can Lead to Mental Illness" got Salon internal e-mail servers working overtime deep into a Sunday night. In the wake of "new" studies suggesting that abortions increase the risk of mental illness, Britain's Royal College suggested that women not be allowed to have abortions without getting counseling on the risk to their mental health.

Just thinking about how such a law would play into the tactics of pro-life clinics in America gives me the heebie-jeebies. ("I'm OK, I don't need counseling"/ "You're not OK -- let us help you deal with your inner demons -- er, doubts.")

On the other hand, having just come from a conversation with a friend who called her abortion the most "horrible, traumatic experience" of her life, I was curious about what new research might have changed these doctors' minds.

The debate around the mental health effects of abortion is an old and inconclusive one. Back in the 1980s Reagan directed Surgeon General C. Everett Koop to find evidence that abortion causes mental problems, and he did his durndest, but in the end he said that none of the studies available were conclusive and that those that did find a link between mental illness and abortion didn't control for preexisting conditions that cause women to want abortions in the first place -- e.g., sexual abuse, poverty, domestic violence, etc. For a great summary of this debate, read this article from the Guttmacher Policy Review.

The first question, of course, is how does having an abortion compare with the alternatives: a) having an unwanted baby or b) giving that baby up for adoption? As Broadsheet's Katharine Mieszkowski put it: "Is it glib to point out that carrying a pregnancy to term can also lead to mental illness? It's called postpartum depression. There's also the more serious postpartum psychosis. According to Dr. Sears, postpartum depression occurs in 10 to 15 percent of all deliveries. Among adolescent new mothers the number jumps to 30 percent. Another recent study found that poor women are more likely to suffer from postpartum depression."

Post-adoption trauma is also relatively well documented. One study published in the British Journal of Social Work in 1996 found the "long-term implications of relinquishment are severe," particularly in relation to mental health. A 1999 review of previous studies found that "the relinquishing mother is at risk for long-term physical, psychologic, and social repercussions" from "chronic unresolved grief."

I would add to this another set of comparisons: How does having an abortion compare with some other reproductively oriented medical procedures (C-sections, hysterectomies and post-miscarriage D&C procedures) that depress the hell out of many women? Each of these procedures often carries emotional baggage: self-doubt, lingering regret, anxiety about going through another similar procedure again. My friend called the procedure traumatic because a) it hurt, b) the medical staff didn't prepare her for the potential pain and didn't offer any emotional support, and c) her boyfriend wasn't with her. I couldn't help flashing on my first C-section. It was bad enough to have a physically painful, traumatizing medical procedure that doctors didn't prepare me for, but I got what I wanted: a healthy baby. Having a medical team stab around in my nether regions only to then walk away empty-handed might trigger even more heartache.

The "new" study, cited by the Royal College and published in 2006 by the Journal of Child Psychology and Psychiatry, found a link between abortion and later problems with depression, anxiety, suicidal behaviors and substance abuse disorders. But like so many previous studies, this one doesn't control for preexisting mental health problems or sexual abuse. More important, the control group consisted of all young women who had babies, not those who had babies as a result of unintended pregnancies. Another more recent study found that young women who had abortions had better educational outcomes than their peers who chose to have babies of unintended pregnancies.

Maybe the hard truth is that getting knocked up with a baby you don't want isn't an easy problem to escape, no matter which path you choose. But until science finds that abortions are worse than the alternative, I'll advocate for giving women the right to get out of the jungle any way they want.

Carol Lloyd

Carol Lloyd is currently at work on a book about the gentrification wars in San Francisco's Mission District.

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