Abortion Doesn't Cause Mental Health Problems & Science Has Confirmed It — So Why Are We Still Having This Conversation?

WASHINGTON - APRIL 25: Pro-choice activists shout slogans as they take part in the March For Women's Lives April 25, 2004 in Washington, DC. Hundreds of thousands of activist demonstrated for abortion rights and opposition to the Bush Administration's policies on reproductive health issues. (Photo by Alex Wong/Getty Images)
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A few major beliefs form the cornerstones of anti-choice activism: people who fight against the right to abortion typically cite their views that life begins at conception, the rights of the fetus supersede the rights or beliefs of the mother, and abortion itself is deeply traumatic for women themselves. In fact, the idea that abortion is inherently traumatic for women is so deeply woven into anti-choice culture, it has been given a scientific-sounding name: Post-Abortion Stress Syndrome. But while that moniker may sound very official, it isn't recognized by the American Psychiatric Association — and the idea that post-traumatic stress disorder, stress, guilt and disordered thinking are common among women who have had abortions has been dealt a major blow today with the release of a new study which found the mental health impacts of abortion over a 5-year period were found to be, well, negligible. Yup, that's right: a study has proven that abortion is not inherently bad for your mental health.

The study, which appears in JAMA Psychiatry, has been in the works for a while; the scientists behind it started recruiting women who were seeking abortions in 2008, and continued all the way through 2010, after which they pursued five-year questionnaires about how the abortion (or decision to not have an abortion) had affected participants' mental health in the short and long term. It's the first study of its kind, and its discoveries are pretty formidable — and directly combat the notion that abortions will always be inherently distressing and upsetting to the people who seek them. Here's what the study says and why it matters. 

Abortion Doesn't Lead To Depression Or Other Mental Health Problems For Most Women 

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The study was pretty vast, recruiting from 30 different clinics across 21 states, and eventually involving 956 women who were observed over 5 years. All the women involved were seeking abortions for reasons that weren't related to fetal abnormalities or their own health. And some of those women were denied abortions for being outside the gestational limit (i.e. the law in that state about the legal point beyond which abortion couldn't be performed). Hence its name: "The Turnaway Study." 

What the researchers discovered was the exact opposite of the so-called Post-Abortion Stress Syndrome: the women who were denied abortions were the ones who, eight days after the experience, reported "significantly more anxiety symptoms and lower self-esteem and life satisfaction" compared to those who had received an abortion. The two groups had comparative levels of depression at the time, but those who hadn't been able to fulfill their choice were, understandably, frustrated and afraid. 

The study was rigorous: it included women who'd had abortions in their first trimester, those who'd been near the legal limit and been able to get an abortion, those who'd been turned away and had a baby, and those who'd been turned away and later miscarried or had abortions elsewhere. After interviews with subjects every six months over the course of five years, the researchers concluded that "women receiving wanted abortions had similar or better mental health outcomes than those who were denied a wanted abortion. The convergence of most outcomes between groups by 6 months to 1 year suggests that future divergence is unlikely." 

This all ties in to how the study debunks the idea of Post-Abortion Stress: if the argument that abortions are traumatic for all women held true, the subjects who'd been denied abortion would likely show better mental health results later on (yep, the scientists included previous mental health factors in it as well). 

Instead, they found the opposite. Being denied made the biggest impact on a wide variety of factors, from self-esteem to anxiety to depression, within the first week; the scientists proposed that the "initial elevated levels of distress experienced by both turnaway groups may be a response to being denied an abortion, as well as other social and emotional challenges faced on discovery of unwanted pregnancy and abortion seeking." Ultimately, though, everybody's mood improved: "everyone kind of evens out together at six months to a year," as a bioethicist commenting on the study told the New York Timesthough women who'd been turned away still often had higher incidences of anxiety and depression.


Preventing Women From Exercising Their Choice Is A Very Real Source Of Mental Distress

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The reason this study is being hailed as a victory by pro-choice activists is that it indicates, for the first time, that it's denial of abortion that seems to cause immediate psychological issues for women.

There are, of course, limitations on the study. For one thing, it only focuses on abortions that were wanted for non-medical reasons, where the fetus wasn't abnormal or the health of the mother wasn't at risk. But there's a good reason for the exclusion of those — those cases are often likely to be highly traumatic, not because of the abortion process itself but because of the circumstances of grief and loss surrounding them; deciding to terminate a much-wanted pregnancy because of a severe abnormality or because the pregnancy is life-threatening is, in certain ways, a different experience to seeking one because of economic, relationship or other issues (though all are valid and important reasons for abortion-seeking). 

The study's other conclusion was quite uplifting: women are amazingly resilient, regardless of how people attempt to control our wombs. Distress in those who wanted abortions, sought them, and received them "declined significantly" after five years, and those who were denied abortions nearly caught up. The ones who seemed to experience the greatest lasting distress, crucially, were the ones who were prevented from having abortions and gave their infants up for adoption, which is often depicted as a "better" choice than abortion by anti-choice activists. The study seems to show that if you're truly concerned by women's welfare, your best option is to allow them to make the choice that matches up with their life and beliefs, not yours.

As in any analysis of a situation like this, there is danger in attributing general responses to every woman. As the diversity of the study showed, there are a lot of factors that can mediate how women respond to the need for an abortion and the process itself, from their location, to the stage of pregnancy at which they seek the procedure, to their own history of mental health issues. 

But the idea that it's always "traumatic" is deeply incorrect — which is important to remember, because the idea that this trauma is part of the process has been the basis for the laws that require mandatory "counseling" sessions before abortion in 35 states. Some of these counseling sessions use the opportunity to inform women of "facts" that are not recognized by the U.S.scientific community, like that life begins at conception and that they may have "negative emotional responses" to the procedure, as the Guttmacher Institute notes. 

Some women will have traumatic responses to the circumstances of their abortion. But telling all women that abortion is likely going to distress them long-term, no matter what their circumstances are, not only pushes a theory that is not backed up by the facts — it also dismisses the real-life experiences of women who have actually had abortions and experienced no distress ("You must be traumatized. We'll ignore what you say for your own good.") 

The scientists behind the study put it very eloquently: "By understanding that each woman’s experience is unique and that women will vary in their responses to having an abortion or being denied an abortion, we can better serve women’s individual needs." All responses to abortion are valid, and laws telling people how they "should" feel about abortion (particularly ones that try to use imaginary negative responses to restrict their access to their rights) are more than just ridiculous — they often steamroll over the truth.

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