Available studies. Do pro-life activities
contribute to PAS? Experience. Support.

Sponsored link.

Review of available studies:

Many studies into the incidence and nature of PAS have been conducted. Some have been "... widely cited in legislative and judicial testimony in support of the existence of adverse psychiatric sequelae of induced abortion." ₁ A review of 216 such studies was published in the Harvard Review of Psychiatry in the fall of 2009. The review found that the quality of recent studies is highly variable.

The article abstract states:

"Recent studies that have been used to assert a causal connection between abortion and subsequent mental disorders are marked by methodological problems that include, but not limited to: poor sample and comparison group selection; inadequate conceptualization and control of relevant variables; poor quality and lack of clinical significance of outcome measures; inappropriateness of statistical analyses; and errors of interpretation, including misattribution of causal effects. By way of contrast, we review some recent major studies that avoid these methodological errors."

"The most consistent predictor of mental disorders after abortion remains preexisting disorders, which, in turn, are strongly associated with exposure to sexual abuse and intimate violence. Educating researchers, clinicians, and policymakers how to appropriately assess the methodological quality of research about abortion outcomes is crucial. Further, methodologically sound research is needed to evaluate not only psychological outcomes of abortion, but also the impact of existing legislation and the effects of social attitudes and behaviors on women who have abortions." ₂

"Serena," writing for Feminists For Choice, comments that the authors of the review found that:

"... most well controlled studies continue to demonstrate that there is no convincing evidence that induced abortion of an unwanted pregnancy is a per se significant risk factor for psychiatric illness." (Page 276) ₁

The authors note that:

"... in some of the studies of abortion outcome, researchers recruited women who had already self-identified as suffering negative psychological effects from abortion, and then used the self-reports of these women as evidence for high rates of ill effects in all women who have had abortions. ..."

"The use of retrospective reports from women who had an abortion years earlier is problematic. Recall bias can affect any individual’s perspective on a historical event. Mood-related memory effects also may bias recall of both the abortion experience and the timing of previous psychiatric episodes–especially if many years have passed. Later feelings about abortion may be influenced by subsequent reproductive experiences, failure to recall the circumstances leading to the decision to abort, current depression related to stressful life events, or the effects of public campaigns attributing psychological problems to abortion. ..."

"Some studies of abortion fail to use a comparison group, or use as a comparison group women in general or women who have never been pregnant, who have never delivered (with the wantedness of the pregnancy unspecified) but have never had an abortion, who are currently pregnant who had a spontaneous abortion, or who have delivered following wanted pregnancies. ..."

These circumstances "... are not comparable to those associated with a voluntary, elective abortion ... At a minimum, the appropriate comparison group for assessing the relative risks of negative mental health outcomes of such abortions is women who carry unwanted pregnancies to term. An unwanted pregnancy is different from an unplanned pregnancy. Women with unwanted pregnancies are more likely to suffer from a number of co-occurring life stressors, including childhood adversity, relationship problems, exposure to violence, financial problems, and poor coping capacity, all of which contribute to emotional distress. These factors increase the risk of poor mental health, whether or not a woman has an abortion.  (Page 270). ₃

Many of the studies reviewed did not define depression. Many used the respondents personal descriptions of their memories of depression rather than a clinical diagnosis of depression from a professional at the time. Most of the studies did not ask about positive outcomes -- like a feeling of relief or a satisfaction with their decision.

Aspen Baker, a co-founder and executive director of Exhale -- a non-judgmental service provided as an alternative to politically motivated counseling agencies -- commented:

"What the Harvard literature review and other similar literature reviews point out is that there has been no perfect-science study done that provides real evidence that there is a direct correlation between abortion and mental ILLNESS, or a psychological disorder. Which also doesn’t mean one doesn’t exist, it just means no study has shown it to exist. ..."

"The spectrum of feelings that women and men can have after an abortion – from relief and empowerment to grief and sadness – all deserve to be heard and supported. The presence of normal, natural human emotion does not in fact predetermine mental illness. Quite the opposite, in fact. A person’s ability to identify and cope with their feelings around an abortion experience is a very positive action and one that puts them in charge of promoting their own emotional health."

"Exhale believes that more research needs to be done to better understand the emotional experience of abortion and the kinds of strategies women can use to promote their own well-being. ..."

"The current social climate around abortion is definitely not the most conducive environment to a woman’s wellbeing after an abortion. And yet, we know from listening to women on our talkline, that they have everything they need to be well after an abortion. The best each of us can offer is to listen and be a witness to their unique story." ₄

Do pro-life activities aggravate PAS?

Although pro-life groups often emphasize their concern over the mental health of women who have had abortions, they may also actually contribute to restrictions that aggravate whatever women's mental health problems do exist.

Women seeking an abortion may suffer additional stress from a number of causes:

All of these factors are either caused or aggravated by pro-life activities. All place the woman under increased stress.

The Harvard Review article commented that a woman entering:

"... abortion clinics through a group of anti-abortion demonstrators [is] a stressor that has been shown to be associated with psychological distress ... increasing a women’s belief in her ability to deal with having an abortion decreased her likelihood of experiencing depressive symptoms following abortion. Such findings suggest that insofar as inaccurate 'informed consent scripts' undermine a woman’s belief in her ability to cope after an abortion, they may contribute to her risk for depression. (Page 270) ₃

One woman's experience:

We received the following note in an Email from a woman in her late 20s who had an abortion for medical reasons about a year previously. Her experience emphasizes the importance of a woman being fully informed in advance about all aspects of the procedure, including the possibility of future emotional distress from PAS. With her permission we reprint part of the Email below:

"I am not saying that I condone this practice [of abortion access]. I do think that one thing should be changed and I want to tell you why because if my story can help just one person then it was worth while. Never in my time of having this procedure done did anyone go over the aftereffects of what this procedure can do to you mentally. I thought that by detaching myself that I wouldn't have to deal with the mental pain it caused. I was wrong and since then I have learned to grieve for my loss because after all it is a loss. I believe that women who are thinking about having this done should be told of the after effects it has and the loss they will feel."

"I have been pretty open about my decision to have an abortion so that I may hopefully be able to help someone make the right decision for them and hope that if they do go through with the procedure that they understand the lasting after effects it has. I know that this will be with me till my dying day and I have to accept that to be able to get through this. My only hope it that I can change one persons mind who is border line on their decision. By no means am I saying to have an abortion is wrong or right I just think that there should be a little more honesty involved in it. I put postings on websites in hopes to reach out to someone who needs the honest truth. Nothing can ever prepare someone for what they will deal with afterwards but the truth from someone who has been there. I hope that this is seen and I hope that I can reach as many women as humanly possible."

Support for women experiencing PAS:

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

1. Gail. E. Robinson, et al., "Is there an 'Abortion Trauma Syndrome'? Critiquing the evidence," Harvard Review of Psychiatry, Volume 17, Issue 4, 2009-AUG, Pages 268 to 290.
2. An abstract of the Harvard Review of Psychiatry article is available at: http://www.informaworld.com/
3. Serena, "New study debunks 'Abortion Trauma Syndrome," Feminists for choice, 2009-AUG-24, at: http://feministsforchoice.com/
4. Aspen Baker, comment posted on the "New study debunks 'Abortion Trauma Syndrome," article at: http://feministsforchoice.com/
5. Anne Speckhard and Vincent Rue, "Post-Abortion Syndrome a Growing Health Problem," Journal of Social Issues, 1992-FALL. Available at: http://www.forerunner.com/