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July 29, 2004

Most Women Do Not Feel Distress After Their Abortions

Forget the nonsense about "post abortion syndrome," which is yet another form of junk science meant to portray women as damaged goods. The fact is that most women do not feel regret or distress after undergoing an abortion.

The majority of women who choose to have legal abortions do not experience regret or long-term negative emotional effects from their decision to undergo the procedure, according to a study published in the June issue of the journal Social Science & Medicine, NewsRx.com/Mental Health Weekly Digest reports. Dr. A. Kero and colleagues in the Department of Clinical Sciences, Obstetrics and Gynecology at University Hospital in Umea, Sweden, interviewed 58 women at periods of four months and 12 months after the women's abortions. The women also answered a questionnaire prior to their abortions that asked about their living conditions, decision-making processes and general attitudes toward the pregnancy and the abortion. According to the study, most women "did not experience any emotional distress post-abortion"; however, 12 of the women said they experienced severe distress immediately after the procedure. Almost all of the women said they felt little distress at the one-year follow-up interview. The women who said they experienced no post-abortion distress had indicated prior to the procedure that they opted not to give birth because they "prioritized work, studies, and/or existing children," according to the study. According to the researchers, "almost all" of the women said the abortion was a "relief or a form of taking responsibility," and more than half of the women said they experienced positive emotional experiences after the abortion such as "mental growth and maturity of the abortion process" (NewsRx.com/Mental Health Weekly Digest, 7/12).

Yes, women have abortions because they "prioritize work, studies, and/or existing children." I don't believe that those life decisions can be condemned as being selfish or insensitive, nor do I believe that a "good" abortion is one where other people approve of the reasons or the woman's way of discussing the issue, if she chooses to discuss it at all. I certainly don't like the idea of pathologizing women and forcing guilt on them the way those who approve of junk science such as "post abortion syndrome" tend to do.

Posted on July 29, 2004 at 01:11 PM | Permalink

Comments

Are you saying one study with a "N" of 58 limited to one country (I'm assuming the women were all Swedes) that has a generally more liberal attitude about sex and sexual issues and with a sample of women who had apparently the same "priorities" (which is a proxy for values) is representative of all women? And is 12 months sufficient to stop the study and make a definitive conclusion?

I don't know enough about this issue to make a claim either way on the "science", but I'm a little doubtful you can extrapolate this study to "all or most women."

Posted by: Col Steve at Jul 30, 2004 12:30:27 AM

Interesting that you mention that if a society is positive about female sexuality, that would lead to less distress after abortion. That's probably quite true--a society that makes women feel guilty about their own sexual pleasure is probably also one that would make them feel guilty about abortion.

Posted by: Amanda at Jul 30, 2004 11:12:03 AM

I always find it amazing that people who can never experience an abortion for any reason are always the first to lambaste studies which show them (abortions) to be a positive influence in a woman's life.
Yes, mine was 32 years ago when it was only legal in NY and I went through a great deal of difficulty getting one, with the support of my mother and father, as I was only 18 at the time. I have two children, planned for and loved and one grandchild who was unplanned for, but still loved.I don't think men are the ones who should choose whether we have a right to choose.

Posted by: Kathy at Aug 1, 2004 8:25:13 PM

Kathy:
I was not "lambasting" the study. If I were to do that, I would have critiqued the findings or methodology of the study. I merely questioned the extent to which one can generalize the study's finding beyond the sample population. I don't find it critical to ask whether the study finding would be similar to women in different societies and cultures? The doctors in the article make a broad claim "most woman" without clarifying whether the "most" is limited to the 58 women, limited to some larger population that share similar characteristics, or is indicative of women in general.

I'm curious whether taking your two sentences about (1) people who can never experience an abortion (men and perhaps a limited number of women who cannot conceive - but I take it you mean men) and (2) men shouldn't be the ones who decide on the the issue of legalized abortion means you believe in general that people who can never experience "something" should therefore be excluded from participating in decisions about that "something."

Should people who have never been in hostile/combat situations be allowed to send people into harm's way then? I've been to Panama, Haiti, Bosnia, and Kuwait/Iraq on military operations and it makes no difference to me whether the President or the majority of the member of Congress who get to make the decision on my behalf have had the combat, let alone military service, as long as they make an informed decision with the best interest of the nation in mind.

Should members of a community without children be excluded from participating in the local school board?

My orginal post was not to question the study's findings, but merely to ask the question whether Trish believed the study's findings were applicable beyond the sample population given the multitude and complexity of factors which may influence the degree to which an abortion may cause long-term distress - nothing more and nothing less.

Posted by: at Aug 2, 2004 1:26:42 AM

I also find the attitude strange that men can't have an opinion about abortion because they cannot give birth. Does that mean childless people cannot have an opinion about parents who abuse their children? Every person in a society should have an opinion involving a life or death decision of another citizen.

Posted by: Fran at Aug 2, 2004 10:39:42 AM

Six or seven studies have been published in the last two years in publications including the British Medical Journal and the Canadian Medical Journal that find a statistical correlation between abortion and higher rates of depression, psychiatric hospitalization, suicide, substance abuse and other adverse reactions--I have links to those studies at my blog (right-hand links rail).

Peer-reviewed medical studies on this question disagree. I don't think it is safe to say one way or the other, based on what studies there are. More studies would be good and I hope we can all support such studies.

Posted by: Emily at Aug 2, 2004 2:30:28 PM

The correlation Emily suggests doesn't surprise me at all. It makes sense that depression and other mental health problems might lead to a higher rate of unplanned pregnancy, and make a woman to feel less able to continue the pregnancy and/or raise a child. Substance abuse and similar behaviour might also be seen as grounds to advise abortion.

It's difficult to know whether the abortion contributed to the problems, or whether the woman's mental health and other problems might have been even worse had she been refused abortion. No, the study mentioned in the original post can't be extrapolated to make definite assumptions about every individual woman who has an abortion. It does however support the view that an otherwise healthy woman isn't particularly likely to suffer long term harm just from having an abortion, even if the procedure itself is an unpleasant or emotional experience.

I don't understand why anyone would consider that other than good news?

Posted by: Sarah at Aug 3, 2004 2:39:43 PM

Sarah wrote--

It makes sense that depression and other mental health problems might lead to a higher rate of unplanned pregnancy.

Most of the recent studies compare the mental health outcomes of women with an unplanned pregnancy who aborted versus women in an unplanned pregnancy who carried to term. That is to say, the studies are trying to control for whatever factors may have led to unplanned pregnancy. They also control for psychiatric conditions that existed prior to the pregnancy.

Posted by: Emily at Aug 3, 2004 6:35:12 PM

Trying to is the operative word. Women who elect to go forth with unplanned pregnancies and women who choose not to probably have very different situations on average. Like it or not, even women who've never had abortions often feel that the right to choose is essential and would have probably made that choice themselves in different situations. For instance, I know women who had abortions they didn't regret but when they found themselves unexpectedly pregnant again, but in different circumstances, went forth with the pregnancy. And not because of any regret over the first one, but usually because they were married to the father this time around.

Posted by: Amanda at Aug 3, 2004 10:01:50 PM

Amanda, you're right that "trying is the operative word". Human beings are infinitely complex and it is very difficult to isolate causal factors in any kind of research, especially about psychology. The best that some studies can do is show a positive statistical correlation. You're also right that many women don't regret abortions. If you look at the record-based study published in the Canadian Medical Journal last May that showed that the rate of psychiatric hospitalization for women who aborted an unplanned pregnancy is 2.6 times higher than the rate of psychiatric hospitalization for those who carried an unplanned pregnancy to term, this only shows a positive statistical correlation and clearly does not in any way suggest that all women in the study experienced a negative emotional aftermath from abortion.

Posted by: Emily at Aug 4, 2004 8:11:56 AM

Emily’s “research citations” do not establish any causal link between abortion and adverse psychological effects. Of the eight links she provides, only six reference primary research sources. The other two are links to essays on the “Elliot Institute” website. The Elliot Institute is an anti-abortion organization dedicated to the promotion of the idea that abortion harms women. Of Emily’s six links to primary research, one appears to be to an unpublished paper, and another one links to a page on the website of a subscriber-only journal whose contents I have been unable to verify.

Of the five links to visible primary research sources, every study was authored by one David C. Reardon and his colleagues Jesse Cougle and/or Priscilla Coleman. Reardon is the director of the aforementioned Elliot Institute, is famously and outspokenly opposed to abortion for religious reasons regardless of its effects on women’s health, and has publicly stated that he seeks to use his research to persuade women not to have abortions. Without even examining the substantive content of his research, these facts—the fact that all the studies are the work of the same small group of researchers, the fact that Reardon is strongly opposed to abortion, and the absence of any independent confirmation of the results—casts serious doubt on the reliability and impartiality of the research.

Substantively, each of the five studies shows only a correlation between abortion and some kind of adverse condition, such as drug use or depression. As others have noted, correlation does not imply causation. An equally or more plausible interpretation of the correlation in each case is that the adverse condition caused the abortion, or that the adverse condition and the abortion have a common cause that the study did not identify. In other words, the observed correlation between, for example, depression and abortion may simply reflect the fact that a woman is more likely to choose to have an abortion if she is suffering from depression than if she is not. In every cited study, there is either no control at all for these confounding factors, or the attempted control is superficial and inadequate. There are also other methodological and interpretive problems with the studies that cast serious doubt on the reliability of the authors’ claims. You can find some of these critiques in the letters written by other researchers in response to the studies that appeared in the British Medical Journal and the Canadian Medical Association Journal, for example. Reardon also has a history of previous research that is even more methodologically flawed (and that is apparently unpublished). For example, in one of his earlier studies that purported to find a relationship between abortion and negative psychological effects, Reardon’s study sample was drawn entirely from an anti-abortion group called Women Exploited By Abortion, an example of a sampling bias that is so obvious and egregious that the study wouldn’t meet even the most minimal standards of scientific integrity.

What all of this shows is that the scientific research allegedly supporting the claim that abortion harms women psychologically is at best extremely weak.

In contrast, there is a much larger body of research, by varied and independent teams of researchers, studying much larger samples of women for longer periods of time, the consensus of which is that abortion poses little risk of psychological harm to the vast majority of women who undergo the procedure, and that the risks from completing an unwanted pregnancy may be much greater.

But don't expect to see any citations to that research on Emily's website.

Posted by: Don P at Aug 12, 2004 11:23:41 PM

Don, please feel free to cite with links the research to which you allude. It is true that two of my research citation links go to the Elliot Institute's write-ups of those medical journal articles. These are in the two cases where the medical journals in question don't put their articles online. Are you suggesting that the medical journals and articles in question don't exist? If so, please provide me with your name and postal address, and I will mail you hard copies of the articles in question.

One of your complaints about recent published post-abortion research is about the authorship of the studies. The editors of the Canadian Medical Association Journal got a few similar complaints when they published an article in May 2003 that indicated a statistical correlation between induced abortion and higher rates (compared to women who carried unexpected pregnancies to term) of subsequent psychiatric hospitalization.

As they noted in an editorial comment, the fact that an author has political views doesn't mean that the statistical correlation doesn't exist. Peer-review boards are there to assess the quality of submitted articles and, as they say, they subjected this particular article to even more careful scrutiny than normal because of the author's well-known political views on abortion.

Of course it is true that correlation doesn't equal causation. However, researchers are often able to confer a greater likelihood on one causal theory than other, and find ways to control for competing causal hypotheses. And, while I appreciate that you have thrown out a few competing causal hypotheses to explain the observed statistical correlation, I am not aware of any research that suggests that your causal hypotheses have any validity. Are you?

Posted by: Emily at Aug 14, 2004 7:23:11 AM

Emily:

The fact that every one of the studies you cited is the work of the same small group of researchers, at least of one whom (Reardon) is strongly opposed to abortion for religious reasons regardless of its effects on women’s health, and has a strong pre-existing committment to the position that abortion harms women, casts serious doubt on the reliability of the research. The fact that the CMAJ felt it necessary to subject the study by Reardon that it published to heightened scrutiny illustrates this obvious conflict of interest. And as I said before, Reardon also has a history of prior work that is even more methodologically flawed than the studies you cite, such as the (apparently unpublished) study he reported in his 1987 book Aborted Women: Silent No More, in which his study sample consisted entirely of members of the anti-abortion group Women Exploited By Abortion. Obviously, that sample is not going to be representative of women who have abortions generally, and thus Reardon’s findings are essentially worthless as evidence of the effects of abortion of women generally.

As for the correlations the studies you cite found, even if they are real, they do not imply any causal relationship. In fact, Reardon himself is careful to say only that the correlations may indicate a causal relationship between abortion and depression, drug use, etc. An equally plausible alternative explanation is that women with a prior history of depression, etc., are more likely to choose abortion than women without such a history. Without properly controlling for obvious confounding factors such as prior medical history, there is simply no basis for concluding that the correlations are evidence that abortion causes adverse psychological effects in any women, let alone in a significant number of them. In one or two of the studies, Reardon does attempt to control for some confounding factors, but his controls are superficial and inadequate. For example, simply excluding women with a psychiatric admission in the year prior to the abortion or birth event from the study sample is a hopelessly inadequate control for pre-existing depression. Psychiatrists believe that most cases of depression are undiagnosed, and even most diagnosed cases of depression probably do not involve a psychiatric admission to a hospital; the condition would be treated on an out-patient basis. A realistic control for pre-existing medical conditions would require a comprehensive review of the subjects’ medical records coupled with extensive personal interviews to minimize the confounding effects of unreported or undiagnosed conditions. I would again urge readers to consult the letters attached to the British Medical Journal and Canadian Medical Association Journal articles from other medical researchers that discuss these methodological and interpretive flaws in Reardon’s work in more detail.

Posted by: Don P at Aug 14, 2004 4:47:35 PM

Emily writes:

Don, please feel free to cite with links the research to which you allude.

The overwhelming consensus amoung scientists who have studied the relationship between abortion and mental health is that adverse psychological effects from abortion are relatively rare and that serious adverse psychological effects from abortion are extremely rare.

This briefing paper from the American Psychological Association summarizes the findings of the scientific research. It’s worth reading the whole paper, but the bottom line is summarized in the following paragraph:

“Well-designed studies of psychological responses following abortion have consistently shown that risk of psychological harm is low. Some women experience psychological dysfunction following abortion, but post-abortion rates of distress and dysfunction are lower than pre-abortion rates. Moreover, the percentage of women who experience clinically relevant distress is small and appears to be no greater than in general samples of women of reproductive age. A recent study showed not only that rates of disorders, such as depression and posttraumatic stress disorder (PTSD), were not elevated in a large sample of 442 women followed for two years post-abortion, but also that the incidence of PTSD was actually lower in women post-abortion than the rate in the general population”

The paper also contains citations to the primary research literature on which its conclusions are based.

And this article from Planned Parenthood describes additional research also showing that the risk of adverse psychological effects from abortion is low. Here’s the bottom line from this piece:

“Research studies indicate that emotional responses to legally induced abortion are largely positive. They also indicate that emotional problems resulting from abortion are rare and less frequent than those following childbirth …

“In 1989, a panel of experts assembled by the American Psychological Association concluded unanimously that legal abortion "does not create psychological hazards for most women undergoing the procedure." The panel noted that, since approximately 21 percent of all U.S. women have had an abortion, if severe emotional reactions were common there would be an epidemic of women seeking psychological treatment. There is no evidence of such an epidemic (Adler, 1989). Since 1989, there has been no significant change in this point of view.”

Again, I would encourage those interested to read the entire article.

If Emily wishes her readers to be informed of the true state of expert opinion on the psychological effects of abortion, rather than just presenting the view of an unrepresentative minority that abortion is harmful, I urge her to post these links on her website.

Posted by: Don P at Aug 14, 2004 5:09:05 PM

Don, one of the reasons I asked you if you could provide citations is because you claimed that in contrast to several large, record-based, recent studies in leading medical journals--

"a much larger body of research, by varied and independent teams of researchers, studying much larger samples of women for longer periods of time" exists that says that abortion poses a minimal risk to a woman's psychological health.

The article you link to from the APA lists seven articles in its tiny bibliography. Two of them aren't about psychological research one way or the other. Of the remaining five articles, four are small-scale studies published more than a decade ago. The fifth is a small-scale study published last year in the APA's own journal.

If you can cite any articles that "study much larger samples of women for longer periods of time' as per your original observation, I'd like to take a look at them.

The Canadian Medical Association Journal article from May, 2003 studied a population of 56,000 women and is included in a longer list of such studies available on my blog, After Abortion.

Where possible, I provide links to actual journal articles. If you could do the same thing, I'd appreciate it.

And again, no one is disagreeing with the idea that correlation doesn't imply causation. I asked if you could provide any research that lends support to the causal hypotheses you favor to explain the observed correlation. You haven't done that.

Posted by: Emily at Aug 14, 2004 6:53:03 PM

Emily:

I see that you have now moved the research citations on your blog into a post and added some commentary of your own to the citations. I haven’t reviewed all your comments but in at least one case you seriously misrepresent the findings of the study reported in the abstract. In your comments on the study Psychological Responses of Women After First-Trimester Abortion by Brenda Major et al. published in the Archives of General Psychiatry, you claim, for example, that the study found that “28% reported more harm than benefit [from] their abortion.” That statement is a misrepresentation of the study’s findings. What Major actually says is that 72% reported more benefit than harm from their abortion. You cannot infer from that statement that the remaining 28% reported more harm than benefit. You simply don’t know what they reported. They may have reported no harm or benefit at all, or equal levels of harm and benefit, or they may have responded with some version of “don’t know" or "no opinion," or they may have refused to answer the question. Your other statements similarly misrepresent the findings reported by the study’s authors. You also fail to note the authors’ conclusion that women who do experience psychological problems after having an abortion or who regret their abortion (a minority of the women in the study) tend to have a prior history of depression. That finding supports the interpretation that the correlations found by Reardon et al. indicate that depression causes abortion rather than vice versa.

Posted by: Don P at Aug 14, 2004 7:30:41 PM

Emily:

The article you link to from the APA lists seven articles in its tiny bibliography.

The citations in the APA briefing paper itself are not intended to be an exhaustive list of the primary research. They are mainly summary papers documenting the conclusions reported in the briefing. The Pro-Choice Forum, for example, which is one of the cited sources, contains a more detailed list and discussion of the primary research literature. The Planned Parenthood Fact Sheet I linked to also provides a much longer list of research citations, with 47 citations in total (including some to Reardon’s work). The APA conclusion represents a comprehensive evaluation by the world’s foremost organization of professional psychologists of the research into the psychological effects of abortion. As you may have noticed the briefing paper is also very recent, having been written in March of this year.

If you can cite any articles that "study much larger samples of women for longer periods of time' as per your original observation, I'd like to take a look at them.

The APA study reported in 1997 tracked over 5,000 women for 8 years, interviewing each woman during every year of the study, and extensively investigating her medical history and life circumstances. The study concluded:

"Data from [a] long-term study demonstrate that even highly religious women are not at significantly greater risk of psychological distress because they had an abortion."

The Canadian Medical Association Journal article from May, 2003 studied a population of 56,000 women

The raw sample size was large, but the only study performed on the sample was a crude examination of Medi-Cal records of births, abortions and psychiatric admissions. For the reasons I explained in a previous post, psychiatric admission records alone are virtually worthless as indicators of depression. Much more comprehensive analysis is required to effectively measure a woman’s psychological state. In addition, Medi-Cal recipients are not representative of the general population of women of child-bearing age. They consist almost entirely of low-income women, often single parents, so even if Reardon’s study had demonstrated a causal link, rather than merely a correlation, between abortion and depression, it is not clear that that conclusion could be applied to the female population in general.

I asked if you could provide any research that lends support to the causal hypotheses you favor to explain the observed correlation. You haven't done that.

Yes, I have. The totality of the research, as evaluated by the APA and others, shows that the risks of adverse psychological effects from abortion are low. This conclusion is supported by numerous primary research findings, many of which are described in the APA and Planned Parenthood papers I linked to. The clear implication of this conclusion for the correlation found by Reardon is that something other than abortion caused the adverse psychological effects he found.

Posted by: Don P at Aug 14, 2004 8:35:26 PM

Don,

I suggest you purchase the book.... Women's Health after Abortion, The Medical and Psychologial Evidence... by Elizabeth Ring-Cassidy and Ian Gentles. It's published by the deVeber Institute for Bioethics and Social Research. It might be some "enlightening" reading for you.

-Stacy

Posted by: Stacy Massey at Aug 14, 2004 10:03:18 PM

Don,

I suggest you purchase the book.... Women's Health after Abortion, The Medical and Psychologial Evidence... by Elizabeth Ring-Cassidy and Ian Gentles. It's published by the deVeber Institute for Bioethics and Social Research. It might be some "enlightening" reading for you.

-Stacy

Posted by: Stacy Massey at Aug 14, 2004 10:04:10 PM

Wow, that was wierd... posted without me finishing.

Don, it's a collection of over 500 articles that have appeared in medical journals over the past 20 years regarding the medical and psychological evidence following abortion. It's a great read for those who disbelieve women are hurt by their abortion experiences. GIve it a read and let us know what you think.

-Stacy
abortionrecovery@cox.net

Posted by: Stacy Massey at Aug 14, 2004 10:10:41 PM

Stacy:

It is unlikely, to say the least, that the book you mention references research that refutes the consensus opinion amoung scientists who have studied the issue that abortion carries a low risk of psychological harm. If you think the book presents a credible challenge to that consensus, I suggest that you send a copy to the American Psychological Association for evaluation.

Posted by: Don P at Aug 14, 2004 10:38:34 PM

Actually Don, I believe it has already been forwarded to the APA. It was just printed this past year! I'm sorry that you don't feel comfortable reading it. It's unfortunate, as you might be "enlightened" as I stated previously!

Under the Diagnostic and Statistical Manual of Mental Disorders, (DSM-3) abortion is listed as a stressor for post-traumatic stress syndrome. Maybe you should obtain a copy of that book instead.

I'm curious Don as to if you are post-abortive yourself...

Posted by: Stacy Massey at Aug 14, 2004 11:22:43 PM

Stacy:

Actually Don, I believe it has already been forwarded to the APA. It was just printed this past year!

Then if the research referenced in the book has scientific merit and is relevant to the issue it will be reflected in the APA's position paper. I doubt that it does have merit, though.

I'm sorry that you don't feel comfortable reading it.

I didn't say that.

Under the Diagnostic and Statistical Manual of Mental Disorders, (DSM-3) abortion is listed as a stressor for post-traumatic stress syndrome.

I have seen no evidence that abortion is a cause of PTSD in anything more than a very small percentage of women who undergo the procedure. The scientific consensus is not that abortion never has adverse psychological effects, but that such effects are relatively rare, and that severe adverse effects (such as PTSD) are extremely rare. See the APA and Planned Parenthood links I provided earlier for more details. If you think you can cite research showing a significant risk of PTSD from abortion, please do so.

Posted by: Don P at Aug 14, 2004 11:45:34 PM

Absolutely Don. Here's a link to the National Center for Post-Traumatic Stress Disorder. If you skim down the page, about 2/3 of the way, under "Medical Procedures", then under subcatagory "Surgical Procedures".. you'll see "Abortion" listed as a stressor for PTSD. Hope this clears this up for you.


http://www.ncptsd.org//publications/pilots/Thesaurus_ST.html

-Stacy

Posted by: Stacy Massey at Aug 14, 2004 11:54:35 PM

Stacy:

I asked for a research citation showing that abortion is a significant risk for PTSD. Your link does not show that. As I said, abortion may be a cause of PTSD in a very small percentage of women, but that is not the same thing as a significant risk. Do you have a cite showing that abortion is a significant risk for PTSD?

The APA briefing paper I referred you to in my last post states the following about the relationship between abortion and PTSD:

"A recent study showed not only that rates of disorders, such as depression and posttraumatic stress disorder (PTSD), were not elevated in a large sample of 442 women followed for two years post-abortion, but also that the incidence of PTSD was actually lower in women post-abortion than the rate in the general population" [emphasis added]

The study Psychological Responses of Women After First-Trimester Abortion that Emily cited herself found that only one percent (that is, 1 in 100) of the women surveyed reported PTSD in the two years following their abortion, and the study provides no reason to conclude that abortion was the cause of the PTSD even for that 1%.

Posted by: Don P at Aug 15, 2004 12:50:41 AM

The most common feeling after abortion is relief and a sense of loss. But as many of you know, post-abortion distress can set in anywhere from 2 weeks to 30 years after the abortion. Therefore, only surveying women immediately after their abortion doesn't give accurate results.
Shame on anyone who belittles the emotions and experiences of those who hurt after abortion! Just because the majority doesn't grieve, doesn't mean these women's experiences are any less valuable and their decision any less of a "choice".

Posted by: Rachael at Aug 15, 2004 12:51:30 AM

Rachael:

But as many of you know, post-abortion distress can set in anywhere from 2 weeks to 30 years after the abortion. Therefore, only surveying women immediately after their abortion doesn't give accurate results.

The studies I have cited followed women who had had abortions for up to 8 years. No study has found anything more than a low risk of adverse psychological effects from abortion. If you have evidence that abortion is a significant risk for psychological problems, please present it.

Shame on anyone who belittles the emotions and experiences of those who hurt after abortion!

I agree. I would also say: Shame on anyone who exaggerates the risks to women from abortion! And also: Shame on anyone who belittles the emotions and experiences of women who choose to have an abortion instead of taking their pregnancy to term!

Posted by: Don P at Aug 15, 2004 1:20:35 AM

Don wrote:
>The studies I have cited followed women who had had abortions for up to 8 >years. No study has found anything more than a low risk of adverse >psychological effects from abortion. If you have evidence that abortionis
>a significant risk for psychological problems, please present it.

Although not common, women do hurt from abortion, sometimes two weeks after their abortion, sometimes 30 years. You ignored half of what I said: "Just because the majority doesn't grieve, doesn't mean these women's experiences are any less valuable and their decision any less of a 'choice'."

>I agree. I would also say: Shame on anyone who >exaggerates the risks to women from abortion! >And also: Shame on anyone who belittles the >emotions and experiences of women who choose to >have an abortion instead of taking their >pregnancy to term!

Don't construe what I said to fit your agenda. I'm not here to debate how many women are emotionally hurt by abortion. If any women, small number or large are hurting from an abortion, we should be concerned. There is no need to dismiss the feelings and emotions of women regreting their abortion by indicating as you have that they are a small and igsignificant number.

In any other surgical procedure, if there is any risk at all the physician would inform the patient. It's not just a political issue, but a medical issue as well. Look beyond politics to the women having an abortion.
Operation Outcry: Silent No More consist of women who regret their abortions, and are speaking out to the public. These women will be silent no more about their decision, despite those who want to silence them.

Posted by: Rachael at Aug 15, 2004 1:46:23 AM

And also: Shame on anyone who belittles the emotions and experiences of women who choose to have an abortion instead of taking their pregnancy to term!

Don,
Yet that is what you're doing here. You're belittling experiences of women who've had an abortion but (don't fit into your political agenda) regretted their abortion or have had difficult emotional coping by implying they are insignificant.

Posted by: at Aug 15, 2004 1:59:09 AM

That previous post was me BTW, just forgot to fill out the top part.

Posted by: Rachael at Aug 15, 2004 2:00:08 AM

Don,
You claim scientific research can tell what these women feel after their abortion, and whether or not they regret. You cannot know what an abortion emotionally feels like until you've experienced it yourself, or have walked a mile in these women's shoes (by reading personal stories).

Posted by: Rachael at Aug 15, 2004 2:07:48 AM

Also I would like to note that the APA is pro-choice in political beliefs, definately some political bias there. Also, many women don't celebrate their abortion, they want to forget about it and push their memories of the abortion and emotions about it deep into their subconsciousness and certainly wouldn't talk about it with strangers. If the survey is done by questionnaire or single interview, a woman routinely denies problems. The APA studies are invalid. Only by lengthy psychological testing and counseling can she often admit to some symptoms, much less tie them to the abortion she so desperately wants to forget.

"What women really feel at the deepest level about abortion is very different from what they say in reply to questionnaires." A Canadian study polled a group of women who had previously completed a questionnaire in which they denied having problems from an abortion. One half of this group was randomly chosen for in-depth psychotherapy." What emerged from psychotherapy was in sharp contrast [to the questionnaires], even when the woman had rationally considered abortion to be inevitable, the only course of action." It was demonstrated that the conscious, rationalized decision for an abortion can co-exist with profound rejection of it at the deepest level. Despite surface appearances, abortion leaves behind deeper feelings "invariably of intense pain, involving bereavement and a sense of identification with the foetus." I. Kent et al., "Emotional Sequelae of Elective Abortion," British College of Med. Jour., vol. 20, no. 4, April 1978 I. Kent, "Abortion Has Profound Impact," Family Practice News, June 1980, p. 80

If post-abortion trauma were rare, there wouldn't be 15+ books on post-abortion emotional/spiritual healing, 7 national professional counseling organizations specializing in post-abortion trauma, 7 online websites featuring post-abortion counseling (of which 4 affiliate themselves with pro-choice political beliefs). For example: http://www.afterabortion.com
Don't tell me post-abortion trauma is rare.

Posted by: Rachael at Aug 15, 2004 2:28:55 AM

Rachael:

You ignored half of what I said: "Just because the majority doesn't grieve, doesn't mean these women's experiences are any less valuable and their decision any less of a 'choice'."

I ignored it because I didn't see any reason to respond to it.

Don't construe what I said to fit your agenda.

I don't know what that's supposed to mean. I agreed with your statement, and added: Shame on anyone who exaggerates the risks to women from abortion! And also: Shame on anyone who belittles the emotions and experiences of women who choose to have an abortion instead of taking their pregnancy to term!

I'm not here to debate how many women are emotionally hurt by abortion.

Fine. I am here in part to point out that the risk of adverse psychological effects from abortion is low, and that the risk of serious adverse effects is very low. I am glad that you don't want to debate these facts.

If any women, small number or large are hurting from an abortion, we should be concerned.

We should also be concerned about women who hurt from completing a pregnancy. We should also be concerned about exaggerated claims of the risks of abortion to women. Women deserve to be given accurate and reliable information about the risks of abortion, not false or exaggerated claims.

There is no need to dismiss the feelings and emotions of women regreting their abortion by indicating as you have that they are a small and igsignificant number.

I haven't said that. I have said that the proportion of women who experience adverse psychological effects from abortion is low. I have no idea why you think that pointing out this fact constitutes a dismissal of the feelings and emotions of anyone.

Posted by: Don P at Aug 15, 2004 2:41:18 AM

Rachael:

These women will be silent no more about their decision, despite those who want to silence them.

I have seen no one here express the desire to "silence" anyone.

You're belittling experiences of women who've had an abortion but (don't fit into your political agenda) regretted their abortion or have had difficult emotional coping by implying they are insignificant.

I haven't said that anyone is insignificant. I have pointed out that the scientific research shows that the risk of significant adverse psychological effects to a woman from having an abortion is low. Women deserve to have that information. I think that the idea that pointing out this fact "belittles" anyone is absurd. It is simply the consensus of expert opinion on the matter. It doesn't "belittle" anyone.

You claim scientific research can tell what these women feel after their abortion, and whether or not they regret.

No, I claim that the scientific research can tell us the psychological risks of abortion by, amoung other things, asking women how they feel after having had an abortion. The overwhelming conclusion from that research is that the psychological risks from abortion are low. Please stop attributing to me statements and claims that I have not made.

Posted by: Don P at Aug 15, 2004 2:53:17 AM

Rachael:

Also I would like to note that the APA is pro-choice in political beliefs, definately some political bias there.

The APA is the largest and most prestigious organization of professional psychologists in the world. Any serious discussion of the psychological effects of abortion on women must include the opinion of the APA. That opinion is that the evidence shows that the psychological risks from abortion are low. There is no credible basis for asserting that this opinion reflects political bias rather than the results of the scientific research. The APA's official position that abortion should be legal is based in part on its determination that the legal availability of abortion is necessary to protect womens' mental health.

The APA studies are invalid.

You have no basis for making that assertion. And most of the studies showing that abortion poses little risk to women are not "APA studies," anyway. They are studies conducted by independent teams of researchers associated with universities and other institutions. The APA briefing paper is primarily a summary of the collective results of these studies.

Only by lengthy psychological testing and counseling can [a woman who has had an abortion] often admit to some symptoms, much less tie them to the abortion she so desperately wants to forget.

You have no basis for this claim, either. But if it is true, then it invalidates every one of the studies Emily cites on her website purporting to show a correlation between abortion and adverse psychological effects, since none of those studies involved "lengthy psychological testing and counseling" of their subjects.

Don't tell me post-abortion trauma is rare.

According to the consensus of available research, trauma caused by abortion is rare, and serious trauma caused by abortion is extremely rare.

Posted by: Don P at Aug 15, 2004 3:11:57 AM

The editors of the Canadian Medical Association Journal wrote an important editorial in July 2003 that takes up some of the topics that have been addressed in this thread.

They write:

"The recent publication of a study on psychiatric admission rates among low-income women after abortion and childbirth has elicited a barrage of letters to CMAJ of a pitch that we do not frequently encounter. We are chided for publishing flawed research and told that we should be ashamed of publishing the 'opinions' of self-evidently biased researchers. We are accused of doing a disservice to women, medicine and the Journal, of failing to conduct proper peer review, and of not adequately scrutinizing the credentials of the authors.

The abortion debate is so highly charged that a state of respectful listening on either side is almost impossible to achieve. This debate is conducted publicly in religious, ideological and political terms: forms of discourse in which detachment is rare. But we do seem to have the idea in medicine that science offers us a more dispassionate means of analysis. To consider abortion as a health issue, indeed as a medical 'procedure,' is to remove it from metaphysical and moral argument and to place it in a pragmatic realm where one deals in terms such as safety, equity of access, outcomes and risk–benefit ratios, and where the prevailing ethical discourse, when it is evoked, uses secular words like autonomy and patient choice.

Hence, perhaps the thing that is most offensive to some of our correspondents is the apparent co-opting of the medical view by persons they believe to be unqualified — or disqualified. The attack in our letters column is largely an ad hominem objection to the authors' ideological biases and credentials. There are two questions here: first, does ideological bias necessarily taint research? Second, are those who publish research responsible for its ultimate uses?

The answer to the first must be that opinion can of course cloud analysis. In light of the passion surrounding the subject of abortion we subjected this paper to especially cautious review and revision. We also recognized that research in this field is difficult to execute. Randomized trials are out of the question, and so one must rely on observational data, with all the difficulties of controlling for confounding variables. But the hypothesis that abortion (or childbirth) might have a psychological impact is not unreasonable, and to desist from posing a question because one may obtain an unwanted answer is hardly scientific. If we disqualified these researchers from presenting their data, we could never hear from authors with pro-choice views, either.

The phrase used by Deborah Stone in her classic text on public policy — 'No number is innocent' — might be read as saying that every statistical analysis is guilty of serving one political agenda or another. A softer interpretation is that quantitative analysis is always subject to contextual influences. Biases and expectations, pre-existing knowledge and methodologic habits all influence what kinds of hypotheses are tested and how. Ultimately, our measurements are delimited by what can be measured, and by what we choose to measure. Feminist critiques have frequently pointed out the failure of mainstream health research to 'count women in,' whether in randomized controlled trials or in economic analyses of health reforms. When researchers do attempt to amass quantitative evidence in women's health the ideological stakes are high: evidence is trailing rather far behind politics. Thus, the values of self-care and patient empowerment exemplified by breast self-examination gave rise to a similar outcry against unwanted results published in this journal.

But if it is true that more explicit research into women's health issues will point the way to better care, better outcomes and more equity in access, we cannot toss out data any time we don't like their implications. Nor can we leap from a single observational study to public policy. We must allow the gradual and honest accumulation of further evidence to confirm or contradict what we think we know.

Which brings us to the second question: Should we deny the publication of a study because it might be applied by one or the other side of a factionalized debate? It strikes us that the results of the study by Reardon and colleagues are neutral: they could be 'used' to further the argument that abortion is undesirable; or to support arguments for better post-abortion counselling and support. We cannot second-guess such interpretations without unfairly imposing our own values on the research we choose to publish. — CMAJ"

Posted by: Emily at Aug 15, 2004 10:05:08 AM

Emily:

The editorial you quote is mainly a defense of the CMAJ’s decision to publish Reardon’s study. That’s not the issue here. No one has suggested that the CMAJ should not have published it. The editorial does not address the methodological and interpretive flaws in the study, or in Reardon’s other work, that were described by its correspondents and that I have also described here.

The basic points I am making here are as follows:

1. The research you cite on your website is not even remotely representative of the published work or the state of expert opinion on the psychological effects of abortion, which is that the psychological risks from abortion are low. You are intentionally misleading your readers by failing to cite the APA briefing paper or other documents that show the true state of expert medical opinion on the health effects of abortion.

2. The research you do cite shows at most a correlation rather than a causal relationship between abortion and adverse psychological conditions. Other research that you fail to cite overwhelmingly suggests that that correlation does not imply that abortion causes psychological problems, but rather that a woman with prior psychological problems is more likely to choose abortion, or that some other factor not identified by the studies causes both the psychological problems and an increased chance of the decision to abort.

3. In at least one instance of the studies that you do cite (the paper by Brenda Major et al.) your own paraphrase grossly misrepresents the findings of the study’s authors.

Posted by: Don P at Aug 15, 2004 3:08:02 PM

I would point out this: whether or not there really is a genuine post-abortion mental illness that affects a minority of women who have abortions hasn't been proven. What HAS been proven is that a minority of women who carry a pregnancy to term suffer from post-natal depression, some so severe that they hurt their children. But you don't see pro-choice activists out there trying to push women into getting abortions to avoid post-natal depression. Why not? Because our political stance is not about telling women what to do, unlike the anti-abortion side.

Posted by: Amanda at Aug 15, 2004 3:20:12 PM

Hey Don,....

You still haven't answered my question... are YOU post-abortive? Have you fathered a child who's life was terminated by abortion?

Are you avoiding answering this question for a specific reason?

Thanks,

Stacy

Posted by: Stacy Massey at Aug 15, 2004 8:12:58 PM

If he was post-abortive, I doubt he'd be talking to us right now. I'm confused.....

Posted by: Amanda at Aug 15, 2004 8:22:01 PM

We'll wait and see Amanda... you might be surprised.

Posted by: Stacy Massey at Aug 15, 2004 8:23:04 PM

Stacy:

You still haven't answered my question... are YOU post-abortive? Have you fathered a child who's life was terminated by abortion?

No.

And I'll add that I think your nasty, accusatory tone is completely out of line.

Posted by: Don P at Aug 16, 2004 1:36:39 AM

i don't know if i'm out of line here but i'm not sure what difference it makes if some women regret their abortions. i'm sure there are some women who regret it just as i'm sure there are some women who regret having children. i also know a significant number of women who do not regret their abortions and are glad that they had the right to safe, legal ones.

being pro-choice doesn't mean that you support abortion as the only option for pregnancy. it means that you trust each woman to make her own decisions regarding her body and her future - if she decides to carry it to term and give it up for adoption, carry it to term and keep it, or terminate the pregnancy altogether. it's her body, her choice. YOUR body, YOUR choice.

if you're against abortion then don't have one, but allow other women the option to make their own decisions as well. if you care about women you should care that they have access to safe medical care. criminalizing abortion will not end it, it will only end SAFE, LEGAL abortions and put millions of women at risk of death, infertility, or serious medical problems.

xoxo, jared

Posted by: ms. jared at Aug 16, 2004 11:55:14 AM

Don said: "And I'll add that I think your nasty, accusatory tone is completely out of line."

Sorry Don, if you interpretted my tone. I wasn't meaning to be "nastY as you state... just curious as to your personal history and how it might influence your position on the matter of abortion.

Posted by: Stacy Massey at Aug 16, 2004 12:42:34 PM

I had an abortion. And I don't regret it. Are you (Emily, Stacy and Rachael) belittiling *my* experience? Are the feelings of women like me, who don't fit into *your* agenda, unimportant?

It would have been traumatic for me to carry the pregnancy to term. I know of women who were traumatized by putting their children up for adoption--oddly enough, I see no concern about *that*.

Posted by: Sheelzebub at Aug 16, 2004 2:03:40 PM

I had an abortion. And I don't regret it. Are you (Emily, Stacy and Rachael) belittiling *my* experience? Are the feelings of women like me, who don't fit into *your* agenda, unimportant?

It would have been traumatic for me to carry the pregnancy to term. Some women are traumatized when they put their children up for adoption--oddly enough, I see no concern about *that*.

Posted by: Sheelzebub at Aug 16, 2004 2:05:41 PM

Well said Sheelzebub (love your blog BTW!) - I'll stand up and be counted alongside her - I've had an abortion and felt nothing but relief. In fact the only distress I've ever felt around it has been the vilification from pro-lifers.

I don't deny that *some* women may feel distress - but show me a life event that *no-one* experiences as negative... I certainly don't accept that the experiences of a few should determine what level of control I am allowed to have over MY body.

Posted by: spicy at Aug 16, 2004 2:32:53 PM

I'm adopted. I'm pro-choice, I've had an abortion, and I don't regret it.

Lively discussion, by the way. I'm enjoying reading it.

Posted by: Trish Wilson at Aug 16, 2004 2:48:55 PM

Sheelzebub,
No I don't belittle you or think less of you or other women because you've no regreted your abortion. I recognize not everyone will regret their abortion, however those that are in distress after their abortion deserve the same respect and understanding as those suffering Post-partum depression. And by the way, I'm pro-life yes. But I spport making abortin rare, rather than illegal. Please withhold any stereotypes.

Posted by: Rachael at Aug 17, 2004 2:16:35 AM

Actually, besides your ad hominem attack, yes I do care about those suffering after placing for adopton. I provide referrals for counseling and information, whether it be post-adoption grief, post-abortion grief, post-partum depression, or parenting support.
I'd rather see an intellagent argument rather than ad hominem attacks and hasty generalizations.

Posted by: Rachael at Aug 17, 2004 2:23:37 AM

Don,
Perhaps I made an incorrect statement. I just felt that by your adamently defending that post-abortion truama is rare, that you were dismissing the feelings of those women who do suffer from post-abortion truama. I honestly admit I made a mistake, my apology.

Posted by: Rachael at Aug 17, 2004 2:30:16 AM

Rachel, the tone of your post makes it seem like you find it unfortunate the Sh. doesn't regret it....

Posted by: Amanda at Aug 17, 2004 4:32:01 PM

Amanda,
Please specify what post and exactly what I said that you drew this conclusion from, so that I can see where you're coming from. I respct if a woman doesn't regret her abortion. I only ask that the same respct is given to women that do. Everyone, please consider before making any more generalizations/assumptions about me, that you don't know me beyond a few posts here and not personally. I ask that you hold your tongue before stereotyping/assumptions, until you've known me in person and for a year.

Posted by: Rachael at Aug 18, 2004 5:11:40 PM

Amanda,
Please specify what post and exactly what I said that you drew this conclusion from, so that I can see where you're coming from. I respct if a woman doesn't regret her abortion. I only ask that the same respct is given to women that do. Everyone, please consider before making any more generalizations/assumptions about me, that you don't know me beyond a few posts here and not personally. I ask that you hold your tongue before stereotyping/assumptions, until you've known me in person and for a year.

Posted by: Rachael at Aug 18, 2004 5:13:04 PM

Amanda,
Please specify what post and exactly what I said that you drew this conclusion from, so that I can see where you're coming from. I respct if a woman doesn't regret her abortion. I only ask that the same respct is given to women that do. Everyone, please consider before making any more generalizations/assumptions about me, that you don't know me beyond a few posts here and not personally. I ask that you hold your tongue before stereotyping/assumptions, until you've known me in person and for a year.

Posted by: Rachael at Aug 18, 2004 5:13:04 PM

Amanda,
Please specify what post and exactly what I said that you drew this conclusion from, so that I can see where you're coming from. I respct if a woman doesn't regret her abortion. I only ask that the same respct is given to women that do. Everyone, please consider before making any more generalizations/assumptions about me, that you don't know me beyond a few posts here and not personally. I ask that you hold your tongue before stereotyping/assumptions, until you've known me in person and for a year.

Posted by: Rachael at Aug 18, 2004 5:13:20 PM

I see that Emily still has not corrected the false statement of findings that she atttributes to the study by Brenda Major published in the Archives of General Psychiatry.

Emily has now at least posted a link to the American Psychological Association briefing paper that I cited earlier. But she still refuses to reference the APA briefing, or the Planned Parenthood statement (with 47 literature citations) in her permanent set of research links. Her citation list continues to grossly misrepresent the state of published research and expert opinion on the psychological effects of abortion.

Emily also says that she has written to the APA to ask why its briefing paper does not reference some of the studies she cites, including Reardon's BMJ study. Perhaps the reason the APA does not reference that study is that its psychological issues research forum has concluded that Reardon's study is so seriously flawed as to be virtually worthless.

Posted by: Don P at Aug 18, 2004 6:33:09 PM

Sorry about the multi-post, had browser problems. No harm intended.

Posted by: Rachael at Aug 18, 2004 8:02:06 PM

you all who do it are murderers how could you do something like that it's not right at all

Posted by: at Nov 9, 2004 2:33:39 PM

What's "not right at all" is a troll who won't even form a coherent sentence.

Posted by: Sheelzebub at Nov 9, 2004 4:11:14 PM

"...showed that the rate of psychiatric hospitalization for women who aborted an unplanned pregnancy is 2.6 times higher than the rate of psychiatric hospitalization for those who carried an unplanned pregnancy to term..."

By the way Emily...children who are adopted have a higher rate of psychiatric hospitalization then children who were raised by their own biological parents.

I think probably a lot of it relates to them living in communities of small-minded, pro-life religious nuts...just my opinion...I bet a lot of them were from Ohio and/or Florida as well...

Posted by: NYMOM at Nov 9, 2004 7:08:44 PM

"I see that you have now moved the research citations on your blog into a post and added some commentary of your own to the citations. I haven’t reviewed all your comments but in at least one case you seriously misrepresent the findings of the study reported in the abstract. In your comments on the study Psychological Responses of Women After First-Trimester Abortion by Brenda Major et al. published in the Archives of General Psychiatry, you claim, for example, that the study found that “28% reported more harm than benefit [from] their abortion.” That statement is a misrepresentation of the study’s findings. What Major actually says is that 72% reported more benefit than harm from their abortion. You cannot infer from that statement that the remaining 28% reported more harm than benefit. You simply don’t know what they reported. They may have reported no harm or benefit at all, or equal levels of harm and benefit, or they may have responded with some version of “don’t know" or "no opinion," or they may have refused to answer the question. Your other statements similarly misrepresent the findings reported by the study’s authors. You also fail to note the authors’ conclusion that women who do experience psychological problems after having an abortion or who regret their abortion (a minority of the women in the study) tend to have a prior history of depression. That finding supports the interpretation that the correlations found by Reardon et al. indicate that depression causes abortion rather than vice versa."

In other words Emily is a big fat liar...Thanks Don...


Posted by: NYMOM at Nov 9, 2004 7:12:03 PM