Do Abortions Affect Mental Health?
Author’s note: If you have been a Chaise Lounge reader since I launched the newsletter, then you probably read my post about the need for medication abortion to be available during the pandemic (and beyond, frankly) without having to go to the clinic to get a prescription. In case you missed it, here is the link for a full explanation of the FDA rules. There is an exciting update that came about on Monday. A federal court judge in Maryland ordered that medication abortion must be available by mail or delivery during the pandemic. “Particularly in light of the limited time frame during which a medication abortion or any abortion must occur, such infringement on the right to an abortion would constitute irreparable harm,” wrote Judge Theodore Chuang in the July 13 ruling. You can read the full article from Forbes here. Now, onto abortion and mental health.
As the abortion discussion roils in the United States, we hear the same stale arguments put forth by anti-abortion proponents. And while they are certainly entitled to their beliefs, current research illustrates that the belief that having an abortion negatively affects mental is wrong. Ignoring recent research on what happens to the woman when she is denied an abortion and the effects on the child resulting from that pregnancy is disingenuous and harmful.
In the history of the abortion discussion, anti-abortion proponents frequently hold that abortion is harmful to a woman’s mental health. However, there is recent evidence showing that not only is the assertion false, but it was also based on faulty research and reasoning. In earlier research studies, researchers compared the mental health of women who had carried a baby to term and raised it with those women who had an abortion. Comparing these two groups of women is a false equivalence. Women who choose to carry their baby to term are comfortable with the idea of giving birth and supporting a child long term. Women who are seeking abortion are in a different mental space. Many women seeking abortion are young, live below the poverty line, and do not have familial or spousal support. Many women already have children, so they understand the cost to their bodies and their wallets. Many women know that it is not the right time in their lives to have a child. When researchers found a higher incidence of mental health disorders, primarily anxiety and depression, among those who had an abortion, they attributed the mental illness to the abortion. This is a classic case of correlation becoming causation based on the logical fallacy of false equivalence, to begin with. As a result, the anti-abortion movement successfully pushed laws requiring mandatory counseling and waiting periods for women seeking an abortion, neither of which are necessary.
If we want to find out if having an abortion has a detrimental effect on a woman’s mental health, we must compare women who actually wanted an abortion but could not obtain one with women who did obtain one. This gives us two groups who had the same objective, but for one of the groups, they did not achieve it. Of course, researchers would not force a woman to bring a baby to term or force an abortion, so this was a difficult topic to research. Fortunately, Diana Greene Foster, Ph.D., of the University of California San Francisco, recently authored the Turnaway Study in which she interviewed and followed 1,000 women across 21 states who were near the end of the time during which they could legally obtain an abortion. She followed both the women who were able to obtain an abortion and those who were turned away because they were a day or two too late to legally obtain an abortion. She followed the women for five years to measure the outcomes on their mental health.
The results of this longitudinal study are clear. Dr. Foster found no evidence that abortion harms women. In fact, the women who received a wanted abortion fared better or the same as women who did not receive the abortion they sought. The factors they examined in the study included physical health, employment and financial situations, mental health, having a wanted pregnancy, and good romantic relationships. Women who were able to procure an abortion had better physical and mental health. They were typically more financially secure and went on to have children later which they planned. Their romantic lives were better as well.
The researchers found that women were endangered by carrying an unwanted pregnancy to term. Of course, pregnancy itself is risky and that was borne out in this study. Two of the women died during childbirth and many others had significant complications during delivery that continued to extend over the five year period of the study. If they were involved with a violent partner, they had more difficulty getting out of that situation. This cohort of women also experienced increased anxiety and loss of life satisfaction and experienced economic hardships that the other cohort did not. The good news is that the depression and anxiety felt by this group dissipated over time as they adjusted to their new normal.
Women have many reasons for seeking an abortion and are clear about them when they do so. The top four reasons women gave for seeking an abortion were: not financially prepared (40%), not the right time for a new baby (36%), partner-related reason (31%), and needs to focus on other children (29%). Interestingly, only 5% of women seeking abortion gave “doesn’t want a baby” as a response. A woman seeking an abortion has already thought through the decision by the time she arrives at a clinic. She does not need to wait three days or receive counseling unless she asks for it. The laws requiring waiting periods and counseling are patronizing and based on false beliefs. Women know what they want. In the words of the assassinated abortion Dr. George Tiller, “Trust women.”
What About the Children?
When it comes to the children who are born as a result of an abortion denied, the research shows that these children and their older siblings fare poorly compared to their peers. The Turnaway Study authors conducted further research examining how the existing siblings of a child born to a mother who had sought an abortion but had been turned away fared. Foster says, “We found slightly lower child development scores and poorer socioeconomic well-being for the existing children of women denied abortions compared with children whose mothers received an abortion. These 2 major findings may be linked. Diminished resources may lead to slowed development, as is supported by the resource-dilution model.” A woman who has children already coupled with poor financial support is further stretched when she has another child.
The Turnaway Study is groundbreaking in that it is the first longitudinal study to compare women who wanted abortions and received one with women who were turned away. The researchers looked at many topics in addition to mental health and children including access to abortion, reasons for having an abortion, physical health, and the men involved. Now that we have real data comparing the appropriate groups of women, we can understand the effects of policies that have no basis in reality. Public policy must be driven by relevant data, not politics or religious belief. The Turnaway Study gives us that data. Now it is time to use it to change policy and allow women and their children more autonomy over their lives.
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