Tiana Sakr
Getting the facts to help women make an informed decision in pregnancy.
Emotional Effects After Abortion
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I feel concerned about women after abortion, particularly after hearing very emotional and negative experiences from women. I looked at a review on mental health and abortion by the American Psychological Association's Task Force on Mental Health and Abortion. Overall, their conclusions seem to reflect how women are usually coping and getting on with their lives. But surprisingly, this important review failed to conclude on the risks of emotional effects after abortion and effects on the general mental health of women.
The 2008 American Psychological Association's - APA Task Force on Mental Health and Abortion (TFMHA) reviewed 223 USA and International studies published in peer-reviewed journals from 1990-2007 and gave its findings in a 100 page report.1 Firstly, the TFMHA defines "mental health" using the World Health Organisation's (WHO) definition of mental health as: "a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community." All the women I know appear to satisfy this definition of "mental health" after abortion.
Then the TFMHA explains that the question of whether abortion causes harm to women's health cannot be scientifically tested. This would require randomised trials where pregnant women are assigned to an abortion verses delivery verses adoption group and this is obviously not desirable nor ethical. So the (testable) questions addressed by the TFMHA were how prevalent are mental health problems among women in the U.S. who have had an abortion and what is the relative risk of mental health problems after abortion compared to alternatives (adoption or motherhood).
The TFMHA specifies mental health problems for an important reason - it emphasises that "mental health problems" are defined as "clinically significant disorders assessed with valid and reliable measure of physician diagnosis." Examples include, major depression, anxiety disorders or postraumatic stress disorders. Excluded from the definition of mental health problems are 'normal' negative emotions or feelings a woman might experience after an abortion and as the TFMHA states, these include regret, sadness or dysphoria.2 "Dysphoria" (psychiatry) means: a "state of unease or generalised dissatisfaction with life", or "an emotional state characterised by anxiety, depression or unease."3
So the TFMHA review on mental health and abortion was largely limited to drawing conclusions on mental health problems after abortion where mental health problems are clinically diagnosed mental disorders in women. Although the TFMHA did review papers that analysed relative mental risks (i.e. including emotional effects) associated with abortion, it rejected all the studies as being unable to provide unequivocal evidence on these, due to "methodological flaws".
The conclusion of the TFMHA was, "the most methodologically sound research indicates that among women who have a single, legal, first-trimester abortion of an unplanned pregnancy for nontherapeutic reasons, the relative risks of mental health problems is no greater than the risks among women who deliver an unplanned pregnancy".
Not surprisingly, this conclusion seems to reflect the women after abortion I know - they had a single, legal, early abortion and seem to be doing fine as capable and successful women without any psychological disorders. However these women have experienced a very deep and personal, ongoing sadness and regret after abortion. These significant adverse effects on the psychological well-being of women after abortion were not well-addressed by the TFMHA because it would not use studies that included evidence on emotional effects to make a conclusion.
The TFMHA gave a conclusion of the relative risk of "mental health problems", i.e. mental health disorders only: their conclusion does not address concerns about the relative risk of abortion on the general mental health of women, including adverse emotional effects. As I discuss in "Planned Parenthood's Misleading Claims on Mental Health and Abortion", unfortunately abortion providers and services, such as Planned Parenthood and government websites in Australia and the U.S. ignore this narrow conclusion of the TFMHA and instead use it to make claims that abortion does not cause emotional effects. This is very misleading to women considering abortion and fails to acknowledge the women who do suffer adverse affects and are in need of care and support from their health care providers and communities.
Are you suffering emotional effects after abortion? You can find help in your area using our online directory or guide or call now:
24 Hr Helpline: 1800 090 777 (Aus)
or
24 Hr International Helpline:
866 482 5433 (USA)
(exit code) 1 866 483 5433 (Intl)
1 TFMHA - Task Force on Mental Health and Abortion (2008). Report of the APA Task Force on Mental Health and Abortion. Washington, DC. American Psychological Association Task Force on Mental Health and Abortion. http://www.apa.org/pi/women/programs/abortion/mental-health.pdf
2 TFMHA. 2008. Report of the APA Task Force on Mental Health and Abortion. Washington, DC. American Psychological
Task Force on Mental Health and Abortion. http://www.apa.org/pi/women/programs/abortion/mental-health.pdf
p.7. "..it is crucial to distinguish between clinically significant mental disorders, such as major depression,
generalised anxiety disorder, or posttraumatic stress disorder, and a normal range of negative emotions or feelings
one might experience following a difficult decision, such as feelings of regret, sadness or dysphoria. While the latter
feelings may be significant, by themselves they do not constitute psychopathology."
3 http://www.thefreedictionary.com/dysphoria
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