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BRIEFING PAPER

Are Women Hurt by Abortion?

by

Dr Pravin Thevathasan, MRCPsych

There is currently a concerted campaign to discredit the notion that some women are adversely affected psychologically by abortion – as the three recent papers, examined here, show:

1.     ‘Post-abortion Syndrome: Creating an Affliction ‘ by E M Dadlez and William L Andrews, Bioethics, vol 24 no 9 (2010), pp445-452

2.      ‘Induced First-Trimester Abortion and Risk of Mental Disorder’, by Trine Munk-Olsen et al, New England Journal of Medicine, vol 364 (2011), pp382-339

3.     ‘Examining the association of abortion history and current mental health:  A reanalysis of the National Comorbidity Survey using common-risk factors model’, by Julia Steinberg and Lawrence Finer, Social Science and Medicine, vol 72, no 1 (2010), pp72-82

            The Dadlez study states in its abstract: ‘We argue that there is no such thing as post-abortion syndrome and that the psychological harm Reardon [Dr David Reardon of the Elliot Institute in the USA, who has written extensively on post-abortion syndrome] and others claim abortion inflicts on women can usually be ascribed to different causes.’

            The study begins with what the authors themselves describe as an ad hominem argument:

            ‘In 1995, Reardon acquired a doctorate from Pacific Western University, an unaccredited online university that offers no classroom instruction and that has been characterized by some as a degree mill.’

            From this it is supposed to follow that ‘there are many questions to be raised about Reardon’s methodology.’

            It is surprising that such a personal attack is deemed acceptable in a professional learned journal, especially as Dadlez is a professor of philosophy and Andrews is a graduate in political science, i.e. not experts in epidemiology.              However, it is perfectly possible to put forward a case that some women are adversely affected by abortion without recourse to Reardon’s work.  One thinks, for example, of the recent studies by Professor David Fergusson, a medical statistician of international repute.

            Dadlez and Andrews go after Fergusson as well.

            The latter is based in New Zealand.  So the two authors begin by noting that New Zealand’s abortion laws are so restrictive as to ‘guarantee a biased sample.’  They then note that those laws are ‘not at all restrictive in practice.’  But ‘the fact remains that a prospective risk to mental health has been linked with the patient’s name’ if the abortion is performed under the mental health clause.

            All this is rather confused and confusing, especially as the mental health clause permits abortion if the woman’s psychological health would be adversely affected if she did not have an abortion, whereas Fergusson shows that some women develop psychological disorder as a consequence of  abortion.  The scenarios are quite different.

            However, Dadlez accepts that some women are ‘traumatised’ after abortion: ‘we have no intention of denying that this can sometimes happen’ because these women ‘acquire a fundamental religious or moral objection to abortion after the procedure has taken place, often as a result of exposure to a pro-life message’.

            So the conclusion of the paper is that post-abortion syndrome does not really exist.  Rather, ‘the pro-life movement creates the syndrome.’

            One gets the distinct impression that Dadlez and Andrews are well out of their depth when it comes to analysing psychological outcomes of abortion.

            The real agenda of the paper is to be found in the last paragraph:

            ‘To call the very real distress that sometimes results from [having an abortion] a syndrome is to grant it a prevalence it simply does not possess.  And to say that such choices should be prohibited by law is neither a solution nor a panacea, but merely a violation of human autonomy.’

The second study by a Danish team led by Dr Munk-Olsen can be dealt with swiftly.It was funded by the US pro-abortion Susan Buffet Foundation. Having compared medical records of women who had first trimester abortions and first childbirths between 1995 and 2007, it concludes that the mental health risks of abortion are no higher than those of childbirth and that the rate of psychiatric treatment of abortive women only a little higher than that of non-abortive women

            But there are three serious problems with these claims.

            First, this research followed women for only twelve months after the abortion or birth – exactly the time when post-puerperal depression is most prevalent and, since post-abortion trauma can lie dormant for many months and even years, exactly the time when the full impact of abortion on the women’s mental health has not yet ‘surfaced’.  This is a flaw to be found in several studies which claim to deny the existence of post-abortion mental health problems.

            Secondly, as Fergusson has pointed out, this paper’s ‘greatest weakness is that it uses measures of medical contacts as a measure of psychiatric morbidity.  The problem with this type of measure is that many people with mental illness do not seek treatment’.  So Munk-Olsen’s  methodology is fundamentally flawed. 

            Thirdly, while conceding that abortive women have much higher rates of mental health problems than women who give birth or who have not been pregnant, Munk-Olsen and co do not answer the following question: abortion may (apparently) not cause many new mental health problems but does it intensify existing ones?  Until they have faced this question and demonstarted that abortion is not an independent, additional cause of mental ill-health their evidence is inconclusive for a third reason.

The Steinberg/Finer study has greater depth. Its overall aim is to discredit a 2009 paper by Professor Priscilla Coleman and colleagues published in the Journal of Psychiatric Research showing that women having abortions are at much grater risk of anxiety, mood disorder and substance misuse.

            Steinberg, of the University of California, and Finer, of the pro-abortion Guttmacher Institute, set out to disprove Coleman’s work by reanalysing the statistics she used.  Steinberg summarised their findings thus during an interview with the Washington Post: ‘Anti-abortion activists have relied on questionable science in their efforts to push inclusion of the concept of post-abortion syndrome in both clinical practice and the law.’

            Speaking to Life News Com, Coleman has responded thus: ‘The critical distinction is in how psychological disorders were defined.  Our analysis reflected 12-month prevalence and their analysis reflected only the 30-day prevalence.  Our results are quite similar to those reported by pro-choice researcher David Fergusson in 2006 and many others.’ There are, she notes, 30 studies published in the last five years which support her findings.

            Steinberg and Finer say that they are unable to ‘replicate’ her findings (i.e. that, using the same data, their results are widely different from hers).  So Coleman asks if they intend to ‘replicate’ the 2010 study by Mota and colleagues published in the Canadian Journal of Psychiatry which comes to similar conclusions to her own.  She notes that such a reputable journal would hardly publish an article ‘indicating that abortion poses psychological risks to women independent of other stresses without scrutinizing the methodology carefully.’

            The Steinberg/Finer thesis is essentially the same as  Munk-Olsen’s, viz that  women who have abortions and especially those who have repeat abortions, have a greater prior history of mood and anxiety disorders (and of prior physical and sexual abuse) than non-aborting women, and that their abortions did not significantly increase those rates.  Hence ‘Focusing on abortion as a cause of mental health problems is not warranted.’  Rather, we should focus on ‘how prior contextual, psychological and structural factors lead to having unintended pregnancies, abortions and subsequent mental health problems.’

            That women who have abortions and especially multiple ones may have had a variety of personal problems, including sexual and physical violence, and suffered from mood, anxiety and substance disorders is plausible enough.  But to say that is to leave unasked the same crucial question which Munk-Olsen and co did not face: did abortion make those conditions worse?

             Interestingly, Steinberg and Finer report only ‘disorders’ (mood, anxiety, substance) before abortion, but agoraphobia, panic disorder, major depression, mania, alcohol and drug dependence afterwards.  Is there not a step-change here which, by sleight of hand, they have tried to hide?

            Certainly, until they have shown that pre-abortion mental illness is not made worse by abortion, they have not proved their case.  On the contrary, their own data seemingly confirm the existence of post-abortion trauma.

One cannot help but conclude that pro-abortion researchers are attempting to use their friends in the academic publishing world and the media to distort  scientific data and push their own agenda.  Some of what they have been saying - for example that post-abortion mental illness is a myth or is caused by pro-lifers – is far-fetched.  Other pro-abortionists accept that some women who have abortions are likely to have a whole array of psychological problems but simply deny a causal link between abortion and mental ill-health or conveniently side-step the question about whether abortion makes previous psychological illness worse.  Hence nothing that they have published recently is a serious challenge to those who know from their personal or clinical experience that post-abortion trauma is, alas, a reality.

I am grateful to Life UK for permission to reproduce the above briefing paper

on this website.


            
Copyright ©; Dr Pravin Thevathasan 2011

Version: 21st March 2011



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