Mental Disorders
Abortion Causes Mental
Disorders: New Zealand Study May Require Doctors to Do Fewer Abortions
Pro-Choice
Researcher Says Some Journals Rejected Politically Volatile Findings
Springfield, IL (Feb. 9, 2005) -- A study in New Zealand that tracked
approximately 500 women from birth to 25 years of age has confirmed that young
women who have abortions subsequently experience elevated rates of suicidal
behaviors, depression, substance abuse, anxiety, and other mental problems.
Most significantly, the researchers - led by Professor David M. Fergusson, who
is the director of the longitudinal Christchurch Health and Development Study -
found that the higher rate of subsequent mental problems could not be explained
by any pre-pregnancy differences in mental health, which had been regularly
evaluated over the course of the 25-year study.
Findings Surprise Pro-Choice Researchers
According to Fergusson, the researchers had undertaken the study anticipating
that they would be able to confirm the view that any problems found after
abortion would be traceable to mental health problems that had existed before
the abortion. At first glance, it appeared that their data would confirm this
hypothesis. The data showed that women who became pregnant before age 25 were
more likely to have experienced family dysfunction and adjustment problems, were
more likely to have left home at a young age, and were more likely to have
entered a cohabiting relationship.
However, when these and many other factors were taken into account, the findings
showed that women who had abortions were still significantly more likely to
experience mental health problems. Thus, the data contradicted the hypothesis
that prior mental illness or other "pre-disposing" factors could
explain the differences.
"We know what people were like before they became pregnant," Fergusson
told The New Zealand Herald. "We take into account their social background,
education, ethnicity, previous mental health, exposure to sexual abuse, and a
whole mass of factors."
The data persistently pointed toward the politically unwelcome conclusion that
abortion may itself be the cause of subsequent mental health problems. So
Fergusson presented his results to New Zealand's Abortion Supervisory Committee,
which is charged with ensuring that abortions in that country are conducted in
accordance with all the legal requirements. According to The New Zealand Herald,
the committee told Fergusson that it would be "undesirable to publish the
results in their 'unclarified' state."
Despite his own pro-choice political beliefs, Fergusson responded to the
committee with a letter stating that it would be "scientifically
irresponsible" to suppress the findings simply because they touched on an
explosive political issue.
In an interview about the findings with an Australian radio host, Fergusson
stated: "I remain pro-choice. I am not religious. I am an atheist and a
rationalist. The findings did surprise me, but the results appear to be very
robust because they persist across a series of disorders and a series of ages. .
. . Abortion is a traumatic life event; that is, it involves loss, it involves
grief, it involves difficulties. And the trauma may, in fact, predispose people
to having mental illness."
Journals Reject the Politically Incorrect Results
The research team of the Christchurch Health and Development Study is used to
having its studies on health and human development accepted by the top medical
journals on first submission. After all, the collection of data from birth to
adulthood of 1,265 children born in Christchurch is one of the most long-running
and valuable longitudinal studies in the world. But this study was the first
from the experienced research team that touched on the contentious issue of
abortion.
Ferguson said the team "went to four journals, which is very unusual for us
- we normally get accepted the first time." Finally, the fourth journal
accepted the study for publication.
Although he still holds a pro-choice view, Fergusson believes women and doctors
should not blindly accept the unsupported claim that abortion is generally
harmless or beneficial to women. He appears particularly upset by the false
assurances of abortion's safety given by the American Psychological Association
(APA).
In a 2005 statement, the APA claimed that "well-designed studies" have
found that "the risk of psychological harm is low." In the discussion
of their results, Fergusson and his team note that the APA's position paper
ignored many key studies showing evidence of abortion's harm and looked only at
a selective sample of studies that have serious methodological flaws.
Fergusson told reporters that "it verges on scandalous that a surgical
procedure that is performed on over one in 10 women has been so poorly
researched and evaluated, given the debates about the psychological consequences
of abortion."
Following Fergusson's complaints about the selective and misleading nature of
the 2005 APA statement, the APA removed the page from their Internet site. The
statement can still be found through a web archive service, however.
Study May Have Profound Influence on Medicine, Law, and Politics
The reaction to the publication of the Christchurch study is heating up the
political debate in the United States. The study was introduced into the
official record at the senate confirmation hearings for Supreme Court Justice
Samuel Alito. Also, a U.S. congressional subcommittee chaired by Representative
Mark Souder (R-IN) has asked the National Institutes of Health (NIH) to report
on what efforts the NIH is undertaking to confirm or refute Fergusson's
findings.
The impact of the study in other countries may be even more profound. According
to The New Zealand Herald, the Christchurch study may require doctors in New
Zealand to certify far fewer abortions. Approximately 98 percent of abortions in
New Zealand are done under a provision in the law that only allows abortion when
"the continuance of the pregnancy would result in serious danger (not being
danger normally attendant upon childbirth) to the life, or to the physical or
mental health, of the woman or girl."
Doctors performing abortions in Great Britain face a similar legal problem.
Indeed, the requirement to justify an abortion is even higher in British law.
Doctors there are only supposed to perform abortions when the risks of physical
or psychological injury from allowing the pregnancy to continue are
"greater than if the pregnancy was terminated."
According to researcher Dr. David Reardon, who has published more than a dozen
studies investigating abortion's impact on women, Fergusson's study reinforces a
growing body of literature showing that doctors in New Zealand, Britain and
elsewhere face legal and ethical obligations to discourage or refuse
contraindicated abortions.
"Fergusson's study underscores that fact that evidence-based medicine does
not support the conjecture that abortion will protect women from 'serious
danger' to their mental health," said Reardon. "Instead, the best
evidence indicates that abortion is more likely to increase the risk of mental
health problems. Physicians who ignore this study may no longer be able to argue
that they are acting in good faith and may therefore be in violation of the
law."
"Record-based studies in Finland and the United States have conclusively
proven that the risk of women dying in the year following an abortion is
significantly higher than the risk of death if the pregnancy is allowed to
continue to term," said Reardon, who directs the Elliot Institute, a
research organization based in Springfield, Illinois. "So the hypothesis
that the physical risks of childbirth surpass the risks associated with abortion
is no longer tenable. That means most abortion providers have had to look to
mental health advantages to justify abortion over childbirth."
But Reardon now believes that alternative for recommending abortion no longer
passes scientific muster, either.
"This New Zealand study, with its unsurpassed controls for possible
alternative explanations, confirms the findings of several recent studies
linking abortion to higher rates of psychiatric hospitalization. depression,
generalized anxiety disorder, substance abuse, suicidal tendencies, poor bonding
with and parenting of later children, and sleep disorders," he said.
"It should inevitably lead to a change in the standard of care offered to
women facing problem pregnancies."
Some Women May Be At Greater Risk
Reardon, a biomedical ethicist, is an advocate of "evidence-based
medicine"-a movement in medical training that encourages the questioning of
"routine, accepted practices" which have not been proven to be helpful
in scientific trials. If one uses the standards applied in evidence-based
medicine, Reardon says, one can only conclude that there is insufficient
evidence to support the view that abortion is generally beneficial to women.
Instead, the opposite appears to be more likely.
"It is true that the practice of medicine is both an art and a
science," Reardon said. "But given the current research, doctors who
do an abortion in the hope that it will produce more good than harm for an
individual woman can only justify their decisions by reference to the art of
medicine, not the science."
According to Reardon, the best available medical evidence shows that it is
easier for a woman to adjust to the birth of an unintended child than it is to
adjust to the emotional turmoil caused by an abortion.
"We are social beings, so it is easier for people to adjust to having a new
relationship in one's life than to adjust to the loss of a relationship,"
he said. "In the context of abortion, adjusting to the loss is especially
difficult if there any unresolved feelings of attachment, grief, or guilt."
By using known risk factors, the women who are at greatest risk of severe
reactions to abortion could be easily identified, according to Reardon. If this
were done, some women who are at highest risk of negative reactions might opt
for childbirth instead of abortion.
In a recent article published in The Journal of Contemporary Health Law and
Policy, Reardon identified approximately 35 studies that had identified
statistically validated risk factors that most reliably predict which women are
most likely to report negative reactions.
"Risk factors for maladjustment were first identified in a 1973 study
published by Planned Parenthood," Reardon said. "Since that time,
numerous other researchers have further advanced our knowledge of the risk
factors which should be used to screen women at highest risk. These researchers
have routinely recommended that the risk factors should be used by doctors to
identify women who would benefit from more counseling, either so they can avoid
contraindicated abortions or so they can receive better follow up care to help
treat negative reactions."
Feeling pressured by others to consent to the abortion, having moral beliefs
that abortion is wrong, or having already developed a strong maternal attachment
to the baby are three of the most common risk factors, Reardon says.
While screening makes sense, Reardon says that in practice, screening for risk
factors is rare for two reasons.
"First, there are aberrations in the law that shield abortion providers
from any liability for emotional complications following an abortion," he
said. "This loophole means that abortion clinics can save time and money by
substituting one-size-fits-all counseling for individualized screening.
"The second obstacle in the way of screening is ideological. Many abortion
providers insist that it is not their job to try to figure out whether an
abortion is more likely to hurt than help a particular woman. They see their
role as to ensure that any woman who wants an abortion is provided one."
"This 'buyer beware' mentality is actually inconsistent with medical
ethics," Reardon said. "Actually, the ethic governing most abortion
providers' services is no different than that of the abortionists: 'If you have
the money, we'll do the abortion.' Women deserve better. They deserve to have
doctors who act like doctors. That means doctors who will give good medical
advice based on the best available evidence as applied to each patient's
individual risk profile."
Fergusson also believes that the same rules that apply to other medical
treatments should apply to abortion. "If we were talking about an
antibiotic or an asthma risk, and someone reported adverse reactions, people
would be advocating further research to evaluate risk," he said in the New
Zealand Herald. "I can see no good reason why the same rules don't apply to
abortion."
# # #
Sources:
David M. Fergusson, L. John Horwood, and Elizabeth M. Ridder, "Abortion in
young women and subsequent mental health," Journal of Child Psychology and
Psychiatry 47(1): 16-24, 2006.
Tom Iggulden, "Abortion increases mental health risk: study" AM
transcript. http://www.abc.net.au/am/content/2006/s1540914.htm
Nick Grimm "Higher risk of mental health problems after abortion:
report" Australian Broadcasting Corporation. 03/01/2006 http://www.abc.net.au/7.30/content/2006/s1541543.htm
Ruth Hill, "Abortion Researcher Confounded by Study" New Zealand
Herald 1/5/06, http://www.nzherald.co.nz
APA Briefing Paper on The Impact of Abortion on Women, http://web.archive.org
of http://www.apa.org/ppo/issues/womenabortfacts.html
Reardon DC. "The Duty to Screen: Clinical, Legal and Ethical Implications
of Predictive Risk Factors of Post-Abortion Maladjustment." The Journal of
Contemporary Health Law & Policy. 2003 Winter;20(1):33-114.