NRL News
Page 4
September 2008
Volume 35
Issue 9

APA’s Flawed Report on Mental Health and Abortion
By Wanda Franz, Ph.D.

From the earliest days of abortion on demand, the American Psychological Association (APA) has taken a strong position on the question of whether there are mental health consequences from having an abortion. The APA has consistently claimed that research indicates that there are no adverse effects on women and that any negative reports of symptoms, such as sadness and depression, are short-lived.

These claims were based on older studies with poor design and methodology. However, that didn’t prevent the APA from drawing firm conclusions that often did not reflect the limited findings of the studies. In other words, the APA has always demonstrated a strong bias in favor of abortion on demand.

But in recent years there have been a number of solid studies, published in peer-reviewed journals, on the question. Most of these researchers estimate that approximately 20–30% of women who have abortions will have serious mental health problems.

With the number of such studies growing, the APA was under pressure to “update” its position on what psychological effect abortion may have on women.

The APA produced a report (dated August 13) that was purported to be an “unbiased” assessment of the science on this topic. Unfortunately, the APA Task Force on Mental Health and Abortion did not produce such a report.

According to the APA, “There is no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems for adult women.” The 90-page report is the result of a year-long review of mental health and abortion. What characteristics would a genuinely unbiased report demonstrate?

First, it would be necessary to show that the researchers/writers and the reviewers of the document were chosen in a manner to assure an unbiased result. However, those chosen to do the review have a history of taking strong positions that abortion has no negative effects.

Second, unbiased findings can be assured if excellent methodology is used to evaluate the studies. In this respect the report is incredibly lacking in the use of modern methodology. What the task force is really claiming to have done is what is called a “meta-analysis” where specific techniques are used to evaluate a large number of studies.

When done properly all available studies are evaluated using the same criteria. Then the “best” and “worst” studies are grouped to see what results are associated with each. In other words, if most of the “best” studies show that women had negative effects following their abortions and the “worst” studies showed that women had no negative effects following their abortions, then we would have good scientific evidence that abortions hurt some women. The APA report does not use this methodology, probably because it would have produced results that didn’t fit with their biases..

It is unfortunate that the APA would not use this opportunity to do impeccable research. Instead, are a number of very obvious failings.

There is selective reporting of the various studies. That is, many studies that found that there were negative effects associated with abortion are simply not included in the evaluation.

Normally researchers decide which studies to include in a review by looking at the quality of the methods used and then picking only the studies using the “best” methods. However, the APA task force used a shifting standard to evaluate the studies in order to obtain findings that fit a “pro-choice” agenda. For example, great weight was put on technical problems associated with the use of very large population groups, probably because only those studies that show abortion has a negative effect used large groups of subjects.

But there is virtually no discussion of the issue of dropout rates, which can really damage the accuracy of a study. Those studies finding no negative effects characteristically have this weakness.

For example, if 40–60% of your sample refuses to answer questions six months after the abortion, these are likely to be women suffering from post-abortion stress. Understandably, they do not want to talk about the experience. The women remaining in the study are the ones with no negative after-effects. The result is a clear bias in favor of the conclusion that there are no negative effects from abortion.

It is important to understand that it is impossible to create a single study that controls for every possible thing. No one study is the “perfect” study. It is necessary to create a body of literature—many different kinds of studies—that can be compared and quantified. Then it becomes possible to get a general picture of the information on the topic of the research.

That is what the APA report should have done. Instead, it simply complained that there was essentially no study that was methodologically good enough to be able to say that there is a relationship between abortion and psychological trauma. However, if it is the case that the studies all have severe methodological flaws, it would be scientifically more accurate to say that there was insufficient evidence to make any conclusion.

However, the dozens of studies that have found negative effects from abortion all have good methodological controls and have all been reviewed by researchers who have recommended that they be published in well-respected journals. Is the APA suggesting that all of these individuals are driven by pro-life biases?

Having condemned the large body of research showing negative effects, the APA report then goes on to break its own rules. In order to support the strong statement that abortion has no negative effects at all, it has to have some evidence. The APA report essentially bases its claims on a single study that is out of date, was published in England, and has a number of methodological problems of its own.

It is a shame that pro-abortion bias continues to interfere in the ability of the APA to give effective scientific input into the discussion of the effects of abortion of women. Unfortunately, this does not provide any help to women considering abortion and those thousands of women who report that abortion has had devastating effects on their lives.

I encourage those in the pro-life movement to continue to help to support and heal these women as we have in the past.

Dr. Franz is NRLC president and professor emerita of child development at West Virginia University.