New Study Confirms

Abortion Associated with Higher Levels of Psychiatric Problems than Carrying Pregnancy to Term

By Wanda Franz, Ph.D., President
National Right to Life Committee

The question of mental health following abortion has been the source of great controversy and continuing debate. From the beginning, the pro-abortion lobby has been in denial about the mental health effects of abortion on women. Unfortunately, some researchers have approached their study of abortion with the same biased zeal. One example of such a study was published in 1997 by Nancy Russo and Amy Dabul.

This study received wide media attention and was hailed as a model study demonstrating that post-abortion trauma does not exist. The authors conclude the study with the stunning statement, "Despite a concerted effort to convince the public of the existence of widespread and severe postabortion trauma, there is no scientific evidence for the existence of such trauma...."

This statement was being made even as studies were continuing to pile up giving evidence that women can suffer from severe post-abortion trauma. The latest study to demonstrate that abortion can cause mental health problems, both early and delayed, appears in the July issue of the American Journal of Orthopsychiatry and is written by Priscilla Coleman, Vincent Rue, David Reardon, and Jesse Cougle.

This study has the virtue of avoiding many of the problems that have been associated with the research on mental health effects of abortion. First of all, many earlier studies relied on the woman's own testimony about her mental health. This is a highly unreliable method. Most people aren't consciously aware that they are having problems related to a trauma in their lives. In addition, if they know they are having problems, they are not trained to recognize and diagnose their own condition.

A second problem is that most studies are affected by reporting bias. This is the problem of women failing to report that they had ever had an abortion. In 1989, then-Surgeon General C. Everett Koop wrote in a government report that national fertility surveys suggest that given published prevalence rates, the percentage of women admitting to having an abortion is only around 50% of that expected. Thus, only half of women will admit to abortion when directly asked.

A third problem is that poor measurements of trauma are being used. In the Russo and Dabul study mentioned earlier, for example, the authors claimed to have demonstrated that no trauma existed in the sample studied.

However, the method they used was not capable of measuring for trauma. Instead, they used a test of self-esteem, which they claimed was a measure of a very vague concept they called "well-being."

The new study, "State-Funded Abortions Versus Deliveries: A Comparison of Outpatient Mental Health Claims Over 4 Years," avoids these problems. This study used a method called record-linkage, using the official records kept by the California Medicaid program.

In this study, the rates of first-time outpatient mental health treatment following an abortion or a live birth in 1989 were compared over the next four years. The claim is often made that only those women who have mental health problems prior to having the abortion actually have problems following the abortion. Consequently, for purposes of this study, all women were eliminated who had made claims for mental health care for a year prior to the pregnancy outcome.

After controlling for age, months of eligibility, and the number of pregnancies, the mental health claims of the 54,419 women in the study were analyzed for 90 days, 180 days, one year, two years, three years, and four years following the pregnancy event.

The overall rate of mental health claims was 17% higher for the abortion group in comparison with group who delivered. Within the first 90 days after the pregnancy, the abortion group had 63% more claims than the birth group.

In subsequent time periods, the abortion group also had a higher percentage of claims compared to the birth group: 42% (180 days), 30% (one year), and 16% (two years). In the three- and four-year periods the results were not significantly different.

The abortion group had a greater need for mental health care than the childbirth group, which persisted for two years following the pregnancy outcome. Comparisons were also made between the two groups for specific diagnostic categories. In these comparisons, the aborting women had significantly higher rates of treatment within the

categories of adjustment reaction, bipolar disorder, neurotic depression, and schizophrenic disorders.

Higher rates of treatment for the abortion group approached significance for the categories of anxiety states and alcohol and drug abuse. No significant differences were found between the groups for categories of depressive psychosis, recurrent depressive psychosis, depression not otherwise classified, nonorganic psychoses, psychalgia, and acute stress reaction.

In those categories where there was a difference between the groups, it was always the abortion group that had a significantly higher rate of claims for services. These findings are consistent with a large body of research evidence pointing to mental health problems for women following abortion.

However, the evidence from this study is especially compelling because, as mentioned, it avoided so many of the methodological problems found in other studies. For example, the sample is very large. The data is based on medical determination of specific mental health categories, not personal report. The data is collected from unbiased records rather than relying on the reports of the patients.

The costs of medical care are becoming more and more of an issue for providers and this study clearly demonstrates that there are more claims for services by women who have abortions than by those who give birth to their babies. It is interesting that a similar finding occurred in an unpublished, in-house study performed in Virginia by the Virginia Department of Medical Assistance Services.

They found that of 325 women who had state-funded abortions, 73% had more health claims (85% higher costs) for reproductive health problems compared with a matched sample of women who carried their babies to term. They also found that women who had state-funded abortions had 62% more mental health claims postdating the procedure (43% higher costs) compared with a matched sample of women covered by Medicaid who had not had state-funded abortions. The findings of this study are severely limited by the fact that the state of Virginia pays for abortions only in cases of rape or incest or to save the life of the mother.

It would probably come as no surprise to learn that this excellent study by Coleman, Rue, Reardon, and Cougle has received no widespread media coverage and has elicited no comments by the pro-abortion lobby. This is in marked contrast to the treatment given to the Russo and Dabul article when it was published in 1997.

Once again it falls upon the grassroots pro-life activists to get the word out that abortion causes mental health problems in women. We, of course, know that it must be so. No woman could purposely kill her own child without becoming the second unwilling victim of abortion.

Studies, such as this one, help to undermine the denial of so many Americans who want to believe that abortion is good for women. For us there is added urgency in having the facts told, because we know that it can save lives--the lives of the innocent, unborn babies who are sacrificed in every abortion.