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NRL News
American
Psychological Association Pulls Briefing Paper Women who have had abortions know that it is real. Professionals who have counseled and cried with those women are certain of its existence. But until recently, institutions like the American Psychological Association (APA) publicly dismissed the idea of a link between abortion and depression, and many in the abortion lobby used the APA’s declaration as justification for their own denials of the link. However, now that a major New Zealand study, undertaken by a self-described “pro-choice” researcher, has found strong evidence of the link, the APA rebuttal has quietly disappeared from the group’s web site. Study author David M. Fergusson singled out the APA by name for criticism. As explained more fully below, Fergusson found that among the young women he studied, “those having an abortion had elevated rates of subsequent mental health problems including depression, anxiety, suicidal behaviors and substance abuse disorders.” Fergusson’s work was hardly the first to find a negative aftermath. Various studies and surveys have found a connection between abortion and a host of subsequent psychological and social disorders and dysfunctions. They range from anxiety, emotional numbing, and depression to substance abuse, intrusion events (flashbacks, nightmares), and suicidal ideation, a cluster of common post-traumatic stress reactions some have identified as “post-abortion syndrome.” In 1984, research therapist Anne Speckhard interviewed 30 women who were identified as having difficult reactions to their abortion experiences. Ninety-two percent reported feelings of depression.1 A larger survey of 260 women reporting negative abortion reactions conducted by the Elliott Institute found 88.2% reporting feeling depression after their abortions.2 As results began to be publicized and debated, the American Psychological Association convened a panel of experts in 1989 to examine and assess women’s psychological responses to abortion. Two interesting things about this move should be noted. First, the APA already had a strong position in favor of abortion. As early as 1969 it argued that abortion should be considered as a “civil right of the pregnant woman,” a position reaffirmed multiple times since. Second, the panel of experts assembled by the APA had a decidedly pro-abortion tilt. It included Henry David, Nancy Adler, Brenda Major, Nancy Russo, and others who either had already publicly expressed strong pro-abortion positions or established one through their articles or statements. Not surprisingly, the report by the panel, published in American Psychologist in October 1992, declared that the “best studies available on psychological responses to unwanted pregnancy terminated by abortion in the United States suggest that severe negative reactions are rare, and they parallel those following other normal life stresses.” Though individual factors and previous psychological history may affect how a particular woman reacts, the authors said that the evidence shows that “abortion is usually psychologically benign.”3 Arguments in the scientific literature have gone back and forth. People like Major and Russo hit back hard whenever pro-lifers published studies linking abortion and depression or other negative social or psychological sequelae. Armed with data from Russo and others, the APA put out a “Briefing Paper on the Impact of Abortion on Women” in March 2004. It claimed that “[w]ell-designed studies of psychological responses following abortion have consistently shown that risk of psychological harm is low.” The APA Briefing Paper cited the original study by the APA panel. It said that rates of disorders, including depression and post-traumatic stress disorder, were lower, not higher, in post-abortion women compared to the rest of the population. Moreover, it also claimed that psychological measures were within normal bounds for both adults and minors after an abortion. In addition, citing an earlier work by Russo, it said that positive, rather than negative emotions are most often experienced immediately after the abortion and in the months that follow. Citing Russo again, the APA Briefing Paper said that the negative psychological responses experienced by a few may actually be due to pre-existing emotional problems rather than to the abortion itself. Pro-abortion groups have confidently cited the APA’s position as proof that there was no such thing as post-abortion syndrome and no link between abortion and depression. NARAL declared that “the American Psychological Association, the Journal of the American Medical Association, and other groups with medical and health expertise have investigated the alleged existence of ‘post-abortion stress’ or ‘post-abortion trauma.’ None has found it to exist.”4 Planned Parenthood made a similar statement on its web site. It declared that “neither the American Psychological Association or the American Psychiatric Association recognizes the existence of these phenomena” [“post abortion trauma” or “post-abortion syndrome”].5 However, the arrival of the large, well-designed New Zealand study by David M. Fergusson in January 2006, definitively linking abortion and depression, has thrown pro-abortion groups and their political allies for a loop. Fergusson, who has publicly stated that he is “pro-choice,” found that among the young women he studied, “those having an abortion had elevated rates of subsequent mental health problems including depression, anxiety, suicidal behaviors and substance abuse disorders.” Fergusson noted that “this association persisted after adjustment for confounding factors.” (For a more detailed analysis of Fergusson’s study, see the August 2006 edition of NRL News.) Notable in the “Discussion” section of Fergusson’s study is his singling out the APA for criticism. Quoting directly from the APA’s Briefing Paper the claim that “well-designed studies ... have consistently shown that the risk of psychological harm is low,” Fergusson said, “This relatively strong conclusion about the absence of harm from abortion was based on a relatively small number of studies which had one or more of the following limitations: a) absence of comprehensive assessment of mental disorders; b) lack of comparison groups; and c) limited statistical controls.” To make matters worse for Russo and her APA colleagues, Fergusson chided the group for a statement that “appears to disregard the findings of a number of studies that claimed to show negative effects for abortion.” He specifically cited Jesse Cougle, David Reardon, and Priscilla Coleman, who have previously done research on abortion and depression, as well as work by Finnish researcher Mika Gissler, who found higher suicide rates among aborting women. Russo defended the APA position by arguing, “To pro-choice advocates, mental health effects are not relevant to the legal context of arguments to restrict access to abortion” (Washington Times, 1/21/06). Russo tried to argue that Fergusson’s study failed to distinguish between planned and unplanned pregnancies. “There has yet to be a well-designed study,” Russo told the Washington Times, “that finds that abortion itself contributes to increased risk of mental health problems.” Fergusson fired back. “We took into account social background, education, ethnicity, previous mental health, exposure to sexual abuse, and a series of other factors,” he said. “It’s true we did not take into account specifically whether a pregnancy was wanted or not. However, this limitation is not sufficient grounds for dismissing the results.” The New Zealand study had a ripple effect. It was enough to prompt 15 of Britain’s top obstetricians and psychiatrists to send an open letter to the London Times. In it they said that “[s]ince women having abortions can no longer be said to have a low risk of suffering from psychiatric conditions such as depression, doctors have a duty to advise about long-term adverse psychological consequences of abortion” (London Times, October 27, 2006). One of the interesting things mentioned in that letter was a statement that “[t]his research has prompted the American Psychological Association to withdraw an official statement denying a link between abortion and psychological harm.” The APA may have a revised, more nuanced statement up on its web site by the time this newspaper reaches its readers. But a November 30, 2006, visit to the APA’s web site at www.apa.org/ppo/issues/womenabortfacts.html found only the following statement: “This fact sheet is currently being updated. For other information, please visit our homepage at www.apa.org/ppo.” It’s not an admission of error. But for now, it will do. Notes 1. Anne Speckhard, Psycho-Social Stress Following Abortion (Kansas City, MO: Sheed & Ward, 1987), 60. 2. The Post-Abortion Review 2, no. 3 (fall 1994): 4–8. 3. Nancy E. Adler, Henry P. David, Brenda N. Major, Susan H. Roth, Nancy Felipe Russo, Gail. E. Wyatt, “Psychological Factors in Abortion: A Review,” American Psychologist 47, no. 10 (October 1992): 1194–1204. 4. NARAL Pro-Choice America release, “Congress Should Not Legitimize ‘Post-Abortion Syndrome,’” 11/29/05. 5. “Emotional Effects of Induced Abortion,” www.plannedparenthood.org, accessed 11/28/06. |