By Dave Andrusko

As we reflect on the profound loss of more than 55 million human beings over the past four decades of legalized abortion, our hearts also naturally turn to the women who have gone through an abortion. The personal and familial cost of abortion often seems immeasurable; abortion “solves” nothing and often sets off a chain reaction of harmful effects on women. Few people do not know at least someone who is abortion’s “second victim.”

But is the evidence for these difficulties just anecdotal? Not anymore. Researchers in the United States, Australia, Canada, China, France, Norway, New Zealand, and elsewhere are systematically assessing the consequences of abortion on women and those closest to them.

Dr. Priscilla Coleman, professor of human development and family studies at Bowling Green State University, has conducted dozens of studies on the psychological impact of abortion. She was interviewed by National Right to Life News on the eve of the 40th commemoration of Roe v. Wade.

Dr. Coleman explained that while there were only a handful of scientific studies published on the mental health implications of abortion in 1973, today there is an abundant literature comprised of hundreds of methodologically sophisticated studies from around the world. This body of evidence clearly indicates that abortion significantly increases a woman’s risk for depression, anxiety, substance abuse, suicidal thoughts, and suicidal behavior following abortion.

Dr. Coleman further noted that abortion is associated with a higher risk for negative psychological outcomes when compared to an unintended pregnancy carried to term. Risk for long-term psychological injury is also greater with abortion than with other forms of perinatal loss, such as a miscarriage. According to Dr. Coleman, studies published in the last few decades are much stronger than prior research. More current research including larger samples, controls for psychological history, use of appropriate comparison groups, and the like. Whatever validity there was to criticism of research done prior to the last decade, it is no longer true.

Dr. Coleman noted that the strongest studies published between 1995 and 2009 are synthesized in her recent meta-analysis, published a year ago in the British Journal of Psychiatry. This review offers the largest estimate of mental health risks associated with abortion available in the world literature.

Results indicated that, overall, women who aborted experienced an 81% increased risk for mental health problems. When specifically compared to unintended pregnancy which were delivered, women who aborted had a 55% increased risk of experiencing any mental health problem. Nearly 10% of the incidence of all mental health problems was shown to be directly attributable to abortion.

This last statistic is very important, because it means that if abortion did not exist in our culture, there would be 10% fewer cases of mental health problems. Millions of American women are diagnosed with mental health disorders every year, meaning an enormous amount of human psychological suffering among women of reproductive age is directly due to abortion.

With so many women hurting from abortion, it is easy to understand why the published literature also contains dozens of studies showing that women who have had abortions are also more likely than women who have not to experience relationship problems including domestic violence, separation, and divorce. Moreover, women who have had an abortion are more likely to experience difficulty in the arena of parenting.

Although the exact psychological mechanisms have not been thoroughly investigated, Dr. Coleman explained that this link between abortion and problems in parenting could be based on many factors in addition to post-abortion mental health problems. That might include relationship problems, risk-taking behaviors, guilt feelings related to the abortion, fears regarding losing one’s children, and relationship issues with the father, among others.

When asked if there is a profile of women who are more at risk for mental health problems in the aftermath of abortion, Dr. Coleman described the results of her recent search of electronic databases for articles identifying demographic, personal, relational, and situational factors that increase women’s risk for post-abortion mental health problems. The search yielded 119 relevant original studies published between 1972 and 2011.

Among the most well-established risk factors in the literature are prior mental health problems (31 studies), negative relationships with others (28 studies), decision ambivalence (21 studies), timing in adolescence (15 studies), being religious or viewing abortion as in conflict with personal values (10 studies), feeling pressured by others (9 studies), preferring to carry to term (7 studies), and believing that abortion terminates the life a human being (6 studies). She described how most of these risk factors are widely recognized as predictors for adverse post-abortion reactions among well-known abortion providers in the U.S. and by the American Psychological Association, yet women are rarely screened for them.

Dr. Coleman noted the inadequacies of some empirical papers and narrative reviews of the literature suggesting abortion does not increase risk for mental health problems. She explained that careful examination of the methodologies of these studies reveals serious problems and the results should not be trusted as a basis for professional training or health care policy initiatives.

She has publically critiqued the 2012 publication in the Archives of General Psychiatry by Munk-Olsen and colleagues. Among the more serious issues were the following: 1) exclusion of older women for whom data are available; 2) including 12% of the full sample in both the abortion and birth group; and 3) no controls for variables that predict the choice to abort.

Dr. Coleman also recently critiqued the review by the Royal College of Psychiatrists, noting alarming problems. For example, 35 studies, most identifying mental health risks, were eliminated based on the nebulously defined ”no usable data” or “fewer than 90 days follow-up.” Of course by only including studies with extended follow-up, it minimizes the number of cases of mental health problems. With time, healing may naturally occur and other events may moderate the effects. Moreover, this approach misses the serious and more acute episodes that are treated soon after abortion.

Asked if she had a parting thought she’d like to share, Dr. Coleman emphasized that there is an active effort by professional organizations and individual researchers to obscure the scientifically verified truths regarding the potential risks associated with abortion. Thus there is an urgent need to counter the claims in a timely, dispassionate fashion in order to affect change. To this end and to foster more collaborative research on abortion and health, she and 10 colleagues have established the World Expert Consortium for Abortion Research and Education (www.wecareexperts.org).