Myths about abortion and women’s mental health are prevalent

(CNN) — It’s an unfounded message that experts say is repeated over and over again: Having an abortion can harm a woman’s mental health, possibly for years.

“There is so much misinformation, so many myths about abortion. That abortion will lead to addiction, depression, suicidal thoughts; that abortion is bad for your health; that all women will regret,” said social psychologist Brenda Major. Emeritus Professor Emeritus of the Department of Psychology and Brain Sciences at the University of California, Santa Barbara.

In fact, decades of research have shown that “the vast majority of women feel like they made the right decision and have no regrets,” said Major, who led a task force for the American Psychological Association (APA) in 2008 which explored the science of abortion and mental health.

Women who had a first-trimester abortion were no more likely to have mental health problems than women who went on with an unplanned pregnancy, the APA review found.

A large, long-term study, called The Turnaway Study, tracked the mental health of nearly 1,000 women in 21 states who wanted and received an abortion and women who wanted but were denied an abortion between 2008 and 2010.

The women were interviewed every six months for the next five years. At the end of this period, 99% of women who had an abortion believed that they had made the right decision; in fact, relief was the predominant emotion, according to one analysis.

According to study results, women who had abortions had similar or lower levels of depression and anxiety than women who were denied abortions and were no more likely to experience post-traumatic stress. than women who have carried babies to term.

The research also found no difference in mental health outcomes between an abortion in the first trimester and an abortion later in pregnancy.

sources of misinformation

Abortion misinformation can come from friends or family, from an article or study read online, or from a mandatory pre-abortion counseling session that some states have in place during of the Roe vs. Wade, experts told CNN.

Of the 33 states that have required patients to receive counseling before an abortion, eight have consistently included the potential for negative psychological responses as part of the discussion, according to the Guttmacher Institute, a nonprofit research and policy organization. which focuses on abortion. reproductive rights around the world.

“There were states where women were told that because they were going to have an abortion, they were at increased risk for depression, suicidal ideation, post-traumatic stress disorder and more,” said Julia Steinberg , associate professor of family science. at the University of Maryland School of Public Health.

“Abortion doesn’t cause depression, it doesn’t cause suicide (or) suicidal thoughts. It doesn’t cause substance use. It doesn’t cause anxiety disorders,” said Steinberg, who studied the impact of abortion on mental health. for years.

In fact, the best indicator that you won’t do well after an abortion was a “history of mental health issues,” Major said. “The best predictor of postabortion substance use was if you were already abusing substances, and the best predictor of postabortion depression was if you had been depressed before having an abortion.”

Abortion misinformation also stems from studies published in academic journals that conclude abortion causes mental health problems, experts say.

“The studies make it look like there’s a debate, but what’s really going on is that these studies are very poorly done,” Steinberg said. “They are not methodologically rigorous and do not adhere to scientific principles.”

The 2008 APA Task Force issued a scathing rebuke to the research quality of many studies that found mental health problems after abortion. Studies have often failed to control for factors such as rape, spousal or sexual violence, or a woman’s history of mental illness or substance abuse.

“We reviewed all the legitimate studies that had been done on this topic,” Major said. “The methodological flaws in so many studies cited as showing damage to women’s mental health following abortion were simply appalling.”

A subsequent 2018 National Academies of Sciences, Engineering, and Medicine review examined studies on the impact of abortion on future fertility and pregnancy outcomes, breast cancer risk, mental health issues and premature death.

“Much of the published literature on these topics does not meet scientific standards for rigorous and unbiased research,” the report states, concluding that “abortion does not increase the risk of secondary infertility, related hypertensive disorders pregnancy, abnormal placentation (after D&E abortion), premature birth, breast cancer or mental health issues (depression, anxiety and PTSD).”

However, this belief that abortion harms women’s mental and physical health has been used to justify “waiting period laws, two-trip requirements (in which women must return twice), and the provision women with inaccurate information about medical abortion,” Steinberg said.

Being denied an abortion

The Turnaway study also looked at the short- and long-term impact of refusing an abortion. The results showed that rejected women were more likely to experience significant anxiety and stress.

“In my research, what we found was that the challenges of having an abortion — finding a place, traveling, having to disclose your abortion to someone you’d rather not see — increase symptoms of depression. , anxiety, and stress,” said Antonia Briggs, a social psychologist, one of the Turnaway Researchers of the Advancing New Standards in Reproductive Health (ANSIRH) project at the University of California, San Francisco.

“And then the minute you’re denied an abortion, those symptoms get even worse. And then over time, they dissipate,” explained Briggs, an associate professor at UCSF.

Women who were denied an abortion and carried their babies to term were “much more likely to experience physical health problems at the time of delivery because childbirth is much riskier than abortion”, she told Briggs. Two of the women in the study died during childbirth.

A 2012 study found that the risk of death associated with childbirth is about 14 times higher than the risk of abortion.

After five years, the study found that women who were denied abortions were more likely to “live in poverty and experience economic hardship, including more bankruptcy, debt and difficulty meeting basic needs. of life,” Briggs said.

Women who were rejected were also more likely to be tied to a violent and abusive partner and to have chronic health conditions, Briggs said. “They also lowered their aspirations (for the future) and were less likely to achieve them,” he added.

If a woman who was denied an abortion had children under the age of 5, those children were less likely to reach their developmental milestones, more likely to live in poverty, and less likely to have ties to their mother, according to the study. .

Will these results affect more women now than Roe vs. Wade?

“I’m completely overwhelmed with worry,” Briggs said. “I fear that people will be able to get the care they want. Some will have to overcome many obstacles to access care.

“Let’s hope that others manage their own abortions safely by accessing medical abortion pills online, which we know are quite safe,” Briggs said. Prior to the Supreme Court’s reversal, more than half of all abortions in the United States were performed via a prescription two-drug method, according to the Guttmacher Institute.

“Then there are women who worry me about using other, less safe methods of monitoring pregnancies themselves or carrying to term a situation that they believe is not ideal for them. “Briggs said.

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