Studying the truth about consequences

The Baltimore Sun

It used to be confined to the quiet talk in Christian crisis pregnancy centers and adoption ministries and support groups with church connections:

If you have an abortion, the sadness and grief will stay with you for the rest of your life. You will never be the same. You will never get over it.

However, the talk of long-term mental health consequences - commonly referred to as post-abortion syndrome - has begun to turn up in more public places: Supreme Court decisions, lower court decisions and debates in state legislatures.

The assumption that a woman risks a lifetime of depression after an abortion took on such solid roots that courts and lawmakers deemed it essential that women seeking abortions be warned.

But evidence of such debilitating regret just isn't there, a new and comprehensive study suggests.

Dr. Robert W. Blum, of the Johns Hopkins Bloomberg School of Public Health, and three colleagues reviewed more than 700 papers written on the topic in the past 20 years and found that all but a handful were essentially junk science, and the remainder did not find a connection between a woman's abortion history and her long-term mental health.

"A clear trend emerges from this systematic review: the highest quality studies had findings that were mostly neutral, suggesting few, if any, differences between women who had abortions and their respective comparison groups in terms of mental health," the researchers concluded.

Blum said he was astonished at the number of papers that had been written on the subject and the poor quality of the research behind them.

"Most of the studies were of small samples, short duration, weak comparison groups and made generalizations and claims that far exceeded their findings," Blum said in a telephone interview.

"And that was true on all sides of this issues - for those who found consequences and those who found no consequences."

Blum and his colleagues, Vignetta E. Charles, Chelsea B. Polis and Srinivas K. Sridhara, were able to glean only 21 papers from the stack of 700 that had "really tried to answer the questions they said they were trying to answer," and the results showed no strong causal link between an abortion and a woman's long-term mental health.

But tell that to those who have heart-rending stories - the women who can't forgive themselves or who grieve for the child not born.

"The individual stories are very compelling," said Blum. "But when you look at it in terms of 150,000 people [who might be included in a study], the numbers don't line up to make this data as compelling as individual stories."

The bottom line, Blum suggests, is that abortion counselors should not be legally required to warn women of long-term mental health risks that do not appear to exist.

"What we are saying is that, given the weight of research and evidence, state governments and legislators and courts should not mandate clinicians to inform patients of things for which there is no viable data in support," he said.

That the research Blum and his co-workers surveyed should be so politically charged is no surprise, considering how polarizing the topic of abortion is.

He found that much of the research was aimed at proving a position - for or against long-term mental health consequences. "They were trying to prove or refute a point instead of taking it as straight-up research," he said.

As long ago as 1989 - the point where Blum picks up his survey of the literature - Surgeon General C. Everett Koop, who was well known to oppose abortion, reviewed the literature up to that point and concluded in a letter to President Ronald Reagan that "the politics of abortion skewed our scientific understanding of its impact and that the empirical evidence [of long-term mental health consequences] was inconclusive," Blum's report said in this month's issue of Contraception.

Elective abortion is one of the most common medical interventions in the world, Blum said. More than 1.2 million are performed annually in the United States alone. That means that, statistically, we should be seeing significant mental health problems. But that's not what the research shows.

"With so many women experiencing a termination, one would anticipate that long-term, post-abortion mental health problems would be similarly common were it a prevalent consequence of the procedures," the report said. "Lingering post-abortion feelings of sadness, guilt, regret and depression appear to occur in only a minority of women," the report said.

Certainly having an abortion is not the same as having a Pap smear. It would be natural for a woman to feel stressed by an unplanned pregnancy and to feel sadness after an abortion.

For women with a complicating mental health history, those feelings could be deeper or more long-lasting.

Women considering the procedure should be told that.

But they should also be told that those feelings nearly always pass.

Copyright © 2021, The Baltimore Sun, a Baltimore Sun Media Group publication | Place an Ad