The assumption that having an abortion brings on negative emotional and mental health effects for women has been used as the basis for legislation to mandate counseling and restrict abortion access in some states.
According to the Guttmacher Institute, which studies reproductive health issues, nine states have laws requiring women receive counseling on the perceived psychological harms of abortion when seeking the procedure.
But a new study – considered to be the most rigorous on the topic to date – finds that women who have abortions are not more likely to experience mental health difficulties than those who do not.
In fact, the research, published in JAMA Psychiatry, showed that denying women access to abortion when they sought one was linked to more initial mental health troubles.
“There’s been a long history and interest in looking at the effects of abortion on women’s mental health outcomes but a lot of the research before this study has suffered from some methodological shortcomings, and this study really aimed to improve on those,” lead study author M. Antonia Biggs, Ph.D., of the University of California, San Francisco, told CBS News.
For the study, Biggs and her team followed nearly 1,000 women over a five-year period after either being denied or receiving an abortion. The women, with an average age of 25, were recruited for the study from 30 abortion facilities in 21 states.
The researchers interviewed the participants one week after seeking an abortion then again every six months for five years.
Of the women studied, almost half (452 women) received an abortion at the facility, as their pregnancy was within two weeks under the facility’s gestational limit. About a quarter (231 women) were denied an abortion because their pregnancy was up to three weeks past the facility’s gestational limit. The researchers report 273 of the women received a first-trimester abortion. (There was some overlap between the first and third groups since gestational age limits varied by state and facility).
The group of women turned away for abortions was further divided into two groups: those who went on to give birth (161 women) and those who did not, either because they miscarried or later had an abortion somewhere else (70 women).
The researchers found that one week after seeking an abortion, those who were turned away reported more symptoms of anxiety, lower self-esteem, and lower life satisfaction than the women who underwent the procedure. The women in the study had similar levels of depression, regardless of whether they received or were denied an abortion, after a week’s follow up.
Within six months to a year, the psychological well-being of the women in the study who were denied abortions improved and became similar to those of other groups.
The authors controlled for a number of factors, including marital status, employment, pre-existing mental health conditions and a history of child abuse.
Previous research has also shown that abortion does not lead to mental health troubles, but this is the first study to follow women for a five-year period.
Additionally, while prior studies focused mainly on women who received abortions in the first trimester, the current research showed that these women were no more or less affected psychologically than women who ended their pregnancies later on.
The authors conclude that the findings debunk the notion that abortion is bad for women’s mental health. “There is no evidence to justify laws that require women seeking abortion to be forewarned about negative psychological responses,” they write.
In fact, the research shows that “the effect of being denied an abortion may be more detrimental to women’s psychological well-being than allowing women to obtain their wanted procedures,” they write.
“If our goal is protect women’s mental health, which is the intention of many of these laws, then really what we see here is that allowing women to make their own decisions about whether or not they want an abortion is more protective than denying them care,” Biggs said.
However, Randall O’Bannon, director of education and research for the National Right to Life Educational Trust Fund, disagreed, telling HealthDay he considers the study’s findings “somewhat of a stretch.”
O’Bannon maintained that “some women do eventually have serious negative psychological responses to their abortions, some within a year or two, but most several years down the road.”
He also said it was “not surprising” that some women would experience greater anxiety in the immediate aftermath of being denied an abortion.
“This is an unremarkable finding, since just one week out these women who had been planning to abort and expecting abortion to provide a resolution to their problems have just found out that the ‘solution’ they sought will not be forthcoming and that they will have to reset all their plans and expectations accordingly,” O’Bannon said, but “once one gets farther out from the initial abortion ‘denial,’ even with their data, depression, anxiety, satisfaction levels are all relatively the same.”
Dr. Raegan McDonald-Mosley, chief medical officer for Planned Parenthood Federation of America, said the new research backs up decades of work showing that “having a safe, legal abortion does not pose mental health problems for women.”
“The best estimate is that nearly one in three women in this country will have an abortion in her lifetime and the vast majority of women who have abortions do not regret their decision,” McDonald-Mosley told HealthDay. “In fact, more than 95 percent of women who have had an abortion report that it was the right decision for them.”
“This research shows, yet again, why politicians should not play doctor,” she added. “Instead of laws not based in evidence, we should be considering the women who may be more likely to experience negative mental health consequences: those who are not able to access abortion when they’ve made that decision.”