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Forget About Abortion. Let's Focus on the Mental Health Effects of Pregnancy and Parenting

Here's an idea courtesy of the Guttmacher Institute:

The body of evidence [Editor's note: related to abortion and mental health] is now so robust that researchers should consider shifting their focus to related issues that might be more valuable to explore, such as the factors that cause women to experience mental health problems in the first place.

The latest study in a long history of rigorous research to reveal a lack of cause and effect between abortion and mental health has been released to much media hoo-ha and predictable anti-choice defensiveness. The American Psychological Assocation, as far back as 1989, found that legal abortion "does not pose a psychological hazard for most women." In 2008, an APA task force, according to the Guttmacher Institute, concluded that:

“the best scientific evidence indicates that the relative risk of mental health problems among adult women who have an unplanned pregnancy is no greater if they have an elective firsttrimester abortion than if they deliver the pregnancy.”

But here we are. It's 2011 and we're still undertaking studies to confirm what we already know. This most recent study, carried out by Danish researchers and published in this month's New England Journal of Medicine, tracked a whopping 84,620 girls and women in Denmark who had a first trimester abortion or who had birthed a baby (for the first time). Researchers found that those women and girls who had an abortion sought mental health treatment at approximately the same rate both prior- and post-abortion while women who had a baby sought counseling at increased rates, post-partum. Shocked? No, neither was I.

Those who identify politically - first and foremost - as "pro-life," even if they are public health professionals or healthcare providers, have attempted to dismantle the methodology in this recent Danish study with the precision one might use to carefully dismantle a house of cards, with the goal of discrediting the conclusions. But, at what point do we, as the Guttmacher Institute points out in a more diplomatic way, put this issue to rest?

Perhaps most harmful to women is the fact that we allow crisis pregnancy centers to continue operating using the underlying misrepresentation that abortion causes psychological trauma. It is, in fact, a foundational value for CPCs. Most recently, a report undertaken in Washington State found that every single crisis pregnancy center investigated offered false or misleading information on pregnancy and birth to the young women who visit the centers. Central to the misinformation? The post-abortion stress disorder claim. Center staff told patients, in an effort to scare them away from choosing abortion, to beware of "post-abortion syndrome." There is no such syndrome which exists and neither the APA nor the American Psychiatric Association recognizes such a disorder.

The Danish study actually confirms that in fact childbirth is more psychologically traumatic for women than is abortion; a significantly well-researched idea that I assume crisis pregnancy centers don't choose to share with the women they see. Yet, we have heaps of evidence that reveal how much effect childbirth can have on a woman's mental health - we've been advocating long and hard for the research and studies necessary to shine a light on post-partum mood disorders and to find resources to help treat those disorders. Women who decide to carry their pregnancies to term face a greater chance of experiencing some sort of mental health issue than women who choose to have an abortion. Many still don't know enough about post partum mood disorders as they should. That goes for both mothers-to-be and new parents, as well as providers.

And though this has historically been a less welcomed discussion in all but the most intimate of circles, we must be willing to confront the less comfortable reality that unwanted pregnancies may have a long term mental health consequence as well. As Delia Lloyd writes on Politics Daily:

I'm sure there are many women who've had abortions that they regret.

But...I'm also sure that there are many women who regret having had children they're incapable of raising.

That's an uncomfortable truth. But that doesn't make it any less true.

Here lies another inconvenient truth, so to speak. While pregnancy and birth have been presented to girls and women on a silver platter from an early age, we as women understand that the "gift" of pregnancy is not always a welcome one. Deciding to carry a pregnancy to term when you don't want to may turn out to be the most wondrous experience one could ever hope to have; and it may be an awful nightmare.

Even when it is the most unimaginably blissful of offerings in the form of a wanted pregnancy, childbirth brings with it the risk of postpartum mood disorders ranging from depression and anxiety for many women, to full-blown psychosis for a relatively small few. Postpartum mood disorders are very real for hundreds of thousands of women each year. Given the stunning lack of focus on the issue, however, you'd be hard pressed to know this. In fact, approximately 950,000 women each year suffer from some sort of post-partum mood disorder. And, to be clear, this is the number of women who self-report a mental health struggle postpartum. Clearly, the number is even higher. Still, if that's a difficult number to put in perspective, allow the expert behind the blog Postpartum Progress to put it into context for you:

How does that compare with the incidence among women of other major diseases in America?

  • Each year less women -- approximately 800,000 -- will get diabetes. (Nat'l Diabetes Information Clearinghouse)
  • Each year about 300,000 women suffer a stroke.  (Centers for Disease Control)
  • Each year approximately 205,000 women are diagnosed with breast cancer.  (National Cancer Institute)

In fact, more women will suffer from postpartum depression and related illnesses this year than the combined number of new cases for men and women of tuberculosis, leukemia, multiple sclerosis, Parkinson's disease, Alzheimer's disease and epilepsy. 

So isn't it obvious that those who are opposed to women having access to safe, legal abortion in this country have very little concern for the psychological well-being of women and girls? In fact, I'd argue they have a complete disregard for it. How else to explain the exploitation of a non-existent diagnosis to manipulate women into a particular decision - childbirth - which does carry a very real risk of mental health issue for millions of women?

Please don't misunderstand. I have two children and if a woman wants to be a parent, understanding the risks and benefits for her particular situation and what types of support and resources are available can help immensely. But how is it that we get to the present day, enmeshed in a political battle which uses immense political capital, time and money to present a false case to women that accessing safe, legal abortion care will harm us psychologically, to the point where we should outlaw even the option, while we struggle to find the resources and funding to address real, honest struggles facing women who chose to carry a pregnancy to term?

If these types of studies can do anything to move us towards a more realistic portrait of the impact of women's reproductive and sexual health decisions upon our psychological health, they can be used to do two things. One, these studies allow us to recognize the range of emotions and experiences women have whether we're talking about pregnancy, childbirth, abortion, offering a child up for adoption, adopting a child, experiencing a stillbirth of a baby, a miscarriage - in effect, any number of experiences related to pregnancy and procreation. Secondly, the Danish study, by comparing the psychological struggles related to both abortion and childbirth, can help strengthen the case for more funding and support towards postpartum research and treatment.


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