The Right That Makes Women Grieve
Every so often, if only to protect its interests, the Eastern Establishment gets curious about what the natives are doing. So it sends its Stanleys and Livingstones—its scribes—out into the hinterland for a closer look. One recent adventure in pith-helmet journalism came when the New York Times Magazine recruited a writer to go deep in the heart of Texas to cover the activities of a prolife woman who does post-abortion counselling. The author, Emily Bazelon, is identified in the piece as an editor of the online magazine Slate, but a short Internet search revealed that she is also a recipient of a George Soros-funded fellowship and a contributor to the leftist Mother Jones magazine. So the red light went on even before I started reading her—and she didn’t disappoint me. Here is her first line, for some reason set in caps: “EARLY ON A WINDY SATURDAY MORNING IN NOVEMBER, RHONDA ARIAS DROVE HER DODGE CARAVAN PAST A WALMART AT THE END OF HER BLOCK. . . .”
So this is going to be an evocative piece. We have a gas-guzzling SUV driving past a union-busting, low-wage-paying mega-corporation run by Bible-belt evangelicals. At the wheel is Rhonda Arias, “who is 53, often wears silver hoop earrings and low black boots.” She is on her way to a holy-rolling, Bible-shouting session with prison inmates who feel guilty about their abortions. Later, Bazelon watched them “drink in” Arias’s preaching of repentance at the prison chapel, and, still later, observed them as they “shuffled out.”
These are just the kind of people the Times pities and despises. It pities them for their ignorance and stupidity, and it despises them for their willingness to listen to right-wing rhetoric instead of what the Times considers to be their authentic self-interest. Thomas Frank, an author much feted in the Times, wrote What’s the Matter With Kansas? from that perspective. What is wrong with these people?, Frank kept asking. Why do they care about fetuses instead of themselves? That people could have serious concerns about the moral condition of America, and be willing to support candidates who speak to those concerns, was baffling to him. The only explanation he could come up with was the old Marxist line about “false consciousness”: The poor wretches keep focusing on the symptoms of their pathology instead of its “real” roots in economic oppression, and that is what makes them vulnerable to “pro-family” hucksters. Emily Bazelon takes somewhat the same approach in diagnosing the ills of the women in Arias’s prison ministry. They suffer from troubled childhoods and troubled marriages, and they’ve messed up their heads with drugs and alcohol. Now they are being seduced into believing that their self-destructive behavior is the result of their abortions. At the end of her article she quotes a pro-abortion psychologist as saying that these women are preyed upon by fake therapists and religious “crusaders” who offer women a diagnosis “that gives meaning to the symptoms, and gives women a way to repent.”
The Svengali behind all of this, according to Bazelon, is Dr. David Reardon, a biomedical ethicist who has published several books and articles often cited by prolifers. On the basis of interviews with post-abortion women, Reardon concludes that many of them are suffering severe and long-lasting psychological distress as the result of their abortions, a pathology he calls “post-abortion syndrome.” Bazelon flatly dismisses this claim. “The scientific evidence,” she asserts, “strongly shows that abortion does not increase the risk of depression, drug abuse or any other psychological problem any more than having an unwanted pregnancy or giving birth.” As evidence she cites the results of studies by various “academic experts,” including the findings of a special panel appointed by the American Psychological Association (APA), which influenced the APA’s decision to issue an official statement in 2005 denying a link between abortion and subsequent psychological trauma.
She omits a couple of important facts. One, noted in a later letter to the editor, is the finding of a 2006 study by psychologist David Fergusson and a research team from Christchurch School of Medicine and Health Science in New Zealand. The study tracked post-abortive women over a 25-year period and found that they subsequently experienced high rates of suicidal behavior, depression, substance abuse, anxiety, and other psychological problems— and, significantly, found that problems could not be explained by anything else in their backgrounds. What makes the New Zealand study especially interesting is that Fergusson is a pro-choice atheist and began the study expecting to find that the women’s problems were due to what he calls “selection factors,” meaning that the background of these women “predisposed them both to abortion and to mental health problems.” He was astounded when “we found that was not in fact the case.” In the aftermath of his study, Fergusson complained to the American Psychological Association about its continuing to assert that abortion posed no psychological risk factors, and the APA removed the statement from its Internet site.
On the surface it seems odd that Bazelon makes no mention of these recent developments. After all, even evocative articles should take account of facts. And these are facts that are not hard to find. As the letter-writer noted, they could have been uncovered by a fifteen-minute Google search. But there is a reason for these omissions, and the reason is that this argument over post-abortion damage to women is taking place in a political pressure cooker. Let us go back again to Dr. Fergusson. In a radio interview, he remarked that “the whole topic [of post-abortion psychological trauma] has been remarkably under-researched.” Why?, he was asked. “I—my view is very clear that it has actually frightened resear—well, I know that I’ve heard researchers say that we were foolhardy doing research in this area.” Then he added, “we had a certain amount of difficulty getting these results published, but . . .” The interviewer interrupted to ask why. “Well, we—journals we would normally have expected to publish them just declined the papers, and I think it’s—because the debate is so very hot, and I think this is particularly so in the US of A, and it’s notable that our paper was published in a British journal.”
Here is a respected researcher, a secular, pro-choice liberal, who has trouble getting his paper published in an American journal because his conclusion contradicts the received wisdom. He tells us that other researchers are “actually frightened” to publish articles in the field. This is not unfettered science. It is an enterprise so immersed in ideology that honest researchers are afraid to get mixed up in it. Whose ideology? It is hard to imagine that if Dr. Fergusson found no evidence of psychological harm caused by abortion— a conclusion he had initially expected to reach—he would have had such trouble getting his results published in the U.S. Not surprisingly, then, what Bazelon calls “the scientific evidence” in this area matches up almost perfectly with the ideology of Planned Parenthood and the New York Times.
Still, it is not hard to feel the current of defensiveness running through the rhetoric of denial, and it is clearly detectable in Bazelon’s article. She knows that the reason post-abortion ministries like Rhonda Arias’s are flourishing is that abortion is a very sad event in women’s lives. The Supreme Court calls abortion a constitutional right, but it is the only right that people don’t feel good about exercising. Bill Clinton said abortion should be “safe, legal, and rare,” but nobody ever says that about other rights. We don’t say people have a right to go to church or publish a newspaper but that they should do it only rarely. Bazelon acknowledges the peculiar nature of this new court-crafted right when she talks about what she calls the “mushy middle” of Americans, “the perhaps 40 to 50 percent who are uncomfortable with abortion but unwilling to ban it.” She has the mood right, though her statistics are flawed. Opinion polls have consistently shown that it is not 40 to 50 percent but a majority, and that “uncomfortable” is quite an understatement; they are uncomfortable with abortion to the point of supporting a ban on it in all cases except rape, fetal deformity, and the life of the mother. What makes most pro-abortion rhetoric so slippery, so full of evasions and euphemisms and ellipses, is that just about everyone is uncomfortable with abortion, including the people who push it. Hillary Clinton has called it “wrong,” and even Kate Michelman, former president of NARAL, once blurted out to a reporter that it is “a bad thing.” (She later complained that she had been misquoted, until she was reminded that the interview had been taped.) Why is everyone so uncomfortable?
The only answer that will survive analysis is this: Everyone knows that abortion is a killing procedure. It kills something, and that something is not a fish or a hamster. Modern biological science tells us that it is the product of the union of a human sperm and a human egg; the zygotes of each get combined to produce a separate and unique living organism of the species homo sapiens—so we call it a human being. I am sorry to be so pedantic about what I learned many years ago in Biology 101, but I do it by way of reminding you that in more recent times a new science has emerged which calls this being “a blob of tissue,” “a woman’s fertilized entrails,” “potential life,” and other new names. The new science is not the work of biologists but of lawyers, judges, politicians, newspaper writers, and women’s studies professors. At some level Emily Bazelon knows that it is not science but primitive nonsense, but she is unwilling to follow through on her knowledge. She acknowledges that a doctor who reassured a woman before her abortion that there was “only blood” inside could rightly be sued for breach of professional duty. If, she writes, the woman’s allegation is correct, that doctor was “lying to her about the basic facts of pregnancy.” But Bazelon apparently objects to the woman’s lawyer’s characterization of what was inside her as “a complete, separate, unique and irreplaceable human being.” I wish Bazelon had told us which of those words she objects to. I can’t imagine my biology teacher objecting to any of them—but that was years ago, before Roe v. Wade brought us the new science of blobs and potential life.
The ultimate lesson to be learned from Emily Bazelon’s article is that when you try to defend abortion by evasion and denial you run a serious risk of becoming incoherent. Bazelon’s article is grounded on two premises: First, abortion does not produce long-lasting or severe psychological traumas in any significant number of women; second, abortion is not morally wrong, and therefore there is no reason for anyone to feel guilty about having one. By the end of the article she contradicts both of those premises.
She dismisses David Reardon’s research on post-abortion trauma and gives her readers an extended, sneering description of Rhonda Arias’s prison chapel ceremony. (“The guard . . . dimmed the lights and cued soft gospel music over a sound system. . . . Some oohed at the lights over the altar. Others walked in sniffling.”) But it soon appears that Bazelon herself approves of healing ceremonies for post-abortive women—as long as they come with pro-choice labels. She commends the work of an abortion-clinic operator named Peg Johnston, who wrote a booklet for women “who are grieving after their abortions.” One of the reassurances Johnston uses in her clinics is an adaptation of “the Jewish ritual of placing stones on the tombstones of departed loved ones”; she offers patients a “worry stone” to hold during their abortions. Another pro-choice healer she admires is Ava Torre-Bueno, the author of a 1994 book, Peace After Abortion. Torre-Bueno writes about the pain some women feel on the anniversary dates of their abortions, heightened by the fact that they have been holding it in for years, and so she has put together a series of “grieving rituals.” In Bazelon’s words, they include “writing a letter to whomever the woman feels she has harmed (the baby, herself, God, her partner), lighting a candle, filling and then burning a ‘letting go’ box.” (Emphasis added.)
Let’s try to put all this together:
1. An abortion does not put a woman at risk of long-term psychological trauma, yet in recent years the market for post-abortion grief counseling has been flourishing, and the women who avail themselves of these services include many who have been trying for years to repress their grief.
2. Rhonda Arias, who is pro-life, conducts stupid, sappy grieving rituals involving altars, lights, and gospel music. Ava Torre-Bueno and Peg Johnston, who are pro-choice, conduct moving, elevating rituals that include worry stones, candles, and the burning of “letting go” boxes.
3. If you’ve had an abortion there’s absolutely nothing to feel guilty about, but for some of you it might be a good idea to write a letter of apology to your baby.
No wonder Planned Parenthood wants nothing to do with these people. Bazelon notes that Planned Parenthood officials have refused to promote Torre-Bueno’s book and won’t make referrals to people who do that kind of pro-choice counseling. I don’t blame them. Start talking about “the baby, herself” and the “departed loved ones” you might have “harmed,” and next thing you know you’ll be staring at sonograms. God knows what could happen after that. Look what happened to Dr. Nathanson.
Most of Emily Bazelon’s article was based on interviews with Rhonda Arias and observations of her ministry, and from my reading it seemed to me that Bazelon’s strategy was to buddy up with Arias, to appear to be sympathetic to her. I assumed that Arias must have read the article and I wondered what her reaction was. So I phoned her.
Bazelon, she said, “e-mailed me a week after the article came out, asking me what I thought of it. I told her I didn’t know she was doing a piece denying that there is a post-abortion syndrome. I thought she did the best she could, and I told her that.” Did Arias think it was an accurate portrayal of her ministry? “She portrayed me as a self-atoning, emotional manipulator. I’ve been doing abortion recovery work for years, and I’ve done research on it. It’s real, and it needs to be dealt with. These women need forgiveness.” Did she feel that she’d been sucker-punched? “I felt somewhat betrayed but not sucker-punched. I’m not here to make judgments on her or anyone else. One thing surprised me. I didn’t know that she and her family were so steeped in the pro-choice movement.”
What are her feelings toward Bazelon today? “I remain open to Emily. I consider her a friend, though our views are totally opposed. I asked her what her religion was, and she told me she was Jewish. Her little boys go to Torah school. And she told me that she herself had suffered a miscarriage—which saddened her, though she didn’t think a human life was involved. I brought her into my home for three days while she did the research for this article, even gave up my bedroom to her. And I think there were some things she saw that may have softened her heart.”
George McKenna is Professor Emeritus of Political Science at City College of New York. He coedits (with Stanley Feingold) Taking Sides: Clashing Views on Controversial Political Issues(McGraw-Hill, 2007), now in its 15th edition. His Puritan Origins of American Patriotismwill be published by Yale University Press in September.
Something No Woman Wants
Shortly before Christmas, I got an e-mail from the journalist and Slate.com editor Emily Bazelon. She said that she was writing an article for the New York Times Magazine about “women’s experiences post-abortion.” She said she hoped to talk to me that day or the next, and apologized for the short notice. Since I was in and out of the office a lot those pre-holiday days, and thought we might not connect by phone in time, I drafted a quick e-mail in the hope that she could mine it for some quotes. Here’s what I wrote her:
I feel bad that I’ve gotten rusty on this topic—lately I’m writing more about Eastern Christian spirituality, etc. So I’ve forgotten all my statistics, and hope I can be a useful interview.
The main general reflection-thing I’d say is that it seems that the abortion issue is “cooling off”—not that advocates on either side are any less passionate about it, and not that the political fight is concluded, but that the public has lost interest. Other issues have grabbed their attention. I first noticed this in 2000, when Newsweek’s 6- page comparison of Bush and Gore on important issues did not include abortion. So I like to say “The abortion debate is over,” meaning that folks aren’t listening any more. The “fight” isn’t over, from the point of view of either side, but the debate is over because we’ve run out of interested listeners. The auditorium is empty and the lights have been turned off.
I think in a way this is a good thing. That there is a lot of ambivalence about abortion out there, as well as much submerged post-abortion grief. This needs a “moment of silence” to be able to rise to consciousness, so people can admit and recognize these conflicted feelings, and move to a new stage. As long as the debate is hot, people immediately think in terms of “which side are you on,” and these deeper questions—about what abortion really is, about how it makes us feel, how it affects our relationships and our sense of ourselves—keep getting stuffed down. One of the women I interviewed in my book “Real Choices” told me that after the abortion she felt she couldn’t tell anyone about her sad feelings. She said that if she told pro-life friends she was depressed about her abortion, they would reject her, saying, “You had an abortion? You’re a murderer!” And she couldn’t tell her prochoice friends because they would say, “What are you complaining about? You had a choice. Are you a traitor to the cause?” It seemed like there was nowhere to go. As the heat cools off, voices like hers can be heard.
I think that as these conflicted feelings rise to the surface we’ll be better able to understand what abortion does to a society, and admit how many of them are negative. That abortion adapts women to a hostile situation, rather than challenging and changing that society—adapts her physically, like a whalebone corset does.
When I was a college feminist and championed women’s right to abortion, I thought of it as something liberating. I had no idea that there would be so *many* abortions—I think the total now is 47 million. We all thought it would just be a few “hard cases.” But it seems like abortion is a funnel that women’s complex situations get stuffed into—she gets changed, so that those around her don’t have to. And the idea that an abortion was a liberating experience was quickly overturned by the reality that women go into it pressured and panicked, and come out of it weeping. Abortion is not something any woman wants. And if women are doing something 3500 times a day that they don’t want to do, this is not liberation that we’ve won. Best wishes for your article, and give me a call if I can help any more.
I did get a call from Emily a little later. I was struck by how young she sounded, and also by the fortification of her voice—the way responsible journalists talk when they’re interviewing psychos. It was clear that there was nothing a pro-lifer could ever say that she could consider reasonable. A pro-lifer who sounds reasonable is worse than a clinic-bombing freak, because at least those guys are honest. A pro-lifer who sounds reasonable is also lying—misrepresenting herself and impersonating a normal person. And that’s just sad.
Early in the conversation I learned that her article was not so much about post-abortion grief as about the political usefulness of the concept. And, though I might have had something to say about the pro-life cause in general, I’m a complete washout when it comes to politics. I took part in the Maryland abortion referendum of 1992, and finished the course depressed and drained. That was my first and last foray into politics, as I detailed in an essay for these pages (Human Life Review, Spring 1993).
After our phone conversation, I described it in a note to a friend:
I had a hard time getting a handle on what she was getting at. Her theory seems to be that some time, years ago, pro-lifers became interested in using post-abortion women in their political efforts. But after Surgeon General Koop disappointed them by failing to endorse the concept of post-abortion trauma they let it drop. (He believed that argument diluted the strength of pro-life argumentation based on the right to life of the unborn.)
I told her that it wasn’t like that, from my perspective; post-abortion women had always been steadily present in the movement. And that I didn’t think there was ever any broad attempt to “use” them in a political sense. Even though some of us had been encouraging a broadening of the pro-life message to emphasize the good works we do for women and their needs, the emotional core of the message pretty consistently focused on unborn babies and fetal development. I said, “We walk the walk but we don’t talk the talk.” The great efforts pro-lifers make to help women are not something we parade in the public square or employ to change opinion.
Emily told me that there is now revived interest in post-abortion women, and mentioned the organization Operation Outcry. But, she asked, if pro-lifers support post-abortion women, why won’t they fund them? Why won’t they give them money? I kept saying “Huh?” Give them money? I didn’t get it. Eventually I said that pro-lifers do fund projects for post-abortion women. They do it mostly through local pregnancy care centers, because that’s where the services are.
It turned out that Emily meant funding for political campaigns. Apparently someone in South Dakota had told her that national organizations would not fund the recent campaign in that state, and Emily seems to think this is because the campaign used post-abortion women.
I said that couldn’t be so. There was no blanket refusal to speak of post-abortion grief in political settings. There must be another explanation. I told her that I thought I’d read somewhere—maybe the New Yorker—that some pro-lifers felt the South Dakota campaign was not the right way to go. But that wouldn’t have anything to do with the involvement of post-abortion women.
I don’t think she was convinced. I am frankly not sure what she’s getting at.
Since I’d proved my incompetence to answer Emily’s questions, we concluded the conversation, and I suppose she went on to locate other pro-lifers who were more familiar with the topic under discussion.
This morning I went to a local Catholic girls’ high school for Career Day; I talked about being a freelance journalist. Several of the girls want to write fiction and others want to be opinion or nonfiction writers; one wanted to be an editor. I warned them about how tough the competition is, and how hard it is to get started, and how thin the pay is even when you’ve been at it for decades.
But, I said, there’s good news. One day, everybody who’s my age will be dead. And people in your generation will be writing the novels and opinion pieces and features and book reviews, and editing them, too. The best, most influential writer of your generation is someone who is your age today, I told them. Why shouldn’t it be you?
When that day comes, perhaps pro-life convictions and reasoning will be heard in the big Establishment publications, and allowed to express themselves in their own terms. I hope some of those girls will make it happen. I will be happy to lean over the edge of the cloud and cheer them on.
Frederica Mathewes-Green is a wide-ranging author whose work has appeared in the Washington Post, Christianity Today, First Things, Touchstone, the Wall Street Journal, and many other publications. A regular columnist for Beliefnet.com and a movie reviewer for National Review Online, Ms. Mattewes-Green is also a popular speaker and talk show commentator.
The Aftermath of Abortion Trauma (Appendix C)
E. Joanne Angelo, M.D.
In my psychiatric practice over the past 40 years I have helped hundreds of women, men, and children grieve the loss of someone they loved. Grief and mourning is a universal human experience, shared by all cultures.
When a beloved old person dies, his or her loss is deeply felt by spouses, siblings, children, grandchildren, and friends. The grief process is eased if the death was anticipated and loving care provided to the dying person. It is more painful if there has been an ambivalent relationship with the deceased, or if the death was not anticipated or traumatic.
In other situations, unexpected death through violence, disaster, or suicide is more difficult to mourn, especially if the body is mutilated or unable to be located for burial. Spontaneous monuments often spring up on the site of a fatal accident or disaster where people bring flowers, mementos, and letters, as we still see at Ground Zero in New York City.
The death of a child is the most difficult for the family and for society to mourn. Funeral directors tell me that the younger the deceased, the larger the crowd at the wake and funeral. Schoolmates and neighbors as well as parents and siblings have a hard time accepting and making sense of the loss of a child. The large, supportive gathering around the immediate family helps them enormously during their time of deep sorrow. At a child’s grave one often sees toys, candy, and bouquets of flowers, yet the emptiness created by the untimely loss of a young person remains an open wound for many years, even for a lifetime.
Grieving the loss of a premature infant is also a heavy burden for parents and families. Intensive-care nurseries for premature infants have developed programs to help parents and staff deal with the death of their tiny babies. Teams of nurses, doctors, social workers, chaplains, and parents who have had similar losses gather around the grieving family and help them create a memory box including pictures of the baby in their arms, and the child’s footprints, clothing, hospital-identification bracelet, and birth and death certificates. A funeral is planned and burial may be arranged, perhaps in a shared grave with a relative who has gone before.
Mothers and fathers whose child is lost through miscarriage suffer profoundly as well, although their grief is often private or hidden. A 2003 article in the American Journal of Maternal/Child Nursing states: “We know from studies of women that miscarriage is a life changing event, and that women experience feelings of emptiness, dread, guilt, and grief. They have an increased need for support and they have many fears about their future childbearing. Women have elevated depression and anxiety scores for up to a year after the event”1. Common themes for women after miscarriage were anger and frustration, guilt, feeling alone, feeling that no one could really comprehend the depth of their sorrow, and feeling numb with grief. All of the women in this study reported guilty feelings about causing the miscarriage, although most of them said they knew that, in fact, they probably had not caused it. Ambivalence about a pregnancy is common in the early weeks and ambivalent feelings make mourning difficult after the loss. These women often mourn alone. If they do share their experience, others may not understand—and respond with such comments as, “There must have been something terribly wrong, it’s better this way,” or “You will have another baby soon.” Women tell me their feelings of emptiness, of being incompetent to nurture their child. They ruminate about what they could have done to cause the miscarriage: too much exercise, a glass of wine, poor nutrition, a fall, negative feelings about the pregnancy, or even wishing it away.
The death of a child by procured abortion is by far the most traumatic loss to grieve. The death is violent and untimely, the body is dismembered. For these parents there are no remains, no child to hold, no pictures to keep, no religious service, no grave to visit. Mothers and fathers of aborted children suffer their feelings of emptiness, grief, loss, and guilt in solitude—often not acknowledging them even to each other. Society offers them no validation for their overwhelming feelings. The parents’ relationship with each other frequently falls apart due to their ambivalent feelings about the abortion and about each other’s role in it. Grief, guilt, depression, self-loathing, and substance abuse cause them to have little physical or emotional energy to invest in personal relationships, work, or study. Their lives spiral downward.
Women who can’t sleep at night because of recurring nightmares of children being killed or dismembered often turn to alcohol, sleeping pills, or illicit drugs to get to sleep. Flashbacks to the abortion experience may haunt them for years, triggered by daily events such as the sound of a vacuum cleaner or the suction apparatus in a dentist’s office, the music they heard at the abortion clinic, a baby in a TV ad, or a gynecological exam. Flashbacks cause them to relive the abortion procedure. They are overcome by waves of anxiety, palpitations, hyperventilation, and hypersensitivity to sound. The date the child would have been born each year and the anniversary of the abortion trigger waves of sorrow and guilt. New pregnancies can be accompanied by feelings of incompetency as a parent—leading to multiple abortions. Deaths in the family trigger sorrow and remorse for past losses as well.
Depressive symptoms may become overwhelming and lead to suicidal ideation and completed suicides. A recent longitudinal study in New Zealand, where abortion is legal, followed over 1000 females from birth to age 25. Forty-one percent of women in this birth cohort became pregnant prior to age 25, with 14.6% undergoing an abortion. Those who had abortions were found to have elevated rates of subsequent mental health problems including depression, anxiety, suicidal behaviors, and substance abuse disorders. These rates were significantly higher than the rates of mental health problems in women who did not become pregnant, or who became pregnant and did not undergo an abortion. These findings could not be attributed to mental health problems in these young women prior to their abortions.2 A study in Finland found the rate of suicide in women the year after an abortion (37.4 per 100,000) to be nearly six times greater than the suicide rate after live birth (5.9 per 100,000) and significantly higher than the suicide rate in the general population of women of childbearing age (11.3 per 100,000).3 Relationships with other children in families where abortions have occurred may be affected as well. Subsequent children may suffer from ambivalent attachment or overprotection by their mothers. Knowing that siblings have been aborted because of birth defects may cause other children to believe that any less-than-perfect performance on their part will cause them to be rejected as well. Grandparents, friends, guidance counselors, and school nurses who counseled abortions and abortion providers do not escape the ripple effect of this current epidemic of grief and guilt.
Other cultures too suffer the aftermath of abortion trauma. In Japan, aborted children are called “water babies” and are believed not to be free to return to God until they are rescued by means of prayers offered in the Buddhist temple by monks, and gifts and offerings of toys, candy, and clothing, which their parents place before small stone statues of infants in the temples.4 In Taiwan, aborted children are considered “spirit babies” who will return to haunt their parents, destroying their marriages and their businesses unless prayers are offered for them in the temples.
Forty-five million abortions in this country in the past 34 years since Roe v. Wade, and 1.2 million more each year, have created an overflowing pool of grief in the hearts of women and men who have lost their children in an untimely and violent fashion—grief which, until recently, they have been concealing, at great emotional cost. As parents of aborted babies find a voice to tell us what a tragedy abortion has been in their lives and the scientific community corroborates their symptoms with irrefutable research data, the havoc which abortion has wrought in our society can no longer be denied. When abortion is recognized as the traumatic event it is, and professional treatment (along with compassionate support and spiritual care) is made available to parents and others, then those who have suffered from abortion can become the wounded healers of our society, crying out, silently or in a loud voice, “No more.” The pool of tears is spilling out into a cresting river of grief which is poised to flood our culture and wash it clean. When the river recedes, my hope is that it will leave its shores fertile for new life—for a culture of life that will emerge in our land and around the world.
E. Joanne Angelo, M.D. is a psychiatrist in private practice and an assistant clinical professor of psychiatry at Tufts University School of Medicine. She has worked with children, adolescents, adults, and families for over four decades, and is keenly aware that the negative after-effects of abortion trouble both women and men and extend through multiple generations.
1. Freda, MC, et al., “The Lived Experience of Miscarriage after Infertility,” American Journal of Maternal/Child Nursing, Jan./Feb. 2003, v 28, nl, pp. 16-23.
2. Fergusson, DM, Horwood, LJ, Ridder, EM, “Abortion in Young Women and Subsequent Mental Health,” Journal of Child Psychology and Psychiatry, 2006; 47 (1): 16-24.
3. Gissler, M. et al., “Suicides after Pregnancy in Finland, 1987-94: register linkage study,” British Medical Journal, Dec. 7, 1996, v 313, n 7070, pp. 1431-34.
4. “Unusual Ceremonies Reveal Doubt in Japan Over the Use of Abortion,” Wall Street Journal, Jan. 6, 1983.
“Is There a Post-Abortion Syndrome?”: A Study of Jaded Journalism
On a quiet day in October 2006, I received a phone call from Emily Bazelon. She identified herself as a writer for the New York Times Magazine and said she wanted to interview me for an article she was writing. I questioned her about what the point of the article would be and she assured me that she was writing a story about women’s experiences with abortion and the healing programs that were helping them. As the co-founder of the Silent No More Awareness Campaign, I was thrilled to hear that a national media outlet was interested in addressing abortion from the woman’s perspective; as Ms. Bazelon conducted various interviews with me and the Silent No More women, I got excited that this might be our big break. We would finally be able to get our message—“abortion hurts women”—out to a mass audience. Unfortunately, the article Ms. Bazelon wrote left me feeling betrayed and disheartened. To help me decide if I was being overly sensitive about the article, I went over every paragraph and made notes where I saw inaccuracies or inconsistencies. Of the 70 paragraphs, I found problems with 23 of them.
- Paragraph 6 states that “the idea that abortion is at the root of women’s psychological ills is not supported by the bulk of the research. Instead, the scientific evidence strongly shows that abortion does not increase the risk of depression, drug abuse or any other psychological problem any more than having an unwanted pregnancy or giving birth.” However, Ms. Bazelon provides no specific study to support her statement. I am aware of 15 studies published since 2001 that support the theory that abortion is psychologically damaging to women, including one study titled “Abortion In Young Women and Subsequent Mental Health” (by David Fergusson et al., published in The Journal of Child Psychology and Psychiatry, January 2006, Volume 47). The study from New Zealand found that 42 percent of women in the study group who had had an abortion also had experienced major depression at some point during the past four years. This was nearly double the rate of those who had never been pregnant and 35 percent higher than those who had chosen to continue a pregnancy. (It should be noted that Mr. Fergusson is pro-choice and wasn’t happy with his findings, but reported them to uphold his scientific integrity.)
- Paragraph 11 contains an inaccurate description of Surgeon General C. Everett Koop’s report on post-abortion. “Koop was against abortion, but he refused to issue the report and called the psychological harm caused by abortion ‘minuscule from a public-health perspective.’” Bazelon does not cite the source for her quote. What he actually said in his three-page letter to President Reagan was that the available studies were flawed because they did not examine the problem of psychological consequences over a sufficiently long period.
- In paragraph 12, Bazelon mentions Theresa Burke, but fails to note that Burke is a Ph.D. and has written a well-known book on the psychological effects of abortion, Forbidden Grief. Neither the book nor Dr. Burke’s extensive work with thousands of women affected by abortion are acknowledged or noted.
- In paragraph 15, she questions why post-abortive women do not “focus on why women don’t have the material or social support they need to continue pregnancies.” In fact, pregnancy centers don’t worry about why women don’t have resources, because they are more focused on providing them with practical help—like clothing, diapers, and parenting skills. Ironically, in paragraphs 44 through 51, Bazelon highlights the work of abortion clinics but never asks the same question of them.
- Paragraphs 20–22 get into research again. This time Bazelon claims that possibly 10 percent of women have problems after abortion but explains the sources of the trouble as being outside circumstances, or the fact that the women were “emotionally fragile beforehand.” The research she quotes is from 1990; and the condescending “tough-luck” tone for unstable women and those with pre-existing risk factors is in remarkable contrast to the concern for women Bazelon professed to me during our interviews.
- Paragraph 25 notes that the American Psychiatric Association is currently reviewing the most recent scientific literature about the effects of abortion, but fails to mention that in September 2006 they removed a statement from their website denying any emotional consequences from abortion. Oddly enough, in the same paragraph, after pages of denying the scientific support for the pain of abortion, Bazelon writes, “For a minority of women, it is linked to lasting pain. You don’t have to be an anti-abortion advocate to feel sorrow over an abortion, or to be haunted about whether you did the right thing.”
- Paragraphs 26 through 39 are a description of a memorial service that takes place at a prison, and while she captures the raw emotion of this private and painful event, her words are tinged with doubt that the ministry being done is valid. This is the one place where Bazelon gives the reader a glimpse into the pain and suffering that women feel from abortion, but sadly she closes the door before too much truth can escape.
- Paragraphs 44 through 51 talk about the pro-abortion approach to the after-effects of abortion for women. Bazelon explains that some clinics and pro-abortion groups are now providing counseling, which is ironic because she continues to question the credibility of the problem.
- Paragraph 59 expresses concern that state informed-consent laws that tell women about the emotional and physical risks associated with abortion are bogus, noting that South Dakota’s “law requires physicians to give patients written state-approved information that supplies a link between abortion and an increased risk of suicide, though no causal connection has been found.” Sadly, the writer missed the study titled “Pregnancy-Associated Mortality after Birth, Spontaneous Abortion or Induced Abortion in Finland 1987-2000,” published in the American Journal of Obstetrics and Gynecology in 2004. The research showed that the mortality rate associated with abortion is 2.95 times higher than that associated with pregnancies carried to term. Non-pregnant women had 57.0 deaths per 100,000, compared to 28.2 for women who carried pregnancies to term, 51.9 for women who miscarried, and 83.1 for women who had abortions (a 46 percent higher death rate than non-pregnant women). The study also revealed a sevenfold-increased rate of deaths from suicide among aborting women. The study included the entire population of women 15 to 49 years of age in Finland between 1987 and 2000.
- In paragraph 62, Ms. Bazelon finally mentions the Silent No More Awareness Campaign. Ironically, after she had spent at least eight hours conducting interviews with me on the phone and in person, the only comment she attributes to the Campaign is not relevant to the work we do to raise awareness. In addition to these inaccuracies and inconsistencies, the entire article was littered with fiscal figures from the various pro-life groups mentioned. Bazelon appears to be insinuating that the effort to make abortion illegal is chiefly a money-making proposition. She realizes that public support for abortion is declining, so her true agenda is damage control—through discrediting our motivation for helping women. At two different places in the article she discusses the South Dakota abortion ban and pending lawsuits as strategies that use women and their pain; she never acknowledges our very real concern for women and children.
While the article was supposed to be about Post-Abortion Syndrome (PAS), the author never defines what that is, explains its symptoms, or tells any of the numerous real-life stories that were shared with her as examples of it. Instead of addressing PAS, as the title indicated, the article portrays those of us working with women wounded by abortion as extreme, law-centered, manipulative, and at odds with the rest of the pro-life movement. Bazelon’s article could have helped so many women and unborn babies if only she had shared with her readers more of the women’s stories, and the following ten facts about women and abortion that I shared with her. (You can also view, read, or listen to numerous testimonies at SilentNoMoreAwareness.org.)
1. Abortion creates emotional and behavioral problems for women.
After an abortion, many women find themselves dealing with increased use of drugs and/or alcohol to deaden their pain, recurring insomnia and nightmares, eating disorders, suicidal feelings, and attempted suicide. Women experience difficulty in maintaining or developing relationships, loneliness, isolation, anger, fears of the unknown, indecisiveness, and a sense of selfhatred. Since 2001, 15 studies focusing on the psychological effects of abortion have been done. These studies underscore the fact that evidencebased medicine does not support the conjecture that abortion will protect women from “serious danger” to their mental health. It indicates the opposite.
2. Abortion creates physical problems for women.
- Abortion advocates frequently assert that carrying an unintended pregnancy to term is more harmful to women than abortion. But all the research and women’s personal experience say something else.
- In the U.S., over 140,000 women a year have immediate medical complications from abortion.
- Long-term health risks include an increased risk of breast, cervical, and ovarian cancer. Abortion can also lead to infertility due to hysterectomies, pelvic inflammatory disease and miscarriage.
- Abortion can cause the following complications during future pregnancies: premature birth, placenta previa, and ectopic pregnancy.
3. Women still die from abortion.
- Women still die from the abortion procedure, as well as from complications that occur afterwards.
- Studies also show that women with abortion history have an increased risk of dying from a variety of causes after abortion.
4. Abortion affects women spiritually.
Many women turn away from God, or fear a “greater power,” because deep inside, we know we’ve taken the life of another being.
5. Women are pressured and coerced by family, friends, employers, institutions of learning, and sexual predators into having abortions.
In some cases, parents threaten to kick the girl out of the home, boyfriends and husbands threaten to leave, or women are told by well-meaning friends that having a baby will ruin their lives and they simply have to have an abortion.
6. Abortion negatively affects women’s future relationships.
- We struggle with issues of trust afterwards. How can we trust those who said they loved us and then allowed us to go through painful abortion?
- It affects how we relate to children we have in the future. Sometimes we can’t bond with them or we over-protect them.
- Abortion is often a secret we keep from spouses, children, or parents. If we do want to seek healing, we must tell them. Telling others creates another set of problems and concerns.
7. Abortion is a band-aid that allows society to abandon women.
- Our culture has come to depend upon abortion so that individuals and churches don’t have to get involved in caring for today’s widows and orphans. It often frees many men from taking responsibility for their sexual promiscuity.
- Abortion stops being one choice among many and becomes the only choice because all the emotional and financial support dries up. Friends default to endorsing abortion so they don’t have to be bothered.
8. Abortion is a form of racism against poor and ethnic women.
- Planned Parenthood identifies its core clients as young, low-income women of color. Black and Hispanic women represent only a quarter of American women of child-bearing age, yet account for more than half of all abortions in the U.S.
9. Abortion has led to increased violence against pregnant women.
According to one study of battered women, the target of battery during their pregnancies shifts from their face and breasts to their pregnant abdomens, which suggests hostility toward the women’s fertility. Women are literally being killed for refusing to abort. The leading cause of death during pregnancy is homicide. In one study of violent deaths among pregnant women, three out of every four were killed during their first 20 weeks of pregnancy.
10. Abortion compromises who we are as women.
- Women are designed to give life and nurture it. When we abort our children, we interfere with the natural process of procreation; this leaves an imprint on our heart, one that is often denied but never goes away.
- Bazelon, had she written a different article, could have had a positive effect on the lives of millions—by helping them consider the true effects of abortion on women. Instead, she chose to engage in a pro-abortion smear.
- A few days after the article was published I learned that Emily Bazelon is the cousin of NARAL co-founder Betty Friedan, and granddaughter of pro-abortion judge David L. Bazelon. I found it ironic that Ms. Bazelon ended her article by implying that our pain can be explained away with the theory of “social contagion”—which may better describe her need to try to discredit women’s abortion pain.
- I wish she and her pro-abortion family members could be around when I’m sitting on the floor in some church, home, or conference room holding a sobbing woman as she begins to acknowledge and mourn the loss of the baby she aborted. It is a real, palpable pain that deserves mercy and compassion. If the abortion advocates can support a woman’s right to abort, why can’t they also support a woman’s right to regret her choice?
Georgette Forney is President of Anglicans for Life and co-founder of the Silent No More Awareness Campaign.
Poor God-crazed Rhonda: Daring to Challenge the “Scientific” Consensus
We are not far into Emily Bazelon’s New York Times article on the postabortion syndrome before she hands us some not-too-subtle clues as to how much faith we should put in the credibility of anti-abortion crusader Rhonda Arias. First of all, Arias wears silver earrings and low black boots. She talks a lot about God, even claiming to have had a revelation from Him. She is interested in Messianic Judaism. She prays out loud. She also has a history of “depression, drinking, and freebasing cocaine” as well as attempted suicide.
As a child she suffered sexual abuse. The typical university-educated, left-leaning NYT reader will thus know how much stock to place in the evidence and arguments presented by this caricature of a pro-life zealot. Just in case there is any doubt about the matter, Bazelon, in an aside, coolly informs us that “the scientific evidence strongly shows that abortion does not increase the risk of depression, drug abuse, or any other psychological problem any more than having an unwanted pregnancy or giving birth.”
Those few researchers who dispute the “scientific” consensus—people like David Reardon and his “ally” Vincent Rue—are dismissed as hardline antiabortionists and consigned to the wastebasket. After all, we are reminded, not even Ronald Reagan’s anti-abortion surgeon general could find any psychological harm attributable to abortion. The dismissal of any factual basis to Arias’s moral crusade is completed by references to a number of proabortion “authorities” who categorically (but perhaps too emphatically) deny any link between abortion and psychological distress.
With the scientific question authoritatively disposed of, the progressiveminded reader is then free to enjoy the amusing tale of a wacky moral crusade being conducted by a 53-year-old exemplar of southern trailer-park trash. But is there a possibility that Arias, in spite of Bazelon’s strong hints that she is intellectually challenged, and hysterical to boot, might have a point? Let’s begin with Bazelon’s statement that “no causal connection has been found” linking abortion with an increased risk of suicide. Of course a causal connection has not been found. No epidemiologist worth his or her salt talks about causes, only about correlations. Between induced abortion and suicide the correlation has been shown to be massive and powerful, in numerous international studies published in the most prestigious journals. These studies are based on the experiences of hundreds of thousands of women, who have been tracked through record linkage. Record linkage in this context means using official hospital and mortality records to trace a given population to find how many have abortions, psychiatric-hospital admissions, or die after their abortion. Research based on record linkage is far more authoritative than research based on interviews. Record-linkage studies typically involve large populations; they are not contaminated by interviewer bias; and they do not suffer from the problem of the refusal of some subjects to participate, or the attrition of those who do agree to participate.
Ironically, it is David Reardon, the anti-abortion researcher, who, in his study of 173,279 low-income California women, found the weakest correlation between induced abortion and suicide. In the four years following their abortion, women who had abortions experienced a suicide rate 160 percent higher than women who delivered their babies.1 A much larger study of 408,000 British women in the 1990s established that women who had induced abortions were 225 per cent more likely to commit suicide than women admitted for delivery of their babies.2 The largest study, based on the records of more than 1.1 million births, induced and spontaneous abortions, and ectopic pregnancies experienced by Scandinavian women between 1987 and 2000 uncovered a suicide rate among women who underwent abortions over six times (518 percent) higher than among pregnant women who had their babies.3 The Scandinavian researchers also made the astonishing discovery that mortality from all external causes—suicide, homicide, external injuries— was more than twice as high among women who had induced abortions as among non-pregnant women, and over six times as high as among women whose pregnancy ended in birth. In light of this they cautiously suggest that not having an abortion may be better for a woman’s mental health than having one. Remember that for decades we were glibly told that “abortion is safer than childbirth.” That myth has now been buried, by the research published in the last decade.
And yet, we continue to be assured—by the American Psychological Association, no less—that “well-designed studies of psychological responses following abortion have consistently shown that risk of psychological harm is low . . . the percentage of women who experience clinically relevant distress is small and appears to be no greater than in general samples of women of reproductive age.”4 It is dogmatic statements like these that fill Bazelon with enormous confidence in her own rightness. But as a New Zealand research team with impeccable credentials has recently pointed out, the APA statement is “based on a relatively small number of studies which had one or more of the following limitations: a) absence of comprehensive assessment of mental disorders; b) lack of comparison groups; and c) limited statistical controls. Furthermore, the statement appears to disregard the findings of a number of studies that had claimed to show negative effects for abortion.”5 Perhaps that explains why the APA will no longer let you read the paper on their website.
Apart from the overwhelming evidence about the link between abortion and suicide, what else do we know at present about the impact of induced abortion on women’s mental health? In fact, a great deal. But the subject is a minefield of political correctness and evasiveness. Some abortion researchers deny in the conclusions to their papers the very information that they have uncovered in their research.6 Thus Zoe Bradshaw and Pauline Slade conclude that women who have abortions do “no worse psychologically than women who give birth to wanted or unwanted children.” Yet in the abstract they tell us that prior to undergoing an abortion 40 to 45 percent of women experience significant levels of anxiety, and around 20 percent experience significant levels of depressive symptoms. Following the abortion, “around 30 percent of women are still experiencing emotional problems after a month.” In the discussion part of the paper they also concede that the studies on which they base their conclusion are plagued by high rates of nonparticipation and attrition. Common sense suggests that women who refuse to participate in an abortion study, or who drop out in the middle of it are more likely to be psychologically distressed than those who sign on and participate to the end. They also reveal that negative effects on sexual functioning were reported by 10 to 20 percent of women in the year following their abortion. Negative effects were also reported on couple relationships.7 Nevertheless, Bradshaw and Slade assure us that in the long run abortion has little adverse effect on women’s psychological health, citing two studies whose authors’ bias in favor of abortion is glaringly obvious. They completely ignore Cougle and Reardon’s analysis of the U.S. National Survey of Youth, which revealed that women who aborted had significantly higher depression scores ten years after their abortion than those who bore their children. After controlling for a wide range of variables, Cougle and Reardon ascertained that post-abortive women were 41 percent more likely to score in the “high-risk” range for clinical depression. Aborting women were 73 percent more likely to complain of “depression, excessive worry, or nervous trouble of any kind,” on average seventeen years later.8 This finding is buttressed by a Canadian study of 50 post-abortive women in psychotherapy.
The researchers found that “although none had entered therapy because of adverse emotional reactions to abortion, they expressed deep feelings of pain and bereavement about the procedure as treatment continued. Typically, the bereavement response emerged during the period when the patient was recovering from the presenting problem.”9
However much pro-abortion researchers may like to assure us that abortion causes little psychological distress among women, or even, perversely, that abortion is actually good for women, they cannot refute record-linkage studies showing a much higher incidence of hospitalization for women who have induced abortions. Such a study was completed just a few years ago by researchers for the College of Physicians and Surgeons of Ontario—hardly an institution known for its anti-abortion bias. Comparing 41,039 women who had induced abortions and a similar number who did not undergo induced abortions, the study revealed that in a mere three months the women who had abortions suffered a nearly five times higher rate of hospitalization for psychiatric problems than the control group (5.2 vs. 1.1 per thousand). In this short period the hospital (as opposed to clinic) patients also experienced a more than four times higher rate of hospitalization for infections, and a five times higher rate of “surgical events.”10
Fortunately, the study of abortion’s aftermath is less politically charged outside North America. Illuminating in this regard is the recent study by Fergusson, Horwood, and Ridder. They gathered data on a birth cohort of 520 females in Christchurch, New Zealand, and tracked them for a 25-year longitudinal study. After eliminating a host of “confounding” factors that have been the bane of most studies of this nature—such as mother’s education, childhood sexual or physical abuse, prior personality problems, smoking, alcohol and cannabis consumption, prior history of suicidal ideation, etc.—they judiciously conclude that “mental health problems [are] highest amongst those having abortions and lowest amongst those who had not become pregnant.”
The presentation of the evidence in their tables show how understated this conclusion actually is. By almost every measure—major depression, anxiety disorder, suicidal ideation, alcohol dependence, illicit-drug dependence, mean number of mental-health problems—those who terminated their pregnancy by abortion suffered much higher rates of disorder than those who were never pregnant, and those who were pregnant but did not abort. After “covariate adjustment”— in other words, taking account of the various “confounding” factors noted above—they found that those in the “not pregnant” and “pregnant no abortion” categories ran far lower risks of suffering various disorders.
Table: percentage lower risks experienced by Not Pregnant and Pregnant No Abortion, compared to Pregnant Abortion11
Percentage lower risk than Pregnant Abortion subjects
Pregnant no abortion
|Illicit drug dependence||
|Number of mental health problems||
Isn’t it interesting that women who didn’t have abortions were 80 to 85 percent less likely to have an illicit-drug dependence than those who did? Striking support for Rhonda Arias’s hunch that a good part of America’s big drug problem is “because of abortion.”
Another recent, non-North-American study shines a spotlight on the various pressures brought on women to terminate their pregnancies, and the devastating impact this can have on their emotional well-being. The authors of this study of 80 Norwegian women admit up front that their sample represents only 46 percent of those who were asked to participate, and concede that because of this “our study may well be an underestimation of the negative emotional responses” to abortion. Fully one-quarter of the women reported pressure from their male partner as a reason for having the abortion. This is only the eleventh most frequently cited reason. However, the fourth most cited reason, given by over a third of the women, was that their partner “does not favor having a child at the moment.” Small but significant numbers of women also listed pressure from friends, mother, father, siblings, and others as reasons for their abortion. If all these various sources of coercive pressure are combined, pressure to have the abortion emerges as by far the leading factor leading these Norwegian women to undergo the operation.12 A sobering finding, that cries out for similar studies to be carried out in other countries.
To conclude, the whole subject of induced abortion and women’s mental health is, in North America, fiercely contested political turf. The establishment media and such heavily politicized professional bodies as the American Psychological Association would have us believe that induced abortion has next to no adverse effects on women’s mental health. Indeed, some social scientists go so far as to argue that abortion is often good for women: It relieves them of a terrible burden, and enables them to turn over a new page in their lives. If only certain groups would stop trying to make them feel guilty for what they have done. On the other hand there are three large-scale record-linkage studies from the U.S., Britain, and Scandinavia that establish irrefutably a strong correlation between abortion and subsequent death from suicide and other causes. Other studies have established that women who undergo an induced abortion have a much higher rate of hospital admission for psychiatric problems. Studies have shown that these problems do not clear up quickly; on the contrary, they often haunt women for decades afterwards. Finally, a methodologically impeccable study from New Zealand has recently shown a clear correlation between induced abortion and a variety of mental-health problems including major depression, anxiety disorder, suicidal ideation, and illicit-drug dependence. So much for Emily Bazelon’s glib assurance that abortion does not increase the risk of psychological problems “any more than giving birth.”
Ian Gentles is the Vice President (Research) of the deVeber Institute for Bioethics and Social Research in Ontario (www.deveber.org) and visiting professor of history at Tyndale College, Toronto, where he teaches the history of population, the family, and bioethics.
1. Reardon, DC, Ney PG, Scheurer FJ, Cougle JR, Coleman PK. Suicide deaths associated with pregnancy outcome: A record linkage study of 173,279 low income American women. Archives of Women’s Mental Health 2001; 3(4) Suppl.2:104.
2. Morgan CL, Evans M, Peter JR. Suicides after pregnancy. Mental health may deteriorate as a direct effect of induced abortion. British Medical Journal 1997 March 22; 314(7084): 902.
3. Gissler M, Berg C, Bouvier-Colle M-H, Buekens P. Injury deaths, suicides and homicides associated with pregnancy, Finland 1987-2000. European Journal of Public Health 2005; 25(5): 460; Gissler M, Hemminki E, Lonnqvist J. Suicide after pregnancy in Finland, 1987-1994: register linkage study. British Medical Journal 1996 December 7; 313 (7070): 1431-1434.
4. American Psychological Association. APA Briefing Paper on the Impact of Abortion on Women (2005), cited in Fergusson DM, Horwood LJ, Ridder EM. Abortion in young women and subsequent mental health. Journal of Child Psychology & Psychiatry 2006; 47(1): 16-24. At the time of writing, the APA has withdrawn the paper from its website with the explanation that it is “currently being updated.”
5. Fergusson et al. Abortion in young women. See note 4.
6. For a general discussion of this problem see Elizabeth Ring-Cassidy and Ian Gentles. Women’s Health after Abortion: The Medical and Psychological Evidence. Toronto: deVeber Institute for Bioethics and Social Research, 2003, ch. 17.
7. Bradshaw Z, Slade P. The effects of induced abortion on emotional experiences and relationships: A critical review of the literature. Clinical Psychology Review 2003; 23, pp. 929, 943-4, 948.
8. Cougle JR, Reardon DC, Coleman PK. Depression associated with abortion and childbirth: A long-term analysis of the NLSY cohort. Archives of Women’s Mental Health 2001; 3 (4) Supp. 2: 105.
9. Kent I, Greenwood RC, Loeken J, Nicholls W. Emotional sequelae of elective abortion. BC Medical Journal 1978 April; 20 (4): 118-119.
10. Ostbye T, Wenghofer EF, Woodward CA, Gold G, Craighead J. Health services utilization after induced abortions in Ontario: A comparison between community clinics and hospitals. American Journal of Medical Quality 2001 May; 6 (3): 99-106.
11. The figures in this table are derived from Table 3 in Fergusson et al.’s study.
12. Broen AN, Torbjorn M, Bodtker AS, Akeberg O. Reasons for induced abortion and their relation to women’s emotional distress: a prospective two-year follow-up study. General Hospital Psychiatry 2005; 27: 36-43.
The Heartless Bastards (Appendix C)
Melinda Tankard Reist
“Is There A Post-Abortion Syndrome?”—Emily Bazelon, NYT Magazine, January 21, 2007
“My God, what a bunch of heartless bastards populate these message boards”—” grn, April 10, 2007
Is there a Post-Abortion Syndrome?
I’m not sure. I don’t exactly know when a pattern of symptoms and suffering become a syndrome.
Is there hatred and contempt for women who have had abortions and suffer afterwards?
In a research paper published last year titled “Women and Abortion: An Evidence-Based Review,” which drew from the available medical literature on the subject, my organisation, Women’s Forum Australia (www.womensforumaustralia.org) found “Ten to twenty percent of women suffer from severe negative psychological complications after abortion.” Our research showed “depression and anxiety are experienced by substantial numbers of women after abortion.” After abortion “women have an increased risk of psychiatric problems including bipolar disorder, neurotic depression, depressive psychosis and schizophrenia.”
In regard to Post Abortion Syndrome, we found “for a small proportion of women, abortion triggers Post-Traumatic Stress Disorder.” Syndrome or not (and others may well demonstrate there is a syndrome, in this symposium) an increased risk of bipolar disorder, depression, psychosis and schizophrenia is pretty damn serious. You don’t want to get any of these.
But the question of a “Syndrome” isn’t what interests me most at this time.
What interests me are the heartless bastards.
The world appears to be populated by heartless bastards. I’m not sure it would make any difference if a post-abortion syndrome was established.
The response I fear would be the same—dismissal, mockery, contempt and blame.
Why am I so cynical?
It’s something I’ve observed over many years of collecting the stories of women. Some of these personal accounts appeared in my first book Giving
Sorrow Words: Women’s Stories of Grief After Abortion (on a happier note, recently published in the U.S. by Acorn books and available through the Elliott Institute). Many hundreds more women have contacted me since then.
When the book was published in Australia in 2000, critics wrote things like: “Abortion can be an emotional subject—particularly for people who choose to get upset about it. There is a movement taking hold called: ‘I’ll always regret what I did and want to burn in hell for it.’”
The women in my book were mocked as whiners and complainers, attention seeking, unsuited to the real world. They were depicted as a pathetic minority (the especially dismissive critics said 2 percent, others 10 percent)— as though there is some percentage below which we ignore suffering.
But it is a more recent experience that causes me to ponder the callousness of many to exquisite suffering.
I interviewed a woman who had undergone a termination. It was a harrowing account, full of darkness, mental affliction, and anguish. She had been pressured to have a termination she didn’t really want. It seemed there was no way out at the time. Now she was seeking a way out with a noose. I posted the story on line. The vehemence of the responses took me aback. The reaction to the article was swift. The bulk of messages posted to the site were brutal. The story was an invention. The woman was foolish for not using birth control. She lacked control. She was trying to blame others. She needed a more “pragmatic” outlook. She was depicted as a silly, emotional girl who was wasting everyone’s time.
There were a smattering of supportive messages, little lights flickering in a sea of cruelty.
A woman who identified herself by the sign-in name “61”: “That’s right.
A woman is assaulted. Blame the woman.”
Wrote “grn”: “My God, what a bunch of heartless bastards populate these message boards.”
I was very grateful to “61” and “grn”. In a few words they captured the cruelty of the majority of posters.
Those identifying themselves as “pro-choice” seemed more concerned with defending abortion than with the exquisite suffering of this woman—and so many others.
But no, you can’t question abortion as a straightforward, morally unproblematic and unmitigated good for all women everywhere. Even those who are firmly on the pro-choice side find themselves hammered when they do.
At a women’s health conference in Canberra a few years ago, the speakers had talked about abortion as a “fertility control strategy,” about removing the “embryonic implant,” about pregnancy as “oppression.” The status of the foetus was “irrelevant,” they said.
A woman rose in the audience, clearly agitated. She was, she said, “facing a conflict between her politics and the reality of removing quite wellformed foetuses from women.” Working in a Sydney abortion clinic for the past year, she felt no one was facing what abortion was really about, she had difficulty advocating for it, she felt it violated women’s bodies too. And it was one thing to be pro-choice—it was another to deal with dead babies every day.
The reaction was brisk. She was told she had no right to express such doubts, that she was merely the provider of a service, that her personal feelings shouldn’t come into it. The woman left the room and I didn’t see her again.
The New York Times piece also provides evidence of the see-no-evil, hear-no-evil approach to abortion provision.
Observes ex-Planned Parenthood social worker Ava Torre-Bueno: “But then what you hear in the movement is ‘Let’s not make noise about this’ and ‘Most women are fine, I’m sure you will be too.’ And that is unfair.” Torre-Bueno, solidly pro-choice but admitting abortion involves pain and needs grieving, published a book in 1994 called Peace After Abortion. She approached Planned Parenthood to ask if they would host a book launch for her. The director said no. “He called me a ‘dupe of the antis,’” she remembers.
Planned Parenthood also stopped sending referrals to Charlotte Taft, who ran a clinic for 17 years which didn’t ram women through to the abortion table assembly-line style. She resigned when the owner of the clinic she directed decided to run a more “traditional practice.”
Then there’s Aspen Baker, who expected counselling after an abortion she had at 23. But there wasn’t any. She volunteered at California NARAL “and tried to talk about the sadness she was feeling. No one seemed receptive.” Why acknowledge a woman’s grief and pain when you can thump them with a slogan?
The Bazelon piece tells us that when a group of abortive women gathered at the Supreme Court with banners saying “I Regret my Abortion,” “two dozen people in NOW and NARAL T-shirts chanted: “Right to life, that’s a lie. You don’t care if women die,” and “You get pregnant, let me know. Anti-choicers got to go.”
Abortion grief is greeted with well-worn chants. Slogans have become a substitute for an honest examination of how women fare after abortion. I hope the heartless bastards don’t win.
Melinda Tankard Reist is author of Giving Sorrow Words: Women’s Stories of Grief After Abortionand Defiant Birth: Women Who Resist Medical Eugenics. She is also a founding director of Women’s Forum Australia, an independent women’s think tank (www.womensforumaustralia.org).
The Question Too Dangerous To Ask: What If Post-Abortion Syndrome Is Real? (Appendix C)
Vincent M. Rue, Ph.D., & Priscilla K. Coleman, Ph.D.
There is an old adage about cross-examination at trial: “Never ask the witness a question if you don’t know the answer.” Given Emily Bazelon’s legal training and undisclosed, yet strong, pro-abortion bias, her article—“Is There a Post-Abortion Syndrome?” in the January 21, 2007 New York Times Magazine—was clearly not an objective exploration but merely an attempt to discredit. But who discredited what?
Bazelon focused on post-abortion counselor Rhonda Arias, to frame the post-abortion-trauma debate as if this entire issue were some sort of religious conspiracy—rather than a matter of scientific and clinical experience. Bazelon found no support for this syndrome in the “bulk of the research,” despite being extensively briefed on the support for it by Priscilla Coleman (co-author of this article). Instead, Bazelon concluded that Post- Abortion Syndrome (PAS) is merely a convenient psychological “dumping ground” on which women can blame all their suffering. Nevertheless, throughout the article, the voices of women traumatized by their abortions resounded loudly, including that of Arias (who attempted suicide following her abortion). Blaming the victim is an old ploy, patronizing and unacceptable in today’s world. If we can’t trust what women disclose about their pain and suffering, those of us in the medical and psychological sciences should simply fade away as rusting relics of pseudo-compassion.
Bazelon would have penned her last article if she had implied that women who were raped should not be believed if they attributed their traumatic suffering to their rape.
The meaningful question Bazelon didn’t ask is: What if Post-Abortion Syndrome is real? What would this mean as a public-health concern? What would this mean to Planned Parenthood and those who perform abortions daily? What would this mean for informed consent and malpractice liability? What would this mean to the millions of women around the world who have had an abortion or are thinking of doing so? If PAS is real, then the consequences are serious and far-reaching. And—tragically—it is real.
Not surprisingly the three primary opponents of the idea of Post-Abortion Syndrome—Nancy Russo, Nancy Adler, and Brenda Major—are social, not clinical, psychologists. It’s likely they have never treated a woman who has had an abortion—yet they know when a clinical syndrome doesn’t exist! On the other hand, published pro-choice professional counselors Torre-Bueno, Baker, Rivera, Depuy and Dovitch, and others have affirmed that abortion can be traumatic and overwhelm some women’s ability to cope.1
Abortion as Trauma
Those of us who have either witnessed trauma or experienced it secondhand through disclosures in therapy know all too well that it is impossible to remain neutral. There are no sidelines on which to hide. Traumatic events are extraordinary, not because they occur infrequently, but because they overwhelm our ability to adapt. The essential characteristics of a traumatic event include the following: (1) the person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others; (2) the person’s response involved intense fear, helplessness, or horror. Delayed responses are also common. Abundant clinical and research evidence indicates that an induced abortion is an intentionally caused human death experience, and as such, is capable of precipitating psychological traumatization.2
The Evidence of Post-Abortion Syndrome
The first clinical evidence of PAS was presented in testimony before Congress in 1981, although many other mental-health experts had previously identified significant emotional harms following abortion. At the least, a fair understanding of the post-abortion literature by any reporter requires a careful read of the latest review articles in professional journals.3 Bazelon did not do this. Accordingly, we have provided a compendium of some of the compelling research that should have been identified by her. See Table 1.
Finally, Bazelon raised the issue that even if abortion has adverse emotional outcomes, the science supporting PAS doesn’t “prove” that abortion caused psychological injury. Michaels and Monforton challenge such tactics in general, and demonstrate how opponents of public health and health regulations often try to “manufacture uncertainty” by questioning the validity of scientific evidence on which regulations are based.4 This strategy has been used by the tobacco industry, and by other producers of hazardous products. Purveyors of this strategy use the label “junk science” to ridicule research that threatens powerful interests. According to the authors, the strategic plan developed by Hill and Knowlton to dispute regulations on or warning about smoking, and the so-called “cancer link,” used this very approach: “That cause-and-effect relationships have not been established in any way; that statistical data do not provide the answers; and that much more research is needed.” This sounds all too familiar in the abortion industry’s response, one echoed in Bazelon’s article. To them, no study can nor should ever justify regulatory measures for abortion. So too did the tobacco industry, until recently. The fact is, in medicine, psychology, public health, etc., absolute certainty is rarely derived from empirical studies. Determinations of causation are rarely definitive; they rely upon accumulated significant associations, controlling for as many variables as possible, using comparison groups, assessing effects over time, and assessing negative outcomes in statistical probabilities of health risk.
The ultimate injustice of Bazelon’s piece is that it politicizes PAS—and thereby dismisses the enormity of women’s and men’s suffering in the aftermath of abortion. This heightened insensitivity is startling given that every conceivable victim in society receives more attention and compassion.5 In another context, Bazelon’s strategy would be utterly shocking: It would be like trying to minimize the negative impact of war by attacking the legitimacy of post-traumatic stress disorder in soldiers. Whether denied, dismissed, or politically incorrect, the invisible and inconvenient injury of PAS remains. In the end, it is that cumulative toll of individual lives harmed that will render the decisive judgment about abortion’s fate.
Vincent M. Rue, Ph. D., is a psychotherapist and director of the Institute for Pregnancy Loss in Jacksonville, Florida. Priscilla K. Coleman, Ph.D., is a developmental psychologist and associate professor at Bowling Green State University in Bowling Green, Ohio.
1. See: Torre-Bueno, A. (1996). “Peace After Abortion.” San Diego: Pimpernel Press; Baker, A. (1995). “Abortion and Options Counseling.” Granite City, Ill: Hope Clinic; Rivera, M. (1998). “Abortion issues in psychotherapy.” In Beckman, L. & Harvey, S. (Eds.) The New Civil War: The Psychology, Culture, and Politics of Abortion. Washington, D.C.: American Psychological Association; and DePuy, C. & Dovitch, D. (1997). The Healing Choice. New York, NY: Simon & Schuster.
2. See: Rue, V. & Speckhard, A. (1991). “Post-abortion trauma: Incidence & diagnostic considerations.” Medicine & Mind, 6, 57-74; Speckhard, A. & Rue, V. (1992). “Postabortion syndrome: An emerging public health concern.” Journal of Social Issues, 42: 95-119; Burke, T. & Reardon, D. (2002). “Forbidden Grief: The Unspoken Pain of Abortion.” Springfield, IL: Acorn; Bagarozzi, D. (1994). Identification, assessment and treatment of women suffering from Post Traumatic Stress after abortion. Journal of Family Psychotherapy, 5: 25-54; Selby, T. (1990). The Mourning After: Help for Post-Abortion Syndrome. Grand Rapids, MI: Baker; Doherty, P. (ed.) (1995). Post-Abortion Syndrome: Its wide ramifications. Cambridge University Press: Cambridge; and Rue, V., Coleman, P., Rue, J., & Reardon, D. (2004). “Induced abortion and traumatic stress: A preliminary comparison of American and Russian women.” Medical Science Monitor, 10:SR 5-16.
3. See: Bradshaw, Z. & Slade, P. (2003). The effects of induced abortion on emotional experiences and relationships: A critical review of the literature. Clinical Psychology Review, 23:929-958; Coleman, P., Reardon, D., Strahan, T. & Cougle, J. (2005). The psychology of abortion: A review and suggestions for further research. Psychology and Health, 20:237-271; and Coleman (2005). Induced abortion and increased risk of substance abuse: A review of the evidence. Current Women’s Health Reviews, 1:12-34.
4. Michaels, D. & Monforton, C. (2005). Manufacturing uncertainty: Contested science and the protection of the public’s health and environment. American Journal of Public Health, 95:S39-S47.
5. See: Grossman, M. (2006). Unprotected. NY: Penguin, chapter 6.
Table 1: Research on Mental Health Risks of Induced Abortion
|Coleman, P. K., Reardon, D. C., Rue, V., & Cougle, J. (2002). “State-funded abortions vs. deliveries: A comparison of outpatient mental health claims over four years.” American Journal of Orthopsychiatry, 72, 141-152.||Women who aborted (n=14,297) or delivered a child (n=40,122) while receiving medical assistance from the state of California (Medi-Cal) in 1989 and who had no psychiatric claims for 1 yr prior to pregnancy resolution. Delivery group had no subsequent abortions.||• Within 90 days after pregnancy resolution, the abortion group had 63% more total claims than the birth group, with the percentages equaling 42%, 30%, 16%, and 17% for the 1st 180 days, yr 1, yr 2 and across the full 4-yr study period respectively.
• Across the 4 yrs, the abortion group had 21% more claims for adjustment reactions than the birth group, with the percentages equaling 95%, 40%, and 97% for bipolar disorder, neurotic depression, and schizophrenia respectively.
|Coleman, P. K., Reardon, D. C., Rue, V., & Cougle, J. (2002). “History of induced abortion in relation to substance use during subsequent pregnancies carried to term.” American Journal of Obstetrics and Gynecology, 187, 1673-1678.||Women who carried a pregnancy to term with a history of one prior abortion (n=74) were compared to women with one prior birth (n=531) and no prior pregnancies (n=738).||• Compared with women who had previously given birth, women who aborted were significantly more likely to use marijuana (929%), various illicit drugs (460%), and alcohol (122%) during their next pregnancy. Results with only first-time mothers were similar.
• Differences between the abortion group and the prior birth and no prior pregnancy groups relative to marijuana and use of any illicit drug were more pronounced among married and higher income women and when more time had elapsed since the prior pregnancy.
• Differences relative to alcohol use were most pronounced among the white women and when more time had elapsed since the prior pregnancy.
|Cougle, J., Reardon, D. C., & Coleman, P. K. (2003). “Depression associated with abortion and childbirth: A long-term analysis of the NLSY cohort.” Medical Science Monitor, 9, CR105- 112.||First pregnancy event of either an abortion (n=293) or delivery (n=1,591) between 1980 and 1992.||• Women whose 1st pregnancies ended in abortion were 65% more likely to score in the “high-risk” range for clinical depression.
• Differences between the abortion and birth groups were greatest among the demographic groups least likely to conceal an abortion (White: 79% higher risk; married: 116% higher risk; 1st marriage didn’t end in divorce: 119% higher risk).
|Coleman, P. K., Reardon, D. C., & Cougle, J. (2002). “The quality of the caregiving environment and child developmental outcomes associated with maternal history of abortion using the NLSY data.” Journal of Child Psychology and Psychiatry and Allied Disciplines, 43, 743-758.||Mothers with (n=672) and without a history of abortion (n=4,172) prior to childbirth, with children between the ages of 1 and 13 yrs.||• Lower emotional support in the home among 1st born 1-to-4-year-olds of mothers with a history of abortion.
• When there was a history of abortion, children (2nd & 3rd born. 1 to 4-yr-olds) of divorced mothers experienced lower levels of emotional support than children of nondivorced women. Decreased emotional support was not observed among children of divorced women with no history of abortion.
• More behavior problems among 5- to-9-yr-olds of mothers with a history of abortion.
|Coleman, P. K., Reardon, D. C., & Cougle, J. (2005). “Substance use among pregnant women in the context of previous reproductive loss and desire for current pregnancy.” British Journal of Health Psychology, 10, 255- 268.||Women with a history of abortion (n=280), miscarriage (n=182), and stillbirth (n=30) were compared to women without the respective forms of loss: no miscarriage, n= 221; no abortion, n=144: no stillbirth, n= 371. Comparisons were also made between women who reported wanting a recent pregnancy (n= 306) and those who reported not wanting it (n=344).||• No differences were observed in the risk of using any of the substances measured during pregnancy relative to a prior history of miscarriage or stillbirth.
• A prior history of abortion was associated with a significantly higher risk of using marijuana (201%), cocaine-crack (198%), cocaine other than crack (406%), any illicit drugs (180%), and cigarettes (100%).
• No differences were observed in the risk of using various substances relative to pregnancy wantedness, with the exception of the risk of cigarette use being higher when pregnancy was not wanted (90%).
|Coleman P. K., Maxey C. D., Rue V. M, Coyle C. T. (2005). “Associations between Voluntary and Involuntary Forms of Perinatal Loss and Child Maltreatment among Low-Income Mothers.” Acta Paediatrica, 94.||The 518 participants included 118 abusive mothers, 119 neglecting mothers, and 281 mothers with no history of child maltreatment. Reproductive loss information: 100 women had a history of one abortion and 99 had a history of one miscarriage/ stillbirth.||• Compared to women with no history of perinatal loss, those with 1 loss (voluntary or involuntary) had a 99% higher risk for child physical abuse.
• Compared to women with no history of induced abortion, those with 1 prior abortion had a 144% higher risk for child physical abuse.
• A history of 1 miscarriage/stillbirth was not associated with increased risk of child abuse.
• Perinatal loss was not related to neglect.
|Coleman, P. (2006). “Resolution of Unwanted Pregnancy During Adolescence Through Abortion versus Childbirth: Individual and Family Predictors and Consequences.” Journal of Youth and Adolescence.||Adolescents in grades 7-11 who experienced an unwanted pregnancy that was resolved through abortion (n=65) or delivery (n=65).||• After implementing controls, adolescents with an abortion history, when compared to adolescents who had given birth, were 5 times more likely to seek counseling for psychological or emotional problems, 4 times more likely to report frequent sleep problems, and they were 6 times more likely to use marijuana.|
|Coleman P., Rue V., Coyle C., & Maxey C. (2007). “Induced Abortion and Child- Directed Aggression Among Mothers of Maltreated Children.” Internet Journal of Pediatrics and Neonatology, 6 (2).||237 mothers who were residents of Baltimore and were receiving Aid to Families with Dependent Children. Women with and without a history of abortion were compared relative to childdirected physical aggression. All of the women had a history of child maltreatment.||• Abortion history was associated with significantly more frequent maternal slapping, hitting, kicking/ biting, beating, and use of physical punishment in general.|
|Conklin, M. & O’Connor, B. (1995). “Beliefs about the fetus as a moderator of post-abortion psychological wellbeing.” Journal of Social Psychiatry, 39, 76-81.||817 women, 132 of whom had a least one abortion and 21 of whom had 2 or more abortions.||• Abortion was found to be associated with compromised self-esteem, decreased life satisfaction, and negative emotions among women who believed in the humanity of the fetus.
• Women who even slightly disagreed that fetuses are human scored lower on the well-being variables than women who responded with a higher level of disagreement.
• On the Beliefs About the Fetus scale, the potential range of scores was from 1-7, with higher scores indicative of endorsement of the fetus as human. Women who aborted had a mean score of 3.42 (SD=1.40).
|Cougle, J., Reardon, D. C., Coleman, P. K., & Rue, V. M. (2005). “Generalized anxiety associated with unintended pregnancy: A cohort study of the 1995 National Survey of Family Growth.” Journal of Anxiety Disorders, 19, 137- 142.||First pregnancy event of either an abortion (n=1,033) or delivery (n=1,813). All were unintended pregnancies.||• The odds of experiencing subsequent Generalized Anxiety was 34% higher among women who aborted compared to women who delivered.
• Differences between the abortion and birth groups were greatest among the following demographic groups: Hispanic 86% higher risk; unmarried at time of pregnancy: 42% higher risk; under age 20: 46% higher risk.
|David, H., Rasmussen, N., & Holst, E. (1981). “Post-abortion and postpartum psychotic reactions.” Family Planning Perspectives, 13, 88-91.||Danish study of over 27,000 women with an abortion history compared to over 71,000 women who carried to term.||• The overall rate of psychiatric admission was 18.4 and 12.0 per 10,000 for women with a history of abortion and delivery respectively.
• Among divorced, separated, or widowed women, the rate of psychiatric admission was 63.8 and 16.9 per 10,000 for women with a history of abortion and delivery respectively.
|Fergusson, D. M., Horwood, J., & Ridder, E. M. (2006). “Abortion in young women and subsequent mental health.” Journal of Child Psychology & Psychiatry, 47, 16-24.||520 women formed 3 groups (never pregnant; pregnant no abortion; pregnant abortion).||• For all outcomes (except alcohol dependence) rates of disorder did not differ significantly between the never pregnant and pregnant no abortion groups.
• Compared to the never pregnant group, those who had abortions scored significantly on depression, anxiety, suicidal behaviors, and substance use disorders.
|Gilchrist, A. C. et al. (1995). “Termination of pregnancy and psychiatric morbidity.” British Journal of Psychiatry 167:243-8.||13,261 women with an unplanned pregnancy requesting an abortion in the UK at multiple sites; 6,410 had abortions; 6,151 continued their pregnancies; 379 were refused abortion; 321 chose abortion but changed their mind.||• Among women with no history of psychiatric illness, the rate of deliberate selfharm was significantly higher after abortion than childbirth.|
|Gissler, M., Kauppila, R., Merilainen, J., Toukomaa, H., & Hemminki, E. (1997). “Pregnancy associated deaths in Finland 1987-1994 definition problems and benefits of record linkage.” Acta Obstetricia et Gynecologica Scandinavica, 76, 651 657.||Death certificates of all fertile-aged women who died in 1987-94 in Finland (n=9,192) were linked to Birth, Abortion, and Hospital Discharge Registers. 281 deaths were identified.||• Post-pregnancy death rates within one year were nearly 4 times greater among women who aborted their pregnancies than among women who delivered their babies.|
|Gissler, M., Berg, C., Bouvier-Colle, M., Buekins, P. (2004). “Pregnancyassociated mortality after birth, spontaneous abortion, or induced abortion in Finland, 1987-2000.” American Journal of Obstetrics and Gynecology, 190, 422-427.||Population-based retrospective cohort study from Finland for a 14-yr period from 1987- 2000. Deaths of women aged 15-49 were linked with Birth, Abortion, and Hospital Discharge Registers.||• The mortality was lower after a birth (28.2 per 100,000) than after an induced abortion (83.1 per 100,000).|
|Gissler, M., Berg, C., Bouvier-Colle, M., Buekins, P. (2004). “Injury, deaths, suicides and homicides associated with pregnancy, Finland, 1987-2000.” European Journal of Public Health 15, 459-463.||Population-based retrospective cohort study from Finland for a 14-yr period from 1987-2000. Deaths of women aged 15-49 were linked with Birth, Abortion, and Hospital Discharge Registers.||• All external causes mortality rate was 6 times higher for abortion compared to birth.
• Abortion was associated with a 10 times higher risk for homicide, a 6 times higher risk for suicide, and a 5 times greater risk for unintentional injuries when compared to birth.
|Harlow, B. L., Cohen, L. S., Otto, M. W., Spiegelman, D., & Cramer, D. W. (2004). “Early life menstrual characteristics and pregnancy experiences among women with and without major depression: the Harvard Study of Mood and Cycles.” Journal of Affective Disorders, 79, 167-176.||From a larger probability-based sample, 332 women who met DSM criteria for past or current depression and 644 women with no such history. Women with and without a history of abortion were examined.||• Compared to women with no history of induced abortion, those with two or more were 2-3 times more likely to have a lifetime history of major depression at study enrollment.
• When only antecedent induced abortions in comparison to no history of abortion, there was a threefold increased risk of developing depression later in life. Marital status did not moderate the relationship—same effect whether or not marries.
|Kero, A., Hoegberg, U., Jacobsson, L., & Lalos, A. (2001). “Legal abortion: A painful necessity.” Social Science and Medicine, 53, 1481-1490.||211 who participated in a larger project on men and women who use abortion services in Sweden. Women with one and multiple abortions were included.||• 46% indicated the abortion initiated a conflict of conscience.
• 56% chose both positive and painful words when describing their abortion-related emotions. The most frequently chosen words to describe the abortion included anxiety, relief, grief, guilt, anguish, release, emptiness, responsibility, shame, and injustice.
• 33% chose words conveying only pain.
|Major, B., Cozzarelli, C., Cooper, M. L., Zubek, J., Richards C., Wilhite, M., & Gramzow, R. H. (2000). “Psychological responses of women after first trimester abortion.” Archives of General Psychiatry, 57, 777-784.||442 women who aborted at one of 3 abortion providers (1 physician and 2 free-standing) in Buffalo, NY.||• Across time, relief and positive emotions declined and negative emotions increased; depression levels decreased from T1 to T2, but increased from T2 to T3 and from T3 to T4.
• Two years post-abortion, 28% were not satisfied with their decision, 31% would not have the abortion again, and 20 % were depressed.
• Younger age and having more children pre-abortion predicted more negative post-abortion outcomes.
|Mufel, N., Speckhard, A., & Sivuha, S. “Predictors of Posttraumatic Stress Disorder Following Abortion in a Former Soviet Union Country.” Journal of Prenatal & Perinatal Psych & Health,17, 41-61 (2002).||150 randomly selected women who had abortions in Belarus (former Soviet republic).||• Posttraumatic consequences of abortion (elevated avoidance, intrusion, or hyper-arousal scores): 35%
• Evidence of PTSD, exceeding the cut-offs for both intrusion and avoidance subscales: 46%
• PTSD, exceeding the cut-offs on all 3 subscales: 22%.
|Ostbye, T., Wenghofer, E. F., Woodward, C. A., Gold, G., & Craighead, J. (2001). “Health services utilization after induced abortions in Ontario: A comparison between community clinics and hospitals.” American Journal of Medical Quality, 16, 99-106.||Patients who had induced abortions (n=41,039) performed in hospitals or community clinics and an age-matched cohort of 28,220 women who did not undergo an abortion.||The results revealed that health services utilization for psychiatric problems was 165% greater for the women with a history of abortion compared to the control group.|
|Reardon, D. C., & Coleman, P. K. (2006). “Relative Treatment Rates for Sleep Disorders Following Abortion and Childbirth: A Prospective Record-Based Study.” Sleep, 29, 105-106.||15,345 women who had an induced abortion and 41,479 women who delivered and had no known subsequent history of induced abortion while receiving medical assistance from the state of California (Medi-Cal) in 1989 and who had no sleep claims for 1yr prior to pregnancy resolution. Delivery group had no subsequent abortions.||Women were more likely to be treated for sleep disorders following an induced abortion compared to a birth. The difference was most pronounced in the first 180 days post pregnancy resolution and was not significant after the third year. Specifically, there was an 85% higher risk for sleep disorders associated with abortion at 180 days and increased risks of 68%, 40%, 41%, and 29% for the 1st year, 2nd year, 3rd year, and across the full 4-year study period respectively.|
|Reardon, D. C., Cougle, J., Rue, V. M., Shuping, M., Coleman, P. K., & Ney, P. G. (2003). “Psychiatric admissions of low-income women following abortion and childbirth.” Canadian Medical Association Journal, 168, 1253- 1256.||Women who aborted (n=15,299) or delivered a child (n=41,442) while receiving medical assistance from the state of California (Medi-Cal) in 1989 and who had no psychiatric claims for 1 yr prior to pregnancy resolution.||• Within 90 days after pregnancy resolution, the abortion group had 160% more total claims than the birth group, with the percentages equaling 120%, 90%, 111%, 60%, 50%, and 70% for the 1st 180 days, yr 1, yr 2, yr 3, yr 4, and across the full 4-yr study period respectively.
• Across the 4-yrs, the abortion group had 110% more claims for adjustment reactions than the birth group, with the percentages equaling 90%, 110%, and 200% for depressive psychosis, single and recurrent episode, and bipolar disorder respectively.
|Reardon, D. C., Cougle, J., Ney, P. G., Scheuren, F., Coleman, P. K., & Strahan, T. W. (2002). “Deaths associated with delivery and abortion among California Medicaid patients: a record linkage study.” Southern Medical Journal, 95, 834-884.||Delivery group had no subsequent abortions. Women who aborted or delivered while receiving medical assistance from the state of California (Medi-Cal) in 1989 and died between 1989 and 1997 (n=1,713).||• With adjustments for age, women who aborted when compared to women who delivered were 62% more likely to die from any cause. More specific percentages are given below. Violent causes: 81%; Suicide: 154%; Accidents: 82%; All natural causes: 44%; AIDS: 118%; Circulatory disease: 187%; Cerebrovascular disease: 446%; Other heart diseases; 159%
• Similar results were obtained when prior psychiatric history was controlled as well.
|Reardon, D. C., Coleman, P. K., & Cougle, J. (2004). “Substance use associated with prior history of abortion and unintended birth: a national cross sectional cohort study.” American Journal of Drug and Alcohol Abuse, 26, 369-383.||Women with prior histories of delivering an unintended pregnancy (n=535), abortion (n=213), or no pregnancies (n=1144).||• Compared to women who carried an unintended first pregnancy to term, those who aborted were 100% more likely to report use of marijuana in the past 30 days and 149% more likely to use cocaine in the past 30 days (only approached significance). Women with a history of abortion also engaged in more frequent drinking than those who carried an unintended pregnancy to term.
• Except for less frequent drinking, the unintended delivery group was not significantly different from the no pregnancy group.
|Rue, V. M., Coleman, P. K., Rue, J. J., & Reardon, D. C. (2004). “Induced abortion and traumatic stress: A preliminary comparison of American and Russian women.” Medical Science Monitor 10, SR 5-16.||Russian (n=331) and U.S. (n=217) women who had experienced one or more abortions and no other forms of loss.||• U.S. women reported more stress, PTSD symptoms, and other negative effects than Russian women.
• Russian women scored higher on the Pearlman Traumatic Stress Institute Belief Scale, indicating more pronounced disruption of basic needs impacted by trauma (safety, trust, self-esteem, intimacy, and selfcontrol).
• No differences were observed relative to perceptions of positive effects (improved partner relationships, feeling better about oneself, relief, feelings of control.
• The percentages of Russian and U.S. women who experienced 2 or more symptoms of arousal, 1 or more symptom of reexperiencing the trauma, and 1 or more experiences of avoidance (consistent with DSM-IV diagnostic criteria) were equal to 13.1% and 65% respectively.
|Söderberg, H., Janzon, L. and Sjöberg, N.O. (1998). “Emotional distress following induced abortion: a study of its incidence and determinants among abortees in Malmö, Sweden.” European Journal of Obstetrics and Gynecology and Reproductive Biology 79, 173-178.||Swedish study of 854 women one year after an abortion.||• 50-60% of the women experienced emotional distress of some form (e.g., mild depression, remorse or guilt feelings, a tendency to cry without cause, discomfort upon meeting children), classified as severe in 30% of cases.
• 76.1% said that they would not consider abortion again (suggesting indirectly that it was not a very positive experience).