Mental health community protests abortion pain

Spending a day shopping can be an excruciating exercise in decisions and reflections on what I can and can’t afford. Lots of friends find shopping relaxing and fun. Others go way overboard and buy things they know they’ll have to return. Some are very methodical with lists–they never forget their cloth bags at the grocery store. At times you may fit into any or all of the above groups. My point is there is no universal reaction to the common female experience of shopping.

So how can mental health professionals say that 55 million abortions have left women with a uniform emotional reaction? And how could abortion possibly be a uniquely positive event in every woman’s emotional and spiritual life?

By taking such a bizarre stand, the mental health community protests too much. For example, this report on a story from the Journal of Psychiatric Research (JPR) concludes that research in 2009 finding emotional trouble after abortion is “false”. There was no qualifier attached to the dismissal of the evidence–the official position is that there is a unilateral response to abortion from women which is devoid of emotional problems. Hence, as Mercator reports, no evidence of the detrimental impact on abortion will be presented at an upcoming international conference:

“In July of this year, there will be an international congress of the Royal College of Psychiatrists in Liverpool. The abortion and mental health presentations will be given by Ian Jones, Rock Cantwell and Trine Munk-Olsen. Professors Fergusson and Coleman will not be presenting. Given that there is good evidence to show that some women are hurt by abortion, it is surprising that there will be such a one-sided presentation that aims to influence psychiatrists from many countries.”

The helping profession has painted itself into a corner. In 2008 the American Psychological Association essentially blamed women for their mental health problems following abortion:

“The task force found that some studies indicate that some women do experience sadness, grief and feelings of loss following an abortion, and some may experience “clinically significant disorders, including depression and anxiety.” However, the task force found “no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.”

You see? If a woman is depressed or anxious after abortion, it’s because . . . she’s depressed or anxious.

A simple search of the JPR archive turns up this 1997 review of a book on Counselling for Loss by Verena Tschudin, RGN, RM, DipCouns, BSc(Hons), MA, Editor, Nursing Ethics; Lecturer/Tutor in Nursing Ethics, University of Surrey, UK:

“Description
This practical, readable book uses a “Four Questions Model” and scenarios to illustrate the appropriate counselling for a variety of situations. Includes coverage of loss of a life partner, loss of a parent, loss of a child, abortion and miscarriage, [emphasis added] infertility, loss of health, divorce and separation, loss of a career, loss of a home, loss of a pet, loss of youth and independence, loss of beliefs and values, and more. Written by a highly acclaimed author, the book includes complete references and suggestions for further reading.”

Maybe the APA members and JPR editors and those attending the upcoming conference should look beyond the research they have rejected out of hand and employ the common sense needed to see that abortion can be at least as painful to a woman as pet loss or lost youth.

The millions of women in need of help deserve at least that much instead of the double bind of blaming them for their distress.

 

Please note: I reserve the right to delete comments that are offensive or off-topic.

Leave a Reply

Your email address will not be published. Required fields are marked *

5 thoughts on “Mental health community protests abortion pain

  1. I’m curious about this question, “So how can mental health professionals say that 55 million abortions have left women with a uniform emotional reaction?” Which mental health professionals say that? It’s not something I’ve ever seen. I just did a quick Google search and found a counseling page from Planned Parenthood that describes a variety of reactions to abortion (https://www.plannedparenthood.org/western-pennsylvania/counseling-services-36356.htm). The page describes what I take to be the standard clinical view, which is that some women do feel depressed or anxious after abortion and that they might benefit from mental health services.

    Separately, I don’t have the same interpretation of “the task force found ‘no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors'”, that saying such amounts to blaming depressed or anxious women for their depression or anxiety. Absence of evidence (of a causal relationship) is not evidence of absence after all, and the APA is not saying that. As a science-based organization, the APA is just stating that there’s not sufficient evidence to establish a causal connection. The fact is that it’s in principle near impossible to establish such a causal relationship, because no reasonable person (for sound moral reasons) would support a randomized controlled trial on abortion and even if someone did run such a study, there couldn’t be blinding so there’d still be tons of room for confounding. This methodological problem isn’t unique to abortion, it’s a general limitation of establishing causality that the social sciences have to face.

    Also, which research do you think is being rejected “out of hand”? The reports I’ve read from the APA have seemed quite thorough in the literature they’ve covered, and where they haven’t accepted the interpretations that anti-abortion activists would favor, it’s for reasons based in widely accepted standards of evidence in the social sciences.

    • Jason, from the APA 2008 study:

      Across studies, prior mental health emerged as the
      strongest predictor of postabortion mental health
      (Major et al., 2000).

      http://www.apa.org/pi/women/programs/abortion/mental-health.pdf
      This is a subtle form of blame-shifting, “The only ones who suffer from what occurs are those who were impaired going in.”

      The reality is that abortion is a pregnancy loss and thus can trigger postpartum depression just as miscarriage and stillbirth do. http://www.cdc.gov/reproductivehealth/Depression/index.htm

      But NARAL and the APA says that is not the case by treating abortion as some separate event which has no relation to other reproductive loss issues except to compare grieving women with those who have experienced other pregnancy experiences. This quote from NARAL Montana is representative:

      Myth: Women who have abortions suffer from “Post Abortion Syndrome”
      Fact: It is rare for women to suffer long-term emotional problems after having an abortion–in fact, studies show that the rate of post-partum depression (depression after childbirth) is higher than the rate of serious depression after abortion. However, anti-choice activists have invented “post abortion syndrome”, and claim women who have had an abortion suffer from a set of emotional symptoms such as sever depression, anxiety, and guilt, in order to scare women and prevent them from choosing abortion. In 1989, the American Psychological Association convened a panel that found no evidence that such a condition exists. Instead, they found most women experience the most stress before choosing abortion.

      http://www.prochoicemontana.org/issues/abortion-myths/

      Research that flows from a flawed premise cannot reveal truth.

      • The lead sentence on the paragraph that contains “Across studies, prior mental health emerged as the strongest predictor of postabortion mental health (Major et al., 2000)” is “This review identified several factors that are predictive
        of more negative psychological responses following
        first-trimester abortion among women in the United
        States.” In that paragraph, the authors summarize their answer to the question about what most strongly predicts worser outcomes after abortion. (No judgment is being made about whether abortion itself causes mental health issues. That’s addressed elsewhere in the report.) The statement is a factual one based on the reviewed evidence; that is, of the factors that have been researched related to what best predicts mental health postabortion, prior mental health is top. There’s no value judgment being made, no person is being blamed.

        Consider: It’s not implausible that one would find the same about a lot of other things if one asked what most strongly predicted mental health after many other major life events. For instance, depression after a housing or job loss likely hits those who were depressed before harder than those who were not. It stands to reason that those with more psychological resiliency (i.e., those not depressed) would fare better. It would be strange indeed if one’s mental health after such events were not most strongly predicted by prior mental health. Besides, many of the women choosing abortion are doing so in unhappy circumstances (that themselves likely to contribute to the women’s mental health status). Those circumstances don’t magically change following abortion (partners don’t suddenly become committed, finanical statuses doesn’t turn around, etc.).

        Revisiting whether “mental health professionals say that 55 million abortions have left women with a uniform emotional reaction”, the APA report (2008) linked to above explicitly states that there is “variability in women’s psychological reactions following abortion.” And later, “Nonetheless, it is clear that some women do experience sadness, grief, and feelings of loss following termination of a pregnancy, and some experience clinically significant disorders, including depression and anxiety.”

        I doubt the researchers would argue that the psychological effects of abortion can’t be or are never like those linked to stillbirth or miscarriage. They do say the following after all, “Importantly, many of the same individual and interpersonal factors that predict how women will appraise, cope with, and react psychologically to abortion are also predictors of how women will appraise, cope with, and react psychologically to other types of stressful life events, including unwanted motherhood or relinquishment of a child for adoption.” As to why the comparison of abortion tends to be made between abortion and childbirth or giving a child up for adoption, I would only guess that it’s because these tend to be elective, unlike miscarriage and stillbirth.

        What do you think the flawed premise is? A conclusion of the researchers is certainly that there’s not sufficient evidence to make the claim that abortion uniquely causes negative psychological effects, but none claim that all women fare the same psychologically after abortion nor that they all fare well.

        • Here’a a response from Dr. Priscilla Coleman, one of the original researchers http://www.wecareexperts.org/content/dr-priscilla-coleman-responds-recent-media-attacks. She makes the point well–the who suffer after abortion are the ones being further hurt by the scientific community dismissing or “debunking” abortion as a mental health non-issue–and they are significant in number. She also notes that her findings have been published in the Journal of Psychiatric Research and the British Journal of Psychiatry to yawns from those who objected to her origianl findings, as well as the media which has reported the story.

          • I don’t get who is treating some women’s mental health problems following abortion as a “non-issue[s]”. The APA report explicitly acknowledges them as it points out that women experience a _variety_ (not uniformity) of reactions following abortion. Nobody’s claiming the the mental health problems experienced by some aren’t real, they’re just claiming abortion is not unique in being linked to them. I’m not sure why that’d be controversial.

            As a general matter, just because something is published in a peer reviewed journal doesn’t mean it establishes a rock solid fact. See the work of John Ioannidis for ample proof of that (https://en.wikipedia.org/wiki/John_P._A._Ioannidis). The peer review process isn’t perfect by a long shot and neither do single studies (or meta-analyses) establish facts, which is in part why debates rage on in journals for decades.

            As to the media being biased and improperly reporting results, I didn’t look into it, but I believe it. They’re just awful in the way they sensationalize and report almost everything, especially science.

            Finally, again to: “So how can mental health professionals say that 55 million abortions have left women with a uniform emotional reaction? And how could abortion possibly be a uniquely positive event in every woman’s emotional and spiritual life?” I still am not clear who is claming this. It strikes me as tilting at windmills.