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Clinical Depression After Unintended Pregnancy Linked ToAbortion

Springfield, IL (January 18, 2002) This weeks prestigious British Medical Journal reports that

women who abort a first pregnancy are at greater risk of subsequent long term clinical depression

compared to women who carry an unintended first pregnancy to term. Publication of the study

coincides with anniversary events related to the Supreme Courts January 22, 1973 Roe v. Wadedecision legalizing abortion.

Data from a national study of American youths, begun in 1979, was used to conduct the research. In

1992, a subset of 4,463 women were surveyed about depression, intendedness of pregnancy, andpregnancy outcome. A total of 421 women had had their first abortion or first unintended delivery

between 1980 and 1992.

An average of eight yeas after their abortions, married women were 138 percent more likely to be at

high risk of clinical depression compared to similar women who carried their unintended first

pregnancies to term. Among women who were unmarried in 1992, rates of high risk depression were

not significantly different. The authors suggest that the lack of significance in unmarried women maybe explained by the higher rate of nonreporting of abortions among unmarried women. Compared

with national averages, unmarried women in this study report only 30 percent of the expected

abortions compared with married women, who report 74 percent of the expected abortions. This may

make the results for married women more reliable, say the authors. Another explanation is thatunmarried women who are raising a child without the support of a husband experience significantly

more depression than their married counterparts.

Since shame, secrecy, and thought suppression regarding an abortion are all associated withgreater post-abortion depression, anxiety, and hostility, the authors conclude that the high rate of

concealing past abortions in this population (60 percent overall) would tend to suppress the full effect

of abortion on subsequent depression. Unreported abortions would result in women who experiencedepression following an abortion being misclassified as delivering women.

Given the very high rate of concealment of past abortions the fact that significant differences still

emerged suggests that we are just catching the tip of the iceberg, said David C. Reardon, Ph.D.,

the studys lead author.

Reardon, the director of the Elliot Institute in Springfield, Illinois, says the studys findings are

consistent with other recent research that has shown a four to six fold increased risk of suicide and

substance abuse associated with prior abortion. He says the findings are also important because

this is the first national representative study to examine rates of rates of depression many years after

an abortion, on average approximately eight years later in this sample.

The data set used was the same as that used by feminist psychologist Nancy Russo of Arizona

State University, whose examination of a self-esteem scale revealed no significant difference

between aborting women and women who carried to term. Russo concluded that the absence of

difference in self-esteem scores in this large national data set proved that abortion has no

substantial and important impact on womens well-being. (see critique of Russo studyhere.)

http://afterabortion.org/PAR/V3/n4/RUSSO.htmhttp://afterabortion.org/PAR/V3/n4/RUSSO.htmhttp://afterabortion.org/PAR/V3/n4/RUSSO.htmhttp://afterabortion.org/PAR/V3/n4/RUSSO.htm

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According to Reardon, Russos much publicized study has frequently been used to support the claim

that, on average, abortion has no significant effect on womens mental health. The Elliot Institutes

new analysis of the same data set reveals that significant differences do exist.

The most serious flaw of the Russo study is that the authors did not even comment on the

extraordinarily high rate of concealment of past abortions in the sample, Reardon said. Womenwho do not want to mention a past abortion are most likely the ones who will have unresolved

feelings of shame, guilt, or grief.

Reardon says that another problem with the prior analysis was that Russos team relied solely on a

measure of self-esteem that is not sensitive to post-abortion stress. He says the examination of

depression scores is more relevant to the known negative reactions to abortion.

Russos previous analysis of this data set was methodologically weak and was frankly a poor basis

on which to build the claim that abortion has no measurable effect on womens well- being, he said.The results of our reexamination of this data setespecially in combination with other studies

showing higher rates of suicide, substance abuse, and other mental health disorders associated with

prior abortionshows that the no effect hypothesis should be rejected. Something is going on

here. Where there is this much smoke, despite the problem of high concealment rates, there is likely

to be a fire beneath the haze.

Another important aspect of this study, says Reardon, is that is one of only a few studies to use any

pre-pregnancy psychological score as a control variable. The most commonly used control variable

used in regarding emotional reactions is pre-abortion evaluation on the day ofthe abortion whenthe woman is in the crux of emotional distress. This is why a pre-pregnancy score is much more

useful than a pre-abortion score for evaluating the independent effect of abortion on long term

emotional reactions.

Asked what the practical implications of this study are for physicians, Reardon said: We recommendthat physicians should routinely inquire about the outcome of all the patients pregnancies. The

simple question, Have you experienced any pregnancy losses such as miscarriage, abortion,

adoption, or stillbirth? may be sufficient to give women permission to discuss unresolved issues

related to prior pregnancy losses. Physicians should remember that there are few social contexts in

which women feel it is appropriate to discuss unresolved feelings about prior pregnancy loss. Many

patients will appreciate the opportunity to discuss their pregnancy losses with an empathetic person

and may welcome referrals for additional counseling.

The new study was funded by the Elliot Institute, a non-profit organization that is involved in

research and education regarding post-abortion complications and also promotes outreach and

counseling programs for women. Reardon is the author of numerous books on post-abortion issues,including The Jericho Plan: Breaking Down the Walls Which Prevent Post-Abortion Healing and

Making Abortion Rare: A Healing Strategy for a Divided Nation. His newest book, Forbidden Grief:The Unspoken Pain of Abortion, co-authored with Theresa Burke, will be published in March of

2002. Information on these titles and other research conducted by Dr. Reardon and the Elliot

Institute can be found at www.afterabortion.org.

KEY POINTS:

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* The association between abortion and subsequent depression persists over at least eight years.

* Screening patients for a history of abortion may help physicians to identify women who would

benefit by a referral to counseling.

* The null hypothesis (the conjecture that there are no differences on average between having anabortion and carrying an unintended pregnancy to term) is rejected.

Referenced Studies:Reardon DC, Cougle JR. Depression and unintended pregnancy in the National Longitudinal Survey

of Youth: a cohort study British Medical Journal, 324: 151-152. Full text available atwww.bmj.com.

Russo NF, Zierk K. Abortion, childbearing, and womens well-being. Professional Psychology:

Research and Practice, 1992; 23: 269-280.

A sample of references to studies finding abortion to be associated with subsequent substance

abuse and suicide attempts.

http://bmj.com/cgi/content/full/324/7330/151http://bmj.com/cgi/content/full/324/7330/151http://bmj.com/cgi/content/full/324/7330/151http://bmj.com/cgi/content/full/324/7330/151