The results of a large body of research suggest abortions do not have a negative effect on women’s mental health, despite claims from anti-abortion groups and state legislatures.1

The authors of a new paper noted the reasons why women decide to undergo an abortion include many mental health risk factors, such as poverty, lack of social supports, domestic violence, rape, incest, pre-existing mental illness, and lack of education. But post-abortion, women’s mental health status does not deteriorate, although stress levels might increase if they experience barriers in obtaining the abortion.1

“The main gist of the paper is, ‘Don’t believe anyone who tells you that abortion causes mental illness or impairs anybody’s psychiatric well-being,’” says Nada Stotland, MD, MPH, professor of psychiatry at Rush Medical College in Chicago. Stotland researches psychiatric issues surrounding abortion. She also is the former (2008-2009) president of the American Psychiatric Association. “There is evidence, going back decades, that having an abortion in and of itself does not cause anybody to have a psychiatric illness, and rarely causes anybody to even have any significant prolonged negative psychological outcome.”

For women who have undergone an abortion, the most common reaction is relief, Stotland says. “Some people may feel guilty. Some people may feel sad, but not clinically depressed. I’ve said in some hearings that if 50% of marriages end in divorce, I think there are a lot more people regretting getting married than having abortions. Are you going to make it harder for people to get married?”

While there are people who will say they are sorry for their abortion, if they are asked if they would still have obtained an abortion if in the same circumstances and could do it over, they say they would do it again. “Maybe they wish they had a child now that they have education, income, and steady support of their living situation,” Stotland says. “But when you say, ‘Was that the wrong decision at the time?’ they say, ‘No, that was the best decision I could do at the time,’ and there’s no evidence of traumatic, lasting regrets.”

In the 1980s, Surgeon General Everett Koop reported extensive research into legalized abortion, finding that the risk of a woman dying was 25 times greater with giving birth than with abortion.2

According to 2013 reports (after Koop’s death), Koop had refused to prepare a report that detailed negative mental health effects of abortions, despite pressure from President Reagan. Koop had written to Reagan that scientific experts and evidence suggested the negative health effects were not as conclusive as Reagan hoped.3

“Reagan appointed Koop as surgeon general and ordered him to report on the impact of abortion on women in America,” Stotland says. “He was expected to write a kill report. But it turned out that Dr. Koop could have been very against abortion, but was not a liar.”

Stotland, who was a committee chair with the American Psychiatric Association in the 1980s, was asked to review literature and speak at a hearing, held by Koop, on abortion. After the hearing, Koop refused to write a report that made unsubstantiated claims about abortion’s mental health effect on women, she explains.

Despite the lack of solid, evidence-based data on causative links between abortion and mental illness, some states require abortion providers to tell patients of the risk of depression, suicide, substance use, and other issues. “There is no other medical procedure in which the state tells doctors and providers which words they have to tell patients about the procedure,” Stotland says.

There also are no parallels to how some states require providers to take an ultrasound of the woman’s embryo and make her look at it, she adds.

“I was a psychiatric consultant in OB/GYN and psychiatric medicine, and there’s no other similar situation,” Stotland says. “It is much more important for women’s mental health to be able to get abortions when they need them, and it’s deleterious to their mental health to put barriers in their way. All the obstacles only increase the stress on your patient. You can reassure the patient that once she decides this is what she has to do with her life, she can rest assured that [having an abortion] will not increase any psychiatric condition.”

REFERENCES

  1. Stotland NL, Shrestha AD, Stotland NE. Reproductive rights and women’s mental health: Essential information for the obstetrician-gynecologist. Obstet Gynecol Clin North Am 2021;48:11-29.
  2. More on Koop’s study of abortion. Fam Plann Perspect 1990;22:36-39.
  3. Heyman R. C. Everett Koop, surgeon general who rebuffed Reagan on abortion, dies. MIC. Feb. 26, 2013.