Having Abortion Does Not Increase Risk of Developing Mental Disorder

A research design using participant matching overcomes limitations in previous research on the effects of abortion on mental health.

Shannon Peters
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A new study conducted in the Netherlands, published in the Journal of Psychiatric Research, investigates the effect of terminating an unwanted pregnancy on the development and recurrence of mental disorders. The results of the study, which used a matching design in order to addresses limitations in previous research, found that having an abortion did not increase the likelihood of developing a mental disorder.

Photo credit: Pexels
Photo credit: Pexels

“After 2.5-3 years post-abortion, we initially found differences in incidence of mental disorders in our unmatched and unadjusted data, but matching strongly attenuated the results by decreasing differences between the two cohorts. This implies that the initial differences in incidence of disorders in the 2.7 year period after the abortion, cannot be attributed to the event of the abortion (including the unwanted pregnancy); rather, they seem to be largely dependent on co-occurring variations in the measured covariates,” write the authors, led by Jenneke van Ditzhuijzen, a lecturer in the Department of Interdisciplinary Social Sciences at Utrecht University.

A woman’s decision to have an abortion is highly stigmatized. There have been many recent reviews of the evidence on whether having an abortion affects mental health and the overwhelming conclusion has been that studies to investigate this question contain a number of methodological issues. These issues include not having a robust and valid way to measure pre-existing mental health problems, not being able to control for confounding factors that may explain the development of a mental health disorder after an abortion, and using an inappropriate reference group.

The authors in the present study attempt to address these methodological limitations by designing a prospective cohort study with 1-to-1 matching. The researchers use this design to “investigate the incidence and recurrence of mental disorders after termination of an unwanted pregnancy.”

They matched 224 women who terminated an unwanted pregnancy to women who did not have this experience based on covariates (e.g., age, have children, ethnicity, religious, employment status, education level, childhood abuse). Data for women who terminated an unwanted pregnancy was gathered from the Dutch Abortion and Mental Health Study (DAMHS) and data for the reference group was from the Netherlands Mental Health Survey and Incidence Study-2, which had the same outcome variables as the DAMHS.

Women participated in two diagnostic interviews, about 2.5-3 years apart. For women who terminated an unwanted pregnancy, the first interview took place about 3-6 weeks after the abortion. The authors specifically investigated the incidence and recurrence of mood disorders, anxiety, substance abuse, and an overall measure of “any mental disorder.”

The researchers found that if covariates were not taken into account, the data showed that women who terminated an unwanted pregnancy were significantly more likely to develop a mental disorder. However, when women were matched based on covariates, there was no longer any significant difference in the incidence of a mood disorder, anxiety, substance abuse, or any mental disorder. This result demonstrates the importance of using a matching design to control for confounding factors.

The authors then examined rates of recurrence of a pre-existing mental disorder. After matching, the only significant finding was that women who terminated an unwanted pregnancy had higher rates of recurrence for the overall outcome measure of any mental disorder. The authors state, “the whole abortion experience (including the unwanted pregnancy) might slightly increase vulnerability for recurrence of mental disorders among women with a psychiatric history.”

However, the researchers recommend caution when interpreting this result, especially because the sample of women with recurring mental disorders was small (38 matches), and therefore less statistically reliable. They also cite evidence that women with a history of psychiatric diagnosis may experience more emotional burden with an unwanted pregnancy, and therefore it may be the pregnancy, and not the abortion itself that is connected to recurrence of a mental disorder. They concluded that “it is unlikely that these possible effects would be related to the abortion treatment only.”

 “Our findings confirm the importance of considering pre-existing differences between abortion and reference groups, as they strongly confound possible linkages between abortion and mental health,” write the researchers.

The authors recognize the diversity in women’s experiences and needs when terminating a pregnancy, but, based on the study findings, suggest that “women with a psychiatric history might benefit from extra attention” from abortion care providers. Women who choose to terminate an unwanted pregnancy face stigma and blame. The authors demonstrate how methodological decisions in research designs can either perpetuate or mitigate bias, and highlight the importance of thoughtful, rigorous studies when investigating the aftermath of having an abortion.

 

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van Ditzhuijzen, J., ten Have, M., de Graaf, R., Lugtig, P., van Nijnatten, C. H. C. J., & Vollebergh, W. A.  M. (2017). Incidence and recurrence of common mental disorders after abortion: Results from a prospective cohort study. Journal of Psychiatric Research, 84, 200-206. http://dx.doi.org/10.1016/j.jpsychires.2016.10.006 (Abstract) 

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Shannon Peters
MIA Research News Team: Shannon Peters is a doctoral student at the University of Massachusetts Boston and has a master’s degree in mental health counseling. She is particularly interested in exploring the impacts of medicalization and pathologizing the experiences of individuals who have been affected by trauma. She is engaged in research on the effects of institutional corruption and financial conflicts of interest on research and practice.

7 COMMENTS

  1. The problem is the nation, not the abortion. Women have had abortions since always, and will continue always. It’s a difficult reality of women’s reproductive lives.

    There’s little trouble to women in nations where they can have free or affordable abortions in safe settings. There’s a lot of risk (physically and mentally) to women in places where they’re forced to have abortions in unsafe settings where their lives are at risk and where getting an abortion is a financial hardship.

    The notion that women suffer long-term emotional effects from abortions was a straw man fantasy built by the anti-abortion movement to further its misogynist political aims, and was heavily funded by the Catholic Church. Too bad institutions have to waste money on studies to defend against this ridiculous fable.

    Liz Sydney

  2. It is been proven that women who decide to have an abortion are the most certain ones compared to other patients. That is because by the time they enter the clinic they have already gone though a mental battle with themselves as well as their family.
    The concept of women going through abortion will have mental problems is so outdated and assuming. While there might be some women who may regret later and have depression; there are women who feel relieved after the procedure. So it really depends upon the person and situation.

  3. Society tells young women like Karen that abortion will solve their problem. It says nothing about the problems abortion creates. Supporters of abortion claim it is a simple procedure with no lasting impact. And women who know better don’t discuss, certainly not publicly, how abortion changed their lives for the worse. They feel ashamed about the abortion and ashamed about their inability to ‘just deal with it’ as they think other women do. And so the deception continues. http://hopeafterabortion.com/?page_id=216

    Jade Rees isn’t the only woman to commit suicide after an abortion

    It’s no surprise that women can come to regret their abortions. Despite what abortion activists like to claim, it’s not an unusual occurrence, especially among women who were lied to or manipulated by the “counselors” at their abortion clinic. Yet pro-abortion extremists never want to acknowledge that women may regret their abortions, or be negatively affected by them; they like to claim that everything is sunshine and roses after an abortion, because for them, abortion fixes everything.

    Unfortunately, the reality can be much more tragic. http://liveactionnews.org/jade-rees-not-only-woman-commit-suicide-after-abortion/

    A study of the medical records of 56,741 California medicaid patients revealed that women who had abortions were 160 percent more likely than delivering women to be hospitalized for psychiatric treatment in the first 90 days following abortion or delivery. Rates of psychiatric treatment remained significantly higher for at least four years.

    http://afterabortion.org/2011/abortion-risks-a-list-of-major-psychological-complications-related-to-abortion/

    I could post 10,000 of these articles and testimonials if space provided.

    And my child is grateful I did not let the mother do it cause her college was so “important” .

  4. The case of a New Mexico man who paid for a billboard ad to protest his ex-girlfriend’s decision to have an abortion against his wishes has once again brought up the father’s rights and paternity rights issue of whether a man should have the right to stop a woman from aborting their child. http://mensrights.com/what-are-a-fathers-rights-to-prevent-an-abortion/

    http://www.google.com/search?q=fathers+rights+to+stop+abortion

    And what about the psychological effects on men when women terminate their children ??

    • Newsflash, women are more than baby vessels. When you are capable of becoming pregnant, you can make your own decisions regarding abortion. Until then, it isn’t your decision. I find it very ironic that when it comes to psych drugs, you believe that you should get to dictate what happens to your body, but when it comes to PERSONAL beliefs on when a fetus (that has no has concept of its own existence ) has the same rights as a living person, you feel it is okay to let others make decisions for an individual woman’s body.

      P.S. How many unwanted children have you personally adopted? There are half a million in the foster care system in the US. If you/some other man wants one so badly (when someone you impregnated doesn’t), there are plenty of children already in the world who need loving homes.

      • You are not capable of becoming pregnant without a guys help.

        “but when it comes to PERSONAL beliefs on when a fetus (that has no has concept of its own existence ) has the same rights as a living person”

        “living person” The abortion photos you are about to view are graphic and you may not want to see them. DO NOT click to see the photos if you feel you are not prepared to view these graphic images.

        http://clinicquotes.com/abortion-pictures-pictures-of-abortions-at-different-stages/

        http://www.advocatesoflife.com/graphicabortionimages.htm

        I should not even be having this conversation, why is MIA taking a side in the abortion debate telling people go ahead you wont feel bad (Abortion Does Not Increase Risk of Developing Mental Disorder) no depression guilt or so called “mental disorder”. Go ahead no negative psychological effects… I don’t believe that.

        Maybe someday they will figure out what causes unwanted pregnancies and then we could prevent them. This abortion debate is getting old.