Abortion and Mental Health - Research Paper Example

? al Affiliation Abortion and mental health Introduction The debate on abortion continues to rage in many parts of theworld. There is gradual mounting of evidence indicating that not only is the pre-born infant human, but that the mother may suffer mental harm due to the act. Doctors have referred to this scenario as Post-Abortion Trauma (PAT). PAT is regarded by psychologists as a form of Post Traumatic Stress Disorder (PTSD) induced by the stressful event of having an abortion. The issue of abortion continues to elicit enormous legal, moral and emotional controversy. Over the past two decades, the issue of abortion effects on mental health of women has taken centre stage (Bazelon, 2007; Cohen, 2006; Lee, 2003). The first public debate on this issue was back in 1987, when President Ronald Reagan directed Dr. C. Everett Koop who was the then-Surgeon General to prepare a report on the psychological and physical effects of abortion. Dr. Koop conducted a comprehensive review of scientific literature, but declined to issue a report; instead he concluded in a letter sent to President Reagan that he available research was not adequate enough to support scientific findings regarding the psychological consequences of abortion (Koop, 1989). He later testified before Congress that his research did not focus on the physical health risks of abortion. The reason for this was that gynecologists and obstetricians had already done this and concluded that the physical effects of abortion on those who aborted their pregnancies were similar to those women who carried their pregnancies to term or those had never been pregnant (Koop, 1989). Dr. Koop added that although the psychological response to an abortion can overwhelm an individual, the psychological risks as a result of abortion were minimal in view of public health (Koop, 1989). The letter by Dr. Koop and an unofficial draft report read into the records of Congress have been cited by both abortion proponents and opponents as a claim of both the absence and presence of scientific evidence of the detrimental effect of abortion on the mental health of women. In February 1989, the American Psychological Association (APA) in recognition of the importance of this issue, constituted a panel of scientific experts to review the scientific literature available on psychological responses to abortion. Since then, several researches have been done with conflicting results being obtained. This paper seeks to find out whether or not abortion has an effect on the mental health of the woman. Overview PTSD is quite common nowadays due to the occurrence of events such as tsunamis, severe earthquakes and wars. Such stressful events that occur outside the normal experiences of humans trigger PTSD. For a while, a person may appear to cope well. Symptoms such as flashbacks, intrusive memories of the violent event, repetitive re-living of the event, vivid nightmares, sleep disturbance, depression, anxiety and suicidal feelings may start to manifest later. Victims usually turn to drugs or alcohol to assist them to cope with the symptoms. PAT is described the psychological consequence that result from repressed grief after an abortion. The stressful event experienced by the woman is the abortion and the emotional conflicts that occur when deciding whether to undergo the abortion or not (Bazelon, 2007). The woman my feel relieved immediately after going through with the abortion. Then, after some time ranging from some weeks to several years, she may start developing recurrent, frightening memories, dreams and nightmares about the abortion experience. This may result in an avoidance phenomenon whereby she becomes less involved with friends, her partner/spouse or anyone who encouraged or supported the abortion. The most common emotional responses are guilt especially when in the presence of pregnant women, guilt of being alive the aborted child is not, anger, shame, sadness, uncontrollable weeping, distrust, and sleep disturbances. The experience of these symptoms varies among different women but most of them need to grieve their lost child in order to heal. Questions Addressed During the examination of the empirical literature on the relationship between abortion and mental health, four primary questions have to be kept in mind. These are the questions that the literature should address: (1) is abortion harmful to the mental health of women? (2) What is the prevalence of mental health problems among United States women who have had an abortion? (3) What relative risk with regard to mental health problems does abortion have compared to alternatives solutions for the pregnant woman? And, (4) what determines the variation in psychological experiences of women after an abortion? Each of these questions requires a varied approach when researching and answering it. Some questions can be scientifically tested while other cannot be scientifically tested (Ferguson, Horwood, & Boden, 2009). Evidence from Research Standard psychiatric textbooks indicate that 25% of women who undergo abortion experience depression and feelings of guilt. A psychiatry textbook entitled Motherhood and Mental Health by Professor Ian Brockington states that self-reproach over abortion is common. Some mothers may feel like criminals due to the act of abortion. Some women find it hard to look at babies and cry when they see a baby or at the mention of abortion. Some isolated cases of obsessive compulsive neuroses may occur following an abortion. Emotional problems during the approximate delivery date of the aborted infant may occur. In some instances, the women attempt suicide. The guilt may act as a factor in precipitating another pregnancy. A study found that out of a sample of a hundred women, fourteen became pregnant again for atonement. Surrogate motherhood may result from remorse over termination of pregnancy. Gissler, a Finnish medical statistician conducted research to explore the link between abortion and suicide. His studies revealed that suicide rates for women after abortion are 300% the general suicide rate and 600% that of women carry their pregnancy to term. After normal delivery, women develop short-term psychiatric problems but these do not translate into suicide. Pro-abortion lobby groups often point out that, apart from the work by Gissler work, most of the other accounts of PAT are anecdotal (Ferguson, Horwood, & Boden, 2008). The accounts are mostly personal stories. This claim may be true, but this does not necessarily mean that they do not hold value or that they are not true. The question that needs to be answered is whether these stories are typical. A study by Zolese and Blacker conducted in 1992 sought the answer for this question. By doing a summary of previous research, they concluded that an average of ten percent of post-abortion women manifested a persistent psychiatric illness. Their findings have never been challenged. This finding seems to conclude that PAT is a major disease in women. Research Problems There seems to be some certainty regarding evidence for PAT. Pro-life groups are familiar with this. Some pro-abortion organisations also acknowledge the existence of PAT. Some psychiatrists and psychologists described it though do not use the term PAT. However, many medical Establishments, including the Royal College of Obstetricians and Gynaecologists, dismiss PAT. Their denial is based on a paper published in 1991 by Canadian psychiatrist Paul Dagg entitled “The Psychological Sequelae of Therapeutic Abortion – Denied and completed.” This meta-analysis of two hundred and fifty papers in learned journals from all over the world appears to deny the existence of PAT. This view may be as a result of several serious difficulties that are encountered when conducting much of the post-abortion research. The first problem is that psychiatrists will tend to mainly rate severe psychiatric symptoms while overlooking subtle symptoms such as guilt, distress and self loathing. These are the most common symptoms experienced by women with PAT. The professionals do not appreciate these conditions. Secondly, the small population covered by the studies make such studies to be statistically insignificant. The high attrition and drop-out rates from psychiatric facilities mean that studies conducted may fail to include women most affected by PAT. Another reason is that some of the women experiencing PAT may be in a state of denial and thus they may deny having any problems. The fifth reason and perhaps most important is that women are usually assessed a few days or weeks after the abortion. It has already been stated that symptoms mostly manifest several months or years after abortion. This factor is a major s flaw in the analysis conducted by Dagg. Most of his meta-analysis was done less than a year after the abortions occurred (Ferguson, Horwood, & Boden, 2008). The Current Evidence The January 2006 publication entitled “Abortion in young women and subsequent mental health” is among the most important studies conducted on post-abortion women to date. The study concluded that women who have had abortions have twice the likelihood of suffering from mental health problems and three times higher likelihood of suffering a depression compared to women who have carried their pregnancy to term. This study, conducted by Professor David Fergusson a distinguished epidemiologist who is not pro-life, was widely ignored by the media. Despite this, it led to withdrawal of the official statement by the American Psychological Association that denied the existence of a connection between psychological harm and abortion (Miller 2005). Professor Fergusson has published other works since. Another publication entitled, “Abortion and Mental Health Disorders: evidence from a thirty-year longitudinal study” concluded that women who abort tend to have approximately thirty per cent higher rates of mental health problems compared to other women. He also found that substance abuse and anxiety disorder are the most common conditions associated with abortion. Fergusson concluded that the relationship between abortion and mental health depends on a person. Some women may be traumatized by abortion while other may cope well with the experience. The most important statement gathered from this study is that, though over ninety per cent of abortions are done on grounds that continuation of pregnancy may result in serious detrimental effects to the mental well being of the woman; no evidence was found to support the notion that abortion helps reduce the mental health risks due to unwanted pregnancy. In addition no other study has shown that it reduces mental health risks (Miller 2005). The study by Fergusson is very valuable because it takes into account the more subtle symptoms of mental health problems such as guilt feelings and anger. Nevertheless, broader psychological studies are needed as opposed to psychiatric studies. This is because they take into account symptoms such as numbness and grief that are frequently experienced by women after abortion. In 2008, a paper entitled “Pregnancy loss and psychiatric disorders in young women: An Australian birth cohort study” was produced. The study concluded that women who abort are twice as likely to have alcohol addiction and depression compared to women who gave birth or those who have never been pregnant. These women are also at risk of using illicit drugs. In contrast, the study indicated that pregnancy and parenting has the potential of discouraging women from engaging in heavy alcohol and drug use. Conclusion The mental health among women who get unwanted pregnancies reflects a several factors. It reflects conditions that preexist in the life of a woman that place her at higher or lower risk for generally having poor mental health regardless of how her pregnancy is resolved. It reflects the appraisals of the woman with regard to the meaning pregnancy and abortion and her appraisals on her ability to cope with the two options. It is also a reflection of the coping strategies that women employ when dealing with emotions experienced as a result of the decision made. The local and broader socio-cultural contexts that surround a woman also affect her mental health after an abortion. Perceived social stigma due to pregnancy of an unwed teenage girl or undergoing an abortion can influence the decisions made by women (Dingle & Clavarino, 2008). These factors will also affect how these women feel about the decisions they make and how they cope with their feelings. Due to the growing evidence that supports the existence of PAT, a challenge should be expected from those who oppose this finding. There is no doubt that some academic and pro-abortion groups will continue with their resistance to the existence and use of the term PAT. It is important to speak out on issues regarding the psychological harm that results from abortion and more studies should be conducted to produce more evidence to support current findings on the issue. More counsellors should be trained to assist women who have been affected. References “Abortion ‘Leaves Mental Legacy’” (2005), BBC News, December 12, Retrieved from http://news.bbc.co.uk/2/hi/health/4520576.stm. Bazelon, E. (2007) Is there a post abortion syndrome? New York Times Magazine, pp. 40-47, 62, 66, 70. Cohen, S. A. (2006). Abortion and mental health: Myths and reality. Guttmacher Policy Review, vol. 9, 8-11, 16. Dingle, K, Alati, R and Clavarino, A (2008), “Pregnancy loss and psychiatric disorders in young women: an Australian birth cohort study”, British Journal of Psychiatry, 193, 455-460. Ferguson, D.M, Horwood, L.J and Boden, J.M (2008), “Abortion and mental health disorders: evidence from a 30-year longitudinal study”, British Journal of Psychiatry, 193, 444-451. Ferguson, D.M, Horwood, L.J and Boden, J.M (2009), “Reactions to abortion and subsequent mental health”, British Journal of Psychiatry, 195: 420-426. Koop, C. E. (1989). The federal role in determining the medical and psychological impact of abortions on women (HR No. 101-392, p.14). Testimony given to the Committee on Government Operations, U.S. House of Representatives, 101st Congress, 2nd session, December 11, 1989. Lee, E. (2003). Abortion, motherhood and mental health: Medicalizing reproduction in the United States and Great Britain. New York: Aldine de Gruyter. Royal College of Psychiatrists (1994), The physical and psychosocial effects of abortion on women. Miller, Dave. (2005). Abortion & Mental Health. Retrieved from http://www.apologeticspress.org/APContent.aspx?category=7&article=1724 Royal College of Psychiatrists (2008), Position Statement on women’s mental health in relation to induced abortion. Read More