APA Issues Report on Abortion's Mental Health Effects

Special Report - August 22, 2008
Researchers on both sides of the abortion debate are questioning the conclusions of an American Psychological Association (APA) task force report that claims there is “no credible evidence” that an elective, first-trimester abortion causes mental health problems for some women. The 91-page report, released August 13 at the APA’s annual convention, is the result of a two-year review by members of the APA Task Force on Mental Health and Abortion of “all of the empirical studies published in English in peer-reviewed journals since 1989.” The APA task force concluded that, “The best scientific evidence published indicates that among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.” According to the APA, many of the studies it reviewed “contained serious methodological flaws.”

The APA task force did find evidence of an association between multiple abortions and mental health problems for some women. “The evidence regarding the relative mental health risks associated with multiple abortions is more equivocal,” the report states. “Positive associations observed between multiple abortions and poorer mental health may be linked to co-occurring risks that predispose a woman to both multiple unwanted pregnancies and mental health problems.”

In addition, the APA report acknowledges the mental and emotional pain that some women suffer after an abortion, stating, “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.” Despite this acknowledgment, the APA task force stopped short of finding that abortion actually causes mental health problems for some women. According to the report, the task force “reviewed 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.” The APA report cited a number of other factors as possibly causing women who have first-trimester abortions to suffer mental health problems, including: “perception of stigma, need for secrecy,” prior mental health problems, and “characteristics of the particular pregnancy, including the extent to which the woman wanted or felt committed to it.”

Pro-life advocates argue that the APA’s findings are a reflection of its own pro-abortion bias. “The APA is spinning the results to their desired political conclusion, which is that they want to keep abortion legal and promoted in the culture,” said Carrie Gordon Earll, senior analyst for bioethics at Focus on the Family Action. The APA is an outspoken advocate of abortion, describing abortion in a 1970 resolution as “a mental health and child welfare issue” and a “pregnant woman’s civil right.”

Abortion researcher Dr. David Reardon of the Elliot Institute called the report “an ideological report that simply ignores the concerns and needs of those women for whom abortion has been a heartache rather than a triumph.” Reardon has conducted a number of studies on abortion’s after-effects that have been published in peer-reviewed journals, including some that the APA task force dismissed as methodologically flawed. In a press release, he said the APA report itself is “flawed by a pattern of wording and reporting which tends to obscure rather than clarify what researchers have found about the mental health effects associated with abortion.”

“Even the modifier that there is ‘no credible evidence’ of mental health risks in the ideal case of a low risk abortion patient is an admission that there is indeed some evidence that a single abortion can pose a risk to the mental health of a emotionally stable, adult woman,” said Reardon. “In fact, the report itself identifies a whole host of studies providing such evidence, but it mutes a clear presentation of the findings of these studies by focusing on the limitations of each study’s methodology, which all studies have, in order to justify ignoring their clear implications.”

New Zealand researcher, Dr. David Fergusson, who served as one of 20 reviewers of the APA’s draft report and describes himself as “pro-choice,” also questioned the report’s findings. Dr. Fergusson is the author of a 2005 study that found that young women who have abortions experience elevated negative life outcomes, such as depression, that cannot be traced to prior life experiences or mental health problems. In an email to Professor Warren Throckmorton of Grove City College posted on Throckmorton’s blog, Dr Fergusson wrote: “By the admission of the report, studies in this area (including my own) have significant flaws relating to sampling, measurement and confounding. What this means is that ‘the best scientific evidence’ to which they refer, is really not all that good. Given that this is true, then it would be inappropriate to draw strong conclusions on the basis of such limited evidence.”

Dr. Fergusson also noted, “The APA report, in fact, does draw a very strong and dogmatic conclusion that cannot be defended on the basis of evidence, since this evidence is lacking by the admission of the report. What the Committee has, in effect, said is that until there is compelling evidence to the contrary, people should act as though abortion has no harmful effects. This is not a defensible position in a situation in which there is evidence pointing in the direction of harmful effects.”

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