Aug. 22, 2000 -- The impact of an abortion on a woman's mental health has been questioned for years. Some studies have suggested that many women suffer depression, regret and even a form of post-traumatic stress disorder called 'post-abortion syndrome.'
But a study out this month finds that 80% of women were not depressed after having an abortion. In fact, the rate of depression in the postabortion group was equal to the rate of depression in the general population. As for post-traumatic stress symptoms, the rate was 1% in the postabortion group compared with an estimated 11% in women of the same age in the general population.
The study's authors say the results agree with previous studies -- including one by former Surgeon General C. Everett Koop, MD -- showing that severe mental distress following an abortion is rare.
"Most women were satisfied with their decision, believed they had benefited more than had been harmed by their abortion, and would have the abortion again," writes study author Brenda Major, PhD. "These findings refute claims that women typically regret an abortion." Major is a professor of psychology at the University of California in Santa Barbara.
For the study, published in the August issue of Archives of General Psychiatry, Major and colleagues interviewed 882 women undergoing abortion. The interviews were conducted prior to abortion, immediately after the procedure, and, for 442 women, again two years later.
Nearly 70% of women reported being satisfied with the decision, and 72% reported more benefit than harm. Of those who reported depression or regret after the abortion, most were depressed or had emotional problems prior to becoming pregnant.
Experts express little surprise at the findings and say this study is more proof that for the majority of women, abortion has few aftereffects.
In an editorial accompanying the study, Nancy Adler, PhD, says that rather than contributing to mental stress, the studies suggest a significant decrease in mental distress and an increase in positive emotions and self-esteem.
Adler, director of health psychology at the University of California in San Francisco, also points out that it is important to look closer at studies that have found psychological harm after abortion to evaluate whether distress really was the result of the abortion, or of other events.
"Experiencing an unwanted pregnancy is itself distressing, as may be the events associated with it. For example, a woman's partner may respond to the pregnancy by leaving her. The abortion then occurs in the context of loss and abandonment, yet depression or distress following the abortion would be attributed to the procedure," Adler writes. Facing hostile protesters and intimidation in seeking an abortion also may be factors that heighten risk for psychological problems postabortion in some women, she says.
"Most women fare very well emotionally," agrees David Grimes, MD. "It's important to understand that abortion is not a problem, it's a solution. The problem is the unintended pregnancy. When that is behind them they oftentimes will feel much better. But it is well documented that relief is the overwhelming response of most women."
Psychological counseling is routine at most facilities that perform abortions.
"It's mainly a discussion about the risk, benefits and alternatives and then a discussion of contraceptive options after the procedure," Grimes tells WebMD. Grimes is vice president of biomedical affairs at Family Health International, a nonprofit group in Research Triangle Park, N.C., that helps women and men obtain access to family planning services and methods.
Both Adler and Grimes say the findings highlight the need to identify and provide extra support and counseling to women who may be experiencing depression or other problems prior to an abortion and may be at risk for problems afterwards.