Abortion not only poses as a physical health issue for women, but also greatly impacts their mental wellbeing and can be emotionally draining. A recent study published in JAMA Psychiatry assessed the psychological well-being of women after five years of receiving or being denied an abortion, to which they found being denied an abortion had higher adverse effects than having an abortion.
An abortion refers to terminating a human pregnancy where the fetus or embryo is removed from the uterus before it is capable of living, usually at 20 weeks gestation or when the fetal weight is less than 500 g. Abortion can lead to negative mental health outcomes and sometimes can take a very long time to recover from. Hence, many clinics in North America require that women seek counseling after an abortion to ensure that they are emotionally stable after the abortion has taken place. It can also be very difficult for women that are denied abortions due to their own complications, their baby’s complications or if the fetus has already started to develop and it is too late in the pregnancy to terminate it.
To further investigate the effects on mental health as a result of abortion, Biggs et al. constructed a study published in the Journal of the American Medical Association Psychiatry. This study examined women’s psychological well-being after five years of receiving or being denied an abortion. It was a longitudinal study with a quasi-experimental design and included five years of data from the Turnaway Study. 956 women were recruited from January 1, 2008, to December 31, 2010, from 30 abortion facilities in 21 states in the United States, where the mean age of the women was 24.9. The study was conducted through phone interviews one week after seeking an abortion and then interviewed semi-annually for five years (11 interviews). There were two groups of women compared, one that received an abortion and those that were denied one because they were over the facility’s gestational limit. To collect and analyze the data, there were six measures of mental health and wellbeing, two measures of depression, two of anxiety, which was assessed using the Brief Symptom Inventory, self-esteem, and life satisfaction. Additionally, interview questions were related to demographics, physical and mental health, childbearing experiences and expectations, and previous history of traumatic life experiences.
Based on this, the researchers found that being denied an abortion, in comparison to undergoing an abortion, had a higher risk of adverse psychological consequences. Moreover, after one week of seeking an abortion, women denied an abortion reported more anxiety symptoms, inferior self-esteem issues, lower life satisfaction and they all seemed to have similar levels of depression. It was also found that with both groups of women that took part in this study, psychological well-being did improve over the years. Other results found that all groups except the first-trimester group (those receiving an abortion in their first trimester) experienced significant declines in anxiety over time, where anxiety was higher in the group where abortion was refused in comparison to those that received one. In relation, the women that were turned down for an abortion either miscarried or went to another place for an abortion, which Biggs et al. suggests is a factor that contributes to high levels of anxiety, low self-esteem and being refused was connected to the women examining their life choices and having to stress over what their next plan would be.
Conducting this study was very essential, as after an abortion, many people focus mostly on physical health and recovery rather than mental health. As a result, this aspect of wellbeing and those that are denied an abortion are often overlooked. However, limitations to this study included that it was longitudinal for five years, so a significant amount of participants had dropped out of the experiment. It was found that by the end of the five-year study, 42% of the participants were lost, which could lead to inaccurate results due to a smaller sample size and change in data. In addition, another limitation and challenge was that mental health is difficult to measure as it is a form of qualitative data and the feelings of these women would be troublesome to describe. However, the conclusion from this study was that being denied an abortion was more detrimental to women’s psychological health as opposed to allowing women to undergo the procedure. These results are an important contribution to mental health and scientific research as there is not a lot of research towards this area.
Written By: Seema N. Goolie, BSc