Clinical Depression After Unintended Pregnancy Linked To Abortion
Springfield, IL (January 18, 2002) -- This week's prestigious British Medical
Journal reports that women who abort a first pregnancy are
at greater risk of subsequent long term clinical depression
compared to women who carry an unintended first pregnancy
to term. Publication of the study coincides with
anniversary events related to the Supreme Court's January
22, 1973 Roe v. Wade decision legalizing abortion.
Data from a national study of American youths, begun in
1979, was used to conduct the research. In 1992, a subset
of 4,463 women were surveyed about depression, intendedness
of pregnancy, and pregnancy outcome. A total of 421 women
had had their first abortion or first unintended delivery
between 1980 and 1992.
An average of eight yeas after their abortions, married
women were 138 percent more likely to be at high risk of
clinical depression compared to similar women who carried
their unintended first pregnancies to term. Among women
who were unmarried in 1992, rates of high risk depression
were not significantly different. The authors suggest that
the lack of significance in unmarried women may be
explained by the higher rate of nonreporting of abortions
among unmarried women. Compared with national averages,
unmarried women in this study report only 30 percent of the
expected abortions compared with married women, who report
74 percent of the expected abortions. This may make the
results for married women more reliable, say the authors.
Another explanation is that unmarried women who are raising
a child without the support of a husband experience
significantly more depression than their married
Since shame, secrecy, and thought suppression regarding an
abortion are all associated with greater post-abortion
depression, anxiety, and hostility, the authors conclude
that the high rate of concealing past abortions in this
population (60 percent overall) would tend to suppress the
full effect of abortion on subsequent depression.
Unreported abortions would result in women who experience
depression following an abortion being misclassified as
"Given the very high rate of concealment of past abortions
"the fact that significant differences still emerged
suggests that we are just catching the tip of the iceberg,"
said David C. Reardon, Ph.D., the study's lead author.
Reardon, the director of the Elliot Institute in
Springfield, Illinois, says the study's findings are
consistent with other recent research that has shown a four
to six fold increased risk of suicide and substance abuse
associated with prior abortion. He says the findings are
also important because this is the first national
representative study to examine rates of rates of
depression many years after an abortion, on average
approximately eight years later in this sample.
The data set used was the same as that used by feminist
psychologist Nancy Russo of Arizona State University, whose
examination of a self-esteem scale revealed no significant
difference between aborting women and women who carried to
term. Russo concluded that the absence of difference in
self-esteem scores in this large national data set proved
that abortion has no "substantial and important impact on
women's well-being." (see critique of Russo study
According to Reardon, Russo's much publicized study has
frequently been used to support the claim that, on average,
abortion has no significant effect on women's mental
health. The Elliot Institute's new analysis of the same
data set reveals that significant differences do exist.
"The most serious flaw of the Russo study is that the
authors did not even comment on the extraordinarily high
rate of concealment of past abortions in the sample,"
Reardon said. "Women who do not want to mention a past
abortion are most likely the ones who will have unresolved
feelings of shame, guilt, or grief."
Reardon says that another problem with the prior analysis
was that Russo's team relied solely on a measure of
self-esteem that is not sensitive to post-abortion stress.
He says the examination of depression scores is more
relevant to the known negative reactions to abortion.
"Russo's previous analysis of this data set was
methodologically weak and was frankly a poor basis on which
to build the claim that abortion has no measurable effect
on women's well- being," he said. "The results of our
reexamination of this data set—especially in combination
with other studies showing higher rates of suicide,
substance abuse, and other mental health disorders
associated with prior abortion—shows that the ‘no effect'
hypothesis should be rejected. Something is going on here.
Where there is this much smoke, despite the problem of
high concealment rates, there is likely to be a fire
beneath the haze."
Another important aspect of this study, says Reardon, is
that is one of only a few studies to use any pre-pregnancy
psychological score as a control variable. The most
commonly used control variable used in regarding emotional
reactions is "pre-abortion" evaluation on the day of the
abortion when the woman is in the crux of emotional
distress. This is why a pre-pregnancy score is much more
useful than a pre-abortion score for evaluating the
independent effect of abortion on long term emotional
Asked what the practical implications of this study are for
physicians, Reardon said: "We recommend that physicians
should routinely inquire about the outcome of all the
patient's pregnancies. The simple question, ‘Have you
experienced any pregnancy losses such as miscarriage,
abortion, adoption, or stillbirth?' may be sufficient to
give women permission to discuss unresolved issues related
to prior pregnancy losses. Physician's should remember
that there are few social contexts in which women feel it
is appropriate to discuss unresolved feelings about prior
pregnancy loss. Many patients will appreciate the
opportunity to discuss their pregnancy losses with an
empathetic person and may welcome referrals for additional
The new study was funded by the Elliot Institute, a
non-profit organization that is involved in research and
education regarding post-abortion complications and also
promotes outreach and counseling programs for women.
Reardon is the author of numerous books on post-abortion
issues, including The Jericho Plan: Breaking Down the Walls
Which Prevent Post-Abortion Healing and Making Abortion
Rare: A Healing Strategy for a Divided Nation. His newest
book, Forbidden Grief: The Unspoken Pain of Abortion,
co-authored with Theresa Burke, will be published in March
of 2002. Information on these titles and other research
conducted by Dr. Reardon and the Elliot Institute can be
found at www.afterabortion.org.
* The association between abortion and subsequent
depression persists over at least eight years.
* Screening patients for a history of abortion may help
physicians to identify women who would benefit by a
referral to counseling.
* The null hypothesis (the conjecture that there are no differences on
average between having an abortion and carrying an
unintended pregnancy to term) is rejected.
# # # #
Reardon DC, Cougle JR. Depression and unintended pregnancy in the National Longitudinal
Survey of Youth: a cohort study British Medical Journal, 324: 151-152. Full text available at www.bmj.com.
Russo NF, Zierk K. Abortion, childbearing, and women's well-being. Professional Psychology: Research and Practice, 1992; 23: 269-280.
A sample of references to studies finding abortion to be associated with subsequent substance abuse and suicide attempts.
Gissler M, Hemminki E, Lonnqvist J. Suicides after pregnancy in Finland: 1987-94: register linkage study. British Medical Journal, 1996; 313: 1431-1434.
Tischler C. Adolescent suicide attempts following elective abortion. Pediatrics, 1981; 68(5): 670- 671.
Morgan CM, Evans M, Peter JR, Currie C. Mental health may deteriorate as a direct effect of induced abortion. British Medical Journal, 1997; 314: 902.
Reardon DC, Ney, PG. Abortion and subsequent substance abuse. American Journal Drug Alcohol Abuse, 2000; 26(1): 61-75.
Frank DA, Zuckerman BS, Amaro H, Aboagye K, Bauchner H, Cabral H, Fried L, Hingson R, Kayne H, Levenson SM, et al Cocaine use during pregnancy, prevalence and correlates, Pediatrics, 1988 Dec; 82(6): 888-95.
Amaro H, Zuckerman B, Cabral H. Drug use among adolescent mothers: profile of risk. Pediatrics, 1989 Jul;84(1):144-51.
Wilsnack RW, Wilsnack SC, Klassen AD. Women's drinking and drinking problems: Patterns from a 1981 national survey. American Journal Public Health, 1984; 74: 1231-1238.
Klassen, A, Wilsnack S. Sexual experience and drinking among women in a U.S. national survey. Archives Sexual. Behavior, 1986; 15(5): 363.