Study Claiming Women Don’t Regret Abortions Deeply Flawed and Deceptive
7/15/2015
“This Study Should End The Debate About Whether Women Regret Having Abortions,” reads the headline from ThinkProgress. The study, published in the journal PLoS One, claims that 95 percent of women having abortions do not have regrets afterward.
From the study:
Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding.
Far from settling the debate, however, the study has a number of flaws that belie the conclusions drawn by the authors. Among the flaws:
- This study’s findings and conclusions are overreaching due to self-selection and high drop out rates. To quote from the study: “Overall, 37.5 percent of eligible women consented to participate, and 85 percent of those completed baseline interviews (n = 956). Among the Near-Limit and First-Trimester Abortion groups, 92 percent completed six-month interviews, and 69 percent were retained at three years; 93 percent completed at least one follow-up interview.” This means 62.5% of women refused to participate in the study, at first request, and another 15% dropped out before or during the baseline interview, yielding only a 31.9% participation rate at baseline.
- With 68.1% percent of eligible women refusing to participate in the study at baseline, it is improper for the authors to suggest that their findings reflect the general experiences of most women. There are numerous risk factors which have been identified as predicting which women will have the most severe post-abortion reactions. One of these risk factors, for example, is ambivalence about having an abortion or carrying to term. Another is the expectation that one will have more negative feelings about the abortion. In a similar post-abortion interview study by Soderberg, the author reported that in interviews with those declining to participate “the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer often given was: ‘Do do not want to talk about it. I just want to forget.'”
- It is very likely that the self-selected 31.9% percent of women agreeing to participate were more highly confident of their decision to abort prior to their abortions and anticipated fewer negative outcomes. This concern about selection bias is highlighted by the study’s own finding that “women feeling more relief and happiness at baseline were less likely to be lost [to follow-up].” Clearly, due to the large numbers of women choosing not to be questioned about their experience, and the large drop out rate of those who did agree, this sample is not representative of the national population of women having abortions.
- Despite the initial selection bias, 15 percent of those agreeing to be interviewed subsequently opted out of the baseline interview and another 31 percent opted out within the three year followup period. This indicates that even among women who expected little or no negative reactions, the stress of participating in follow up interviews lead to a change of mind. Previous research shows that women with a history of abortion feel more discomfort in answering questions about their reproductive history.
- The study population is also non-representative of the women having abortion in that it included 413 women who had an abortion near the end of the second trimester compared to only 254 women having an abortion in the first trimester. This is totally disproportionate. It again shows that the authors should not be extending conclusions about this non-representative sample to the general population.
- The authors report that sample has an elevated number of low socioeconomic backgrounds. That, too, makes the sample non-representative. The offer of $50 per interview may also have created a participation bias toward women who most desperately needed the money.
- Another oddity, the authors report that in the final group analyzed, average age 25, 62% were raising children. This would appear to be a very high rate that is not typical of national averages for women seeking abortion.
- The deceptive practices of the research team are made clear in press releases and an infographic purporting to summarize the study. In these “summaries” the research group conceals the details regarding the high non-participation rate and boldly claims “95 percent of women who had abortions felt it was the right decision, both immediately and over 3 years” — omitting the fact that 62.5 percent refused to participate at the time of their abortion, another 15 percent dropped out prior to the baseline interview, and of those interviewed another 31 percent dropped out by the third year. The fact that the abstract, press release, and other summarizing materials published by the authors consistently omit mention of the high rate of non-participation is problematic itself. The fact that they, to the contrary, consistently imply that their results apply to the entire population of women having abortions is clearly deceptive.
Notably, the claim of declining regret and declining negative reactions is at odds with Brenda Major’s two year longitudinal study, which also had high drop out rates, that found that there was a trend of decline in relief and increase in negative emotions over the two year period among those who did not drop out of her study. (See Major B, et al. Psychological responses of women after first-trimester abortion. Archives of General Psychiatry. 2000: 57(8), 777-84.)
Additionally, the authors do not report on any assessment of whether women experiencing negative emotions sought any post-abortion psychological or spiritual counseling. In other words, it is unclear if the women reporting a decline in negative emotions experienced this decline because of intervention (counseling) or reconciliation (spiritual effort) or whether the decline is “natural” as the authors suggest.
The focus of this report in on women’s persistent satisfaction with their abortion decisions, “decision rightness,” as measured by a single question of whether or not the “abortion was right for them.” Women were asked to answer this question “yes”, “no” or “uncertain.” A better research approach would have been to have this question rated on a numeric scale (1 to 10, for example) in order to better identify any shift in attitudes.
Questions regarding decision satisfaction may produce reaction formation and therefore defensive answers affirming the rightness of a decision even if there are actually unresolved anxieties or other issues. (To voice dissatisfaction may invite anxiety provoking thoughts. Responding the way one is expect to respond, avoids reflection). Additional questions should have been asked to better gauge the subjects thoughts. For example, in the Soderberg study, including a one year post-abortion interview of 847 women (after a 33% self-exclusion rate), 80% of the women were satisfied with their decision to abort but 76% also stated that they would never abort again if faced with an unwanted pregnancy. A woman expressing unwillingness to not have another abortion may tell us more than her expression of the “rightness” of a past abortion decision that cannot be changed.
While the report and accompanying press release claim that this study proved there is “no evidence of widespread ‘post-abortion trauma syndrome,’ in fact it did not use any standard scales for assessment of psychological well being. They certainly did not overcome the findings of record linkage studies which have shown an elevated risk of psychiatric admissions following abortion or elevated rates of suicide. Instead, their assessment of psychological health is all inferred from an assessment of just six emotional reactions they associated with their abortion: relief, happiness, regret, guilt, sadness and anger.
But there is clear evidence from other studies that many women experience symptoms of post-traumatic stress disorder which includes symptoms of denial and avoidance behavior. In a study by Vincent Rue, for example, among women reporting intrusive memories and dreams related to their abortion, only half attributed these thoughts to their abortions. In other words, half were in such denial that while on one hand they could report certain intrusive thoughts, half denied that these thoughts had anything to to do with their abortions.
Therefore, women reporting less “anger” relative to their abortion may in fact have more feelings of anger in their lives but may not be attributing this anger to their abortions, but rather to other problems, though perhaps in counseling, they might discover their increased feelings of anger were projected on other issues but are related to unresolved hurt over the past abortion.
Theresa Bonpartis, who herself underwent an abortion and now offers support for others suffering after abortion through Lumina post-abortion ministry, commented on the study:
I often wonder where they get the women for these “studies.” Certainly not from places where women who are seeking help go. This one in particular was done at the Bixby Center for Global Reproductive Health at UC San Francisco’s School of Medicine. Biased? Please!
The study only looked at three years after a woman’s abortion. Most women do not even begin to deal with an abortion until around seven years after.
Lumina receives about 200 new women every year who come to us because they are suffering from a past abortion and have many regrets. The prochoice side itself says that 10 percent of women who have abortions suffer, which in a country where over 56 million abortions have occurred, brings the figure to millions of women.
Other studies prove differently. One only has to visit the Elliot Institute web site, or Priscilla Coleman’s research, or many others, too many to list, to find that out. Time magazine’s article “Hardly Any Women Regret Having an Abortion…” which was just published and written by “staff” makes a bold statement, while only looking at this one study.
To be honest, this makes me angry. Mostly because it perpetuates the feeling of being crazy if your abortion does bother you, like there is something wrong with you if it does. So, if you see this article and are suffering, please reach out for help, You are not alone; there are millions of us out there and many great resources for healing. Hope and healing are possible.
Learn More
AbortionRisks.org: The Turnaway Study
Expert: Results of Study Claiming No Abortion Regrets Are Meaningless
Abortion Study Provides Incomplete Picture
Hardly Any Women Regret Having an Abortion — Only Millions of Us!
Flawed, Biased Turnaway Study Now Claims 95 Percent of Women Happy After Abortion
They’re Still Trying to Disprove Post-Abortion Trauma Syndrome
NRL News Series: Takeaways from the UCSF Abortion “Turnaway” Study
Part I: Set Up for a Spin
Part II: Finding What They Looked For
Part III: Spinning the Consequences of Abortion
Part IV: Research Team with an Agenda
Part V: How Bias Can Tilt Results
Get Help
Help After Abortion
Help During Pregnancy
Center Against Forced Abortions (legal help)
I wish there was such an in depth analysis of all studies out there. The most beneficial thing I learned in a statistics class was how to really analyze the data & look at possible biases. We should view every study that way particularly those based on surveys.
Truth and what’s right will always prevail in the end. Abortion is murder of a little human being period. Whether a woman feels regret is beside the point! Humans are too flawed and fallible to come to a meaningful conclusion with.
Your going to feel guilt unless your and emotionless monster! I do. And I always will feel deep regret. Thank God for Truth! It will always prevail whether we feel a certain way or not!!
Dear Michele,
I’m sorry for your loss and the feelings of guilt with which you struggle. If you have not yet sought out a post-abortion recovery program, I pray that you will. God is just but also merciful. And sometimes the psychological defense mechanisms like denial and rationalization that suppress feelings of guilt are actually a God-given grace to postpone feelings of loss and guilt that can be so crushing that a person truly can’t handle it. So I never think of those who lack feelings of guilt as monsters. Instead, God knows that they will need to be brought to see the truth over a longer period of time, after perhaps many more experiences and preparations to they can bear the truth about their mistakes and his mercy.
A three year study… A three year study of smokers would also show very few smokers with lung cancer – ipso facto, smoking does not cause lung cancer.
I think the original study needs to be treated like all studies, it is not perfect because it didn’t control all possible variables. But it does offer some evidence. The points in this article expose some of the issues with the study but some points are not very well thought through. For example the selection bias is a good point as you can see how someone with regrets would be more likely to avoid the survey altogether. But the point that mentioned how the study has a bias to attract lower income people (to whom the $50 was a good incentive) fails to explain why how or if that would effect the results. Is this article suggesting that poorer people are more or less likely to have regrets for some reason?
But please remember the most important thing is to take each piece of evidence and add it to your bigger picture world view. This study is not perfect but it is telling us something. The next thing to do would be to do a more accurate study and see how the results are affected. 1 person telling you a story about how they did or didn’t regret something is purely anecdotal evidence (does not necessarily represent the overall trend)
We agree.
What bit of truth can we dig out of this study? Well, it tells us one thing: some women believe their abortions were the right decision for them.
Given the sampling problems, there is no way to generalize that finding to the general population of all women who have had abortions. We have no idea how many, on average, feel that way one year, two years, ten years, or twenty years after their abortions. But we don’t dispute that their study does show that some women, questioned three years after their abortions, believe it was the right choice for them. But that’s hardly a new insight!
We also would note that there rare numerous studies of women reporting regrets after their abortions face similar problems. But these two depend involve self-selection bias which means we can’t generalize a specific percent of women reporting regrets to the general population of all women.
The problem is that the authors of this study pretend that only their data is accurate and that it can be generalized to all women.
But a cautious interpretation of these studies together tell us that (a) some women have regrets; (b) some women believe their decision “was right for them” at that time; (c) and many women have both of these feelings at the same time. Regarding the latter, one study reported: “Almost one-half also had parallel feelings of guilt, as they regarded the abortion as a violation of their ethical values. The majority of the sample expressed relief while simultaneously experiencing the termination of the pregnancy as a loss coupled with feelings of grief/emptiness.”
It is the authors’ overstated conclusion (and the headlines) that their study proves that the vast majority of women have no regrets that we find objectionable.
No, it is just saying that it is not representative of the whole population, but you can asume that these specific poor people have less regrets.
Even if their methodology was perfect and no women dropped out, it would have only accounted for .011% of women who have abortions (relying on Guttmacher Institute numbers on women who have abortions). That means that 99.99% of women who have abortions are unaccounted for. So even with perfect methodology and zero drop out, their conclusion would still be disingenuous.
why would using a larger sample size affect the result in some way. If you asked more people, you would get a more accurate result, but don’t expect it to radically change unless you modify the test conditions (aka ask people in other countries/cultures, or offer a higher incentive so that you include more participants even those who would rather not talk about it). but you cannot say the study is disingenuous – it is offering the data it is up to you to interpret. you aleays extrapolate trends from the sample data, you never actually ask the entire world population. It would be like me surveying 100 cats and concluding that they all have tails and then you saying “but there are 10 billion other cats unaccounted for so these results are disingenuous”.
Part of me wishes studies (in general) were not done. Take the study done by a British scientist that found a link between autism and vaccines, when many other studies done after found no such link. The way this study was done seems as though they were t trying to find out whether or not even men later regret abortion(s), but rather trying to prove that they don’t. That is not right. In such studies people get asked all the ‘wong’ questions, and/,or are expected to give answers that don’t really how someone truly feels or how something may have effected them, or (in cases to do with medications and related) what side effects they may truly have/ the true full rage if heir side effects. I once was at a Christian women’s conference where one of the speakers was talking about her abortion. Years after it she was married with kids (well still is). Fir a long tine she did not tell her husband about the abortion, out of guilt and shame.
Part of me thinks that you are just finding ways to discredit all studies (a ridiculous thing for you to try and do) because you don’t like the outcomes of THIS study. Pointing to the vaccine example you are actually referring to a false conclusion made from a data set, not an incorrect method of carrying out the study. In this case, you are also speculating about the way the questions were asked and for some (unknown) reason you conclude that they must have been the wrong questions. Your mind obviously doesn’t work in a scientific way, because you have already decided which result you want to agree with and because you don’t like the result of this study you are finding ways to say it must be wrong. Cognitive dissonance aka rejecting facts that don’t conform to your world view.
By all means debate the significance of one study. Or the accuracy of it due to some selection bias. But don’t make unfounded criticism about how the questions they were asking were leading questions or were ‘wrong’. Unless you can show how they were leading questions? Do you have examples?
We’re not speculating about the way the questions were asked. The authors of the study report that women were asked to reply yes or no to a single question of whether or not the “abortion was right for them.” From this single question they generate their conclusion, and headline, that “95% of women have no regrets” about their abortions.
Two major flaws with that conclusion and headline. First, how can you claim to know what the majority of women believe and feel about abortion when 70% of women asked to participate refuse (possibly because they are emotionally upset about their abortions and don’t want to talk about it), and of those who agree to participate.
Second, it is well known that most women have both negative and positive feelings about their abortions. A single question about whether the abortion was “right for them” at that time does not mean they have no regrets or even severe guilt or depression. It may simply mean they still believe it was the only choice they could make given the pressures they faced at that time. If the woman had been asked, “If at that time you had received more support from loved ones, would you rather have carried the pregnancy to term,” a significant portion would have said yes. (Based on other studies, we’d estimate 30-50%.) That would tell us that “decision satisfaction” has many nuances not adequately covered by a single yes/no question.
I allowed others to make my decisions, including my mother and the fathers of my children. I’m now 55 years old, and I can still hearby babies’ cries in my head and my heart. I was weak, and I let other people make decisions. My last baby had multiple deformities, which were confirmed by a pathology report, not to mention the dreams of my child telling me I needed to end the pregnancy before I did. I know in my heart God has forgiven me, as have my children. I don’t think I will ever be able to completely forgive myself. The word regret doesn’t even come close to what I feel, but I also feel that I do not have the right to judge someone else’s decision. I just know that I will do my best to talk someone out of doing it.
Hi Cindy, thank you so much for sharing here. Sometimes forgiving yourself for something and letting go of shame and self-blame is the hardest step to take. If you haven’t done so already, please consider talking to a post-abortion counselor about this. They may be able to help you find the peace that is still missing! You can find out more about this on our healing page. Any of the groups listed there have people who would love to talk with and support you, no matter how many years it has been.
I had an abortion almost 40 years ago. Nope. No regrets!
I had abortion 35? years ago. I don’t remember exactly without figuring it up now. No regrets. It was a time before all the guilt tripping started.
Because I never had any children of my own, I was able to give so much more to my students (as a high school teacher) and as a foster parent to teens. I made a difference in many more lives. God apparently had much bigger plans for me. 🙂
You are fortunate. I’m sure you can appreciate that some women are less so.
Thank you for this excellent article. I wish I knew who wrote it and when it was written.
I too deeply regret my abortion and I was in such deep denial that I hid behind a wall of anger that it took me 30 years to admit my mistake.
Hi Carol,
I added the date to the post (I think it was a group effort as far as the writing goes). Somehow in upgrading WordPress the dates got removed from all the posts. Thank you for your comment!
That’s awesome that you got through your denial and anger. However, you are your own person. Other people may not regret their decision the way you did. Let people make their own choices.
The study angered me as well.I know I can’t be alone in this. I am angry at myself for having my abortions and now a skewed study is shouting out that I’m some kind of emotional misfit? I think it is so disrespectful of all of the lives taken.