New Zealand study examines abortion and mental health link

Joining the Coleman et al study is a study reported by this Medical News Today news release:

Women who have an abortion face a small increase in the risk of developing common mental health problems such as depression and anxiety, according to a new study from New Zealand.

But the researchers, writing in the December issue of the British Journal of Psychiatry, say their findings point to a “middle-of-the-road” position on abortion – and do not support either the strong pro-life or pro-choice arguments.

Researchers from the University of Otago studied the pregnancy and mental health history of over 500 women born in Christchurch, a city in South Island.

The women were interviewed six times between the ages of 15 and 30. At each assessment, the women were asked whether they had been pregnant and, if so, what the outcome of that pregnancy had been. The women were asked whether the pregnancy was wanted or unwanted, and if this had caused them to be upset or distressed.

The women were also given a mental health assessment during each interview, to see if they met the diagnostic criteria for major depression, anxiety disorders, alcohol dependence and illicit drug dependence. The researchers took other confounding factors which might be associated with increased risks of various pregnancy or mental health outcomes into account.

Overall, 284 women reported a total of 686 pregnancies before the age of 30. These included: 153 abortions (occurring to 117 women), 138 pregnancy losses (including miscarriage, stillbirth and termination of ectopic pregnancy), 66 live births that resulted from an unwanted pregnancy (or one that provoked an adverse reaction), and 329 live births resulting from a wanted pregnancy (where there was no reported adverse reaction).

The study found that women who had had abortions had rates of mental health problems that were about 30% higher than other women. The conditions most associated with abortion included anxiety disorders and substance use disorders. In contrast, none of the other pregnancy outcomes were consistently related to significantly increased risks of mental health problems.

However, the overall affects of abortion on mental health were found to be small. The researchers estimated that exposure to abortion accounted for between 1.5% and 5.5% of the overall rate of mental disorders in this group of women.

Professor David Fergusson, John Horwood and Dr Joseph Boden said their study had “important implications for the ongoing debates between pro-life and pro-choice advocates about the mental health effects of abortion”.

Writing in the British Journal of Psychiatry they said: “Specifically, the results do not support strong pro-life positions that claim that abortion has large and devastating effects on the mental health of women. Neither do the results support any strong pro-choice positions that imply that abortion is without any mental health effects.

“In general, the results lead to a middle-of-the-road position that, for some women, abortion is likely to be a stressful and traumatic life event which places those exposed to it at a modestly increased risk of a range of common mental health problems.”

Reference:

“Abortion and mental health disorders: evidence from a 30-year longitudinal study.” Fergusson D, Horwood LJ and Boden JM (2008). British Journal of Psychiatry, 193: 444-451

I am still reviewing the study but it looks like the APA should have waited to bring out their report on abortion and mental health.

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  • Patrick

    Okay Table 2 of the study is a little odd.

    In the 5 year lag model the RRs (risk ratios) are:

    1.32 (Abortion)

    1.06 (Pregnancy Loss)

    1.05 (unwanted pregnancy – live birth)

    1.22 (no adverse reaction – live birth)

    Yes the abortion group shows a 32% increase overall in mental health problems, but the group that decided not to have an abortion shows a 22% increase in mental health problems – and this in the group that had no adverse reaction to being pregnant. Oddly the group that didn’t want to be pregnant – but had the baby anyway – did significantly better in mental health outcomes.

    That leads me to wonder if the unwanted preganancy-livebirth group isn’t very representative.

    And if we are to believe table 2 – we would have to conclude that motherhood isn’t the greatest thing for mental health either.


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