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Dispelling the Myths: Abortion and Mental Health

She said, “I deserve this” as she moaned with pain while I dilated her cervix. I tried to numb her, keep her as comfortable as possible, so I asked for more numbing medicine to try to take the pain away. Something told me there was a bigger problem that lidocaine wouldn’t be able to fix.

Guilt, regret, post traumatic stress disorder (PTSD): these are some of the buzz words that anti-choice folks throw at women to deter them from taking control of their own lives. My patient, this woman who could have been a friend or cousin of mine, believed she deserved to be in pain for what she was doing. She believed she fully deserved the pain she was experiencing because she was doing what she needed to do to take care of herself. Why would she feel this way?

She feels guilty, clearly. Why would someone feel guilty about ensuring their own well-being and/or the well-being of their family? Isn’t that what good people do? Perhaps because all too often society, religious leaders, and politicians tell women, “You’re killing your unborn child,” when they really should be saying, “I’m proud of you for being responsible and doing the right thing for you and your family.” The impact on a woman’s mental health before and after her abortion has a great deal more to do with the social stigmatization of her decision and her support system than it has to do with the abortion itself. Deciding the best course of action for an unplanned pregnancy is a decision no woman makes lightly. Those who disagree with abortion may do so, but should do so with compassion and sympathy, not with anger and derision.

Poor-quality research on mental health and abortion has been published (and is often cited by inexperienced readers) stating that abortion increases a woman’s probability of experiencing depression, regret and PTSD. This is not true, however, and the majority of the medical research community has criticized these publications as being borderline criminal. High-quality research has shown the following:

Most women do not experience psychological problems or regret their abortion 2 years post-abortion, but some do. Those who do tend to be women with a prior history of depression.” “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. These findings refute claims that women typically regret an abortion.
— Major et al, Arch Gen Psychiatry, 2000

The vast majority of women expect to cope well after their abortion. A small number make the decision to terminate their pregnancies even though they anticipate difficulty coping after the procedure.
— Foster et al, Contraception, 2012

Protesters do upset some women seeking abortion services. However, exposure to protesters does not seem to have an effect on women’s emotions about the abortion 1 week later.
— Foster et al, Contraception, 2012

The name-calling, guilt-laying, and self-righteous proclamations of why she should do as you say (and you know who you are) must end. There is no malice in having an abortion. It is a decision that a woman makes for herself most importantly, and for her family as well. She does not make it for anyone else; it would be detrimental if she did. A woman having an abortion will most often have feelings of relief knowing that she was able to take care of herself safely and live the life she desires. Guilt and regret come from stigmatization, not from doing the right thing. The stigmatization of abortion must come to an end.

Libertyville abortion protesters

Abortions Save Lives

Some people have surgery because they wish the faces they were born with looked different. Some people have surgery because they feel their bodies need improving. I am not referring to burn victims or those born with physical abnormalities that would benefit from surgery for improved quality of life, I am referring to the “Joan Rivers'” of the world, for example, whose surgeries are elective and not medically indicated.

There is no such thing as an elective abortion. Period. Every woman has an indication to have an abortion and every indication is valid. The choice to undergo the risks of carrying a pregnancy, giving birth to an infant, and then rearing the infant are all different stepping stones with different consequences in the same spectrum of reproductive health. A woman may choose not to undertake any risk of pregnancy and have an abortion, or she may choose to undertake the risks of pregnancy and childbirth but not the risks and sequelae of rearing the child. These are decisions that no woman makes lightly.

I know what you are about to say, but consider this: contraceptive methods fail. Even the most effective methods, such as sterilization, have a failure rate of less than 1 in 1,000, which is as good as it gets after abstinence but that means pregnancy can still happen. Men and women can do everything they are supposed to in order to avoid pregnancy, but nothing is perfect or without risk in this world.

Abortions have saved the lives of many women I have had the privilege of caring for. If a woman has to choose between having an abortion and the financial burden of having another child, risking becoming unemployed, homeless or not being able to provide for herself or the family she has, then the abortion is life-saving. If a woman has to choose between having an abortion and delaying treatment for her diagnosis of cancer, potentially costing her life, then the abortion is life-saving. If a woman has to choose between having an abortion and refusing an abortion that is the treatment for an infection in a pregnant uterus which could spread to her body causing sepsis, then the abortion is life-saving. If a woman has to choose between having an abortion and continuing a pregnancy with her heart condition that would worsen and cause her to have heart failure and possibly die, then the abortion is life-saving.  (modified 11-13-12) (modified 11-13-12)

The list goes on. These are not fairy tales. These cases are real, and I have been involved in others that are similar. What is a valid reason for having an abortion? If a woman does not want to undergo the risks of pregnancy, childbirth, and/or rearing a child that is reason enough. It is valid. It is an indication.

As long as humans have been having sex, humans have been performing abortions. It is one of the treatments for a diagnosis of undesired fertility and an essential part of reproductive health care. Keep it legal. Keep it safe.

“ACOG will promote access to contraception, including emergency contraception, for females of reproductive age, and advocate the use of medically accurate information.  ACOG opposes unnecessary regulations that limit or delay access to care.”