From the Elliot Institute
Researchers Drew the Wrong Conclusions In New England Medical Journal Study
Springfield, IL (January 27, 2010) -- A study that is being reported as showing abortion doesn't increase women's mental health risks actually shows a higher rate of problems among women who have abortions compared to those who give birth, a leading expert says.
The study, published in the New England Journal of Medicine, was based on a comparison of medical records among women in Denmark who had a first-trimester induced abortion or a first childbirth between 1995-2007. The researchers compared inpatient and outpatient psychiatric treatments for nine months before the abortion or birth took place and twelve months afterward. Women who had a history of mental health problems before the study period were excluded.
Dr. David Reardon of the Elliot Institute said the findings showed that aborting women were two to three times more likely to seek treatment for mental health problems compared to women who gave birth or who had not been pregnant.
The study's authors, on the other hand, focused on a finding that the rate of psychiatric treatment was similar for women both before and after abortion. They concluded that the study "does not support the hypothesis that there is an increased risk of mental disorders after a first-trimester induced abortion."
But Reardon, who has worked on more than a dozen studies finding increased mental health problems among women who abort, said the findings don't support this conclusion.
He said the two to three times higher rate of psychiatric treatment among aborting women confirms other studies finding that women who have abortions have higher rates of mental health problems compared to women who give birth. More than 35 such studies have been published in the last five years alone.
"Other studies have found that abortion is a marker for mental health problems, and this study agrees with those findings," Reardon said. "The finding that women who have abortions are more likely to seek psychiatric treatment compared to women who give birth is consistent with previous findings."
Study Raises More Questions
One important factor not covered by the study, he said, was whether women who sought psychiatric help before abortion also sought help after abortion.
"If the same women underwent treatment both before and after abortion, it could indicate that seeking psychiatric care prior to abortion is a risk factor for mental health problems after abortion," Reardon said. "On the other hand, if the women who sought care after abortion had no previous treatment, then the problems likely began after the abortion took place, since the researchers excluded women who sought treatment prior to nine months before the abortion or birth took place."
This meant that the researchers were looking at records for only the most mentally stable women, reducing the possibility that problems among aborting women were related to their previous psychiatric history.
Limitations and Flaws
And although the study has been described as an "extremely, extremely well-done study," Reardon and other critics pointed to a number of flaws and limitations in the study design.
For example, although the researchers compared women having abortions for the first time to women giving birth for the first time, the study wasn't limited to women who had not previously been pregnant. Women who had a previous abortion could thus be included in the birth group and women who had a prior birth could be included in the abortion group. This means that there is no way to know if mental health problems in either group might not be linked to a previous, different pregnancy outcome.
The study also did not control for other factors that could affect a woman's mental health, including whether or not the pregnancy was wanted, coercion to abort, and exposure to violence or other traumas.
And while the study only looked at women's mental health for a year following abortion, previous research has indicated that mental health problems often emerge or persist after that point. A record-based study of psychiatric treatment rates among women receiving state-funded medical care in California, which Reardon co-authored, found that rates of psychiatric treatment remained significantly higher for at least four years after abortion.
Despite this limitation, a breakdown of the rates of psychiatric treatment for each month after abortion showed that the rates of psychiatric treatment for specific problems -- such as stress, neurotic, behavioral and personality disorders -- did increase in certain months after abortion compared to pre-abortion rates.
Reardon concluded that the new study doesn't contradict the findings of previously published studies that link abortion to higher rates of mental health problems.
"Overall, this new Danish study adds to the already available evidence linking abortion and mental health problems," he said. "It also raises new questions that deserve further exploration, such as whether psychiatric care before abortion benefits women. What is doesn't show is that having an abortion benefits women who are facing a crisis or erases their problems. Instead, it may contribute to them."