Women with unwanted pregnancies who have an abortion are no more likely to develop mental health problems such as anxiety and depression than those who give birth, a comprehensive new British study has found.
The study, which was conducted by Britain’s National Collaborating Centre for Mental Health (NCCMH), did uncover an association between unwanted pregnancies and a higher incidence of anxiety and depression. But that association had nothing to do with the choices the women made regarding the outcome of their pregnancy.
In fact, the study found that the most reliable predictor of whether a woman would have mental health problems after an abortion was the existence of such problems before the abortion.
“It could be that these women have a mental health problem before the pregnancy,” Tim Kendall, director of the NCCMH, told BBC News reporter Jane Dreaper. “On the other hand, it could be the unwanted pregnancy that’s causing the problem. Or both explanations could be true. We can’t be absolutely sure from the studies whether that’s the case, but common sense would say it’s quite likely to be both.”
“The evidence shows, though, that whether these women have abortions or go on to give birth, their risk of having mental health problems will not increase,” he added.
The NCCMH study also cites other factors that appear to contribute to a woman’s risk of developing anxiety or depression after an abortion. These include being pressured by a partner to have an abortion and having negative attitudes toward abortions in general.
For this meta-analysis, a team of reviewers spent three years examining data on hundreds of thousands of women in 44 previously published studies from around the world. They included in their review only those studies that had followed women for at least 90 days.
A major methodological flaw was found in the studies in that group that linked abortion with an increased incidence of mental health problems, said Kendall.
“They don’t control for the fact that a number of women going into these studies have mental health problems already, so then it looks as if following abortion they have a raised incidence of mental health problems,” he told the BBC. “But we think that’s an artifact of the way the research is being done.”
Time to switch the focus
The NCCMH study confirms the findings of a similar major review conducted by the American Psychological Association in 2008. That review concluded that “there is no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems for adult women.”
“I think the practice and research around this area should no longer focus on the impact of abortion,” said Kendall. “We don’t think the abortion is the important issue. What we do think is that women with an unwanted pregnancy probably already have significant mental health problems. That may be because significant mental health problems lead to more unwanted pregnancies, or just as likely having an unwanted pregnancy is a personal catastrophe and that itself is leading to mental health problems.”
“The message to mental health workers and people in obstetrics is that women with an unwanted pregnancy probably do have need for our help, and that’s where we should be offering it,” he added.
You can download and read the full report from the website of the Academy of Medical Royal Colleges (the U.K. government agency that commissioned the study).