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Posted at 10:05 AM ET, 12/13/2010

Study disputes link between abortion and mental health problems

By Rob Stein

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Mental Health Awareness Ribbon

A new analysis disputes the contention that women who have abortions are more prone to mental health problems.

Julia Steinberg of the University of California, San Francisco, and Lawrence Finer of the Guttmacher Institute examined data collected by the National Comorbidity Survey. In 2009, Priscilla Coleman of Bowling State University and colleagues published an analysis of the same data that concluded that compared with women who had never had an abortion, women who reported having had an abortion were at increased risk for anxiety, mood disorders and substance abuse.

But the new analysis, published online by the journal Social Science & Medicine, failed to find the same link, even without taking into account other key factors such as a history of mental health problems.

"We were unable to reproduce the most basic tabulations of Coleman and colleagues," Steinberg said in a statement released with the paper. "Moreover, their findings were logically inconsistent with other published research -- for example, they found higher rates of depression in the last month than other studies found during respondents' entire lifetimes. This suggests that the results were substantially inflated."

When Steinberg and Finer examined other factors, such as preexisting mental health disorders and sexual or physical violence before the abortion, they found that women who had had multiple abortions were more likely to have those risk factors before the abortion compared with women who had had one or no abortions. Once the researchers took that into consideration, they found no significant relationship between abortion history and substance abuse or mood and anxiety disorders, they reported.

"Antiabortion activists have relied on questionable science in their efforts to push inclusion of the concept of 'post-abortion syndrome' in both clinical practice and law," Finer said. "Our inability to replicate the findings of the Coleman study makes it clear that research claiming to find relationships between abortion and poor mental health indicators should be subjected to close scrutiny."

Coleman disputed the contention the new analysis contradicted her findings, saying the researchers used different methods. In particular, she said her analysis looked at whether women who had abortions experienced psychological problems over a longer period of time.

"I am not the only credentialed scientists whose research is indicating that abortion is not without serious mental health risks for many women," she wrote in an email.

Advocates opposed to abortion similarly dismissed the new analysis.

"The abortion industry will stop at nothing to advance their agenday, including politicizing science at the expense of women's health," said Jeanne Monahan of the Family Research Council in an email.

By Rob Stein  | December 13, 2010; 10:05 AM ET
Categories:  Abortion, Alcohol and Drugs, Mental Health  
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Below are additional comments provided to Rob Stein at his request.

Despite their many claims to have conducted a “re-analysis” of our study published in the Journal of Psychiatric Research (JPR), Steinberg and Finer have conducted a very different set of analyses. The critical distinction is in how the psychological disorders were defined. Our analyses reflected 12-month prevalence and their analyses reflected only the 30 day prevalence. Our results are quite similar to those reported by pro-choice researcher David Fergusson in 2006 and many others. There are additional differences between the two sets of analyses, most notably related to the choice of potential confounding variables and the methods used to control them in the analyses.”

There are researchers in Australia, Canada, New Zealand, Norway, South Africa, and elsewhere who have published close to 100 studies in the last 10 years indicating adverse psychological effects of abortion.” Are all these studies flawed too? The real story here is the lengths that biased researchers, professional organizations, and the media will go to hide and distort highly credible scientific data.”

Do these authors have plans to “replicate” the 2010 study by Mota and colleagues published in the Canadian Journal of Psychiatry? These authors used the NCS Replication data and their results were quite consistent with ours.

I find it hard to imagine that Steinberg and Finer believe a journal as reputable as the JPR edited by Alan Schatzberg, M.D., president-elect of the American Psychiatric Association, would publish an article indicating that abortion poses psychological risks to women independent of other stressors without scrutinizing the methodology carefully.

These two authors have strong pro-choice ties. The first author is a recent recipient of the generous Charlotte Ellertson Social Science Fellowship and the second author is a long-time employee of the Guttmacher Institute. The conscientious reader will question their objectivity after googling the fellowship and the institute.

These authors wrongly assumed we conducted our analyses in a particular manner and then made unprofessional, disparaging remarks, hoping I suppose to continue to hide the reality from women.

We owe the millions of women who have had abortions in the past and will undergo them in the future a fair representation of the scientific research. After the highly biased American Psychological Association report was published two years ago, I conducted a meta-analysis or quantitative synthesis of the strongest studies. The results based on nearly a million respondents unequivocally indicate that abortion increases the risk of depression, anxiety, substance abuse, and suicide.

Curiously, the psychological benefits of abortion have not been established scientifically, they are we presume the benefits of other medical procedures?

Priscilla K. Coleman, Ph.D.

Posted by: pcoleman2 | December 13, 2010 5:15 PM | Report abuse

Regardless of the scientific findings--which must be very difficult to determine for sure about such a complicated subject--the pro-life community is shooting itself in the foot by depending on their outcome. If you believe on principle that abortion is always (or almost always) wrong, then one should argue on that basis. Otherwise you are at the mercy of whatever scientific finding about abortion and mental health or breast cancer or whatever happens to be current. What if someday a study finds that women who've had an abortion have less colon cancer or something? Then what would you do? The pro-life community is putting way too many eggs into the "abortion causes depression" basket.

And suggesting that people come to the opposite conclusion, or would at least be happy to have it be so, because of their political convictions cuts both ways.

Posted by: di89 | December 13, 2010 6:15 PM | Report abuse

Here are interesting facts about interesting about the Steinberg analysis:

1. They reduced statistical significance 12 fold by cutting the observation time from one year to 30 days.

2. Reduced statistical power causes a spreading of the confidence intervals, which still overlap with the confidence intervals reported by Coleman. Therefore, they do NOT contradict, much less disprove Coleman's findings. Instead, they simply find that within 30 days the difference in depression rates, for example, is not strong enough to be called statistically significant. That does not contradict Coleman's finding that within the first 12 months, the differences are statistically significant.

3. Steinberg confirmed a several fold elevated rate of substance abuse problems associated with women who have 2 or more abortions. Since 50% of all abortions are for women with a prior history of abortion, this finding affects nearly half of all abortion patients.

4. Steinberg confirmed that there are no statistically significant benefits from abortion. Abortion does not reduce the risk of depression or it was predicted to do so in the 1960's, since it was intended to spare women the stresses of having an "unwanted child." Indeed, not one study has shown any statistically associated benefits. All the claims of benefit are merely anecdotal.

5. Steinberg asserts that the association between abortion and mental health problems may be best explained by common risk factors, such as a prior history of depression. Coleman appears to believe that abortion may either cause depression where none previously existed, or may exacerbate or trigger depression if their is a pre-existing tendency toward depression. They are arguing about causality.

But either case, even in Steingberg's interpretation, all the statistical evidence agrees that abortion is a MARKER for higher rates of mental illness. No one disputes this, and given the hundreds of studies confirming it, no one can.

That means that whether or not abortion is the direct cause of mental health problems is a separate question from the irrefutable fact a history of abortion is a reliable marker for increased risk of mental health problems.

Markers are valuable and should be used. Specifically, this means doctors and therapists should be inquiring about abortion history to help identify women who may benefit from referrals for depression, anxiety, substance abuse, suicidal ideation, and sleep disorder -- all of which are associated with a history of abortion.

Proper screening for risk factors is not a political question, it is simply good medical and therapeutic practice.

Yet this common sense view appears to be getting lost in Steinberg's rush to accuse Coleman of producing results that can not be least not when examining only 8% of the time period examined by Coleman.

Posted by: Trig1 | December 13, 2010 6:36 PM | Report abuse

So, someone from The Guttmacher Institute, an arm of Planned Parenthood did the study and we are suppose to believe it was unbiased??

At the present time there are many groups of post abortive women around the country (and it is growing)who would disagree with these findings, yet no one ever calls them. In addition, we are never even mentioned..instead we are labeled "anti abortion" instead of what we are, women who have aborted their unborn babies.

With over 50 millions abortions in our country, everyone knows someone who has suffered. No matter what this study says, we are speaking out for ourselves in the hopes of reaching those who are feeling alone and suffering because of their abortions. Denying their feelings and experiences only adds to the mental anguish felt by these women.

It is a grave injustice to deny what we have felt as a result of our abortions. How is it that anyone, no matter what side of the issue you are on would not be able to understand how ending the life of your child would cause mental health problems?

Tell Julia Steinberg and Lawrence Finer to call me and I can introduce them to tons of women who abused drugs, got eating disorders, lived with depression and a host of other things because of abortion. But then, I do not think they want to speak to any of us.

Posted by: lumina1 | December 14, 2010 7:49 AM | Report abuse

One of the TRULY GREAT THINGS ABOUT UNIVERSAL HEALTHCARE, is we will finally have the entire population health statistics online from birth to grave.

Causal conditions will be brought out of this rich database.

Persons with mental health problems will be recorded (anonymously by encrypted identity) and subsequent abortions recorded, and subsequent problems recorded.

It will become crystal clear, with no room for satanic liars and haters to distort the facts, whether abortion causes downstream problems and needs early intervention counseling or other medicinal support to head off unwanted pregnancy leading towards abortions.

Finally women will get the medical help that they need early enough before it grows into a tragedy. Oh and causal links to cancers will turn up too.

Everybody benefits, even the satanic liars and haters trying to perpetuate misery and maximize bad health.

Posted by: Liann | December 14, 2010 7:13 PM | Report abuse

How about a comparison showing depression in women who have had children (post partum depression) vs women who had an abortion. I know I didn't feel any depression when I had an abortion - I felt a great relief.

Posted by: nova94 | December 15, 2010 1:35 PM | Report abuse

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