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Abortion and Mental Illness: A Phantom Epidemic

By David A. Grimes, M.D.
May is Mental Health Month in the U.S. Focusing national attention on mental illness is important because it is so common and causes so much suffering.  The National Institute of Mental Health estimates that about 44 million persons (19%) in the U.S. have some mental illness.  According to abortion opponents that figure should be vastly higher.  Indeed, their junk science suggests that America should be grappling with a staggering epidemic of depression and suicide stemming from abortions. The good news is that this epidemic is illusory: it does not exist.
Abortion is a common experience in the lives of American women.  Indeed, one in three women will have had one or more abortions before menopause.  More than 50 million U.S. women have benefited from safe, legal abortion since Roe v. Wade in 1973.  If abortion were linked with later psychological problems, the nation's psychiatrists and psychologists should be inundated by now with women suffering from problems related to earlier abortions.  The phantom epidemic never materialized, because abortion does not impair women's emotional health.
Since abortion is so safe, abortion opponents have had to manufacture bogus medical and psychological concerns to frighten women.  In the 1980's, an anti-abortion activist without medical credentials coined the term "post-abortion stress syndrome." Fashioned after post-traumatic stress syndrome, it was catchy -- but bogus.  The term was quickly refuted by psychiatrists and rejected by psychiatry coding manuals.
Reviews of the literature
At the request of President Reagan, Surgeon General C. Everett Koop reviewed the published evidence concerning abortion and mental health.  Despite his well-known opposition to abortion, Dr. Koop concluded that the issue of psychological problems stemming from abortion was "miniscule from a public health perspective."
Several professional organizations have reviewed the world's literature to address the concern.  The American Psychological Associationtwice conducted thorough reviews of the literature.   The most recent report, covering reports published from 1989 to 2008, concluded that a single abortion carries no higher risk of emotional problems than does delivery of an unwanted child.
In the United Kingdom, the federal government commissioned a similar review by the Royal College of Psychiatrists and the Royal College of Obstetricians and Gynaecologists.  Organized by the Academy of Medical Royal Colleges, the 252-page report was released in 2011.  It concluded that, "When a woman has an unwanted pregnancy, rates of mental health problems will be largely unaffected whether she has an abortion or goes on to give birth."
A similar systematic review by researchers from Johns Hopkins University noted an inverse relationship between study quality and research results.  Poor-quality research was more likely to report an association between abortion and later problems than was good-quality research.  Stated alternatively, competent research consistently finds no relationship between abortion and later problems.  Research that violates the standards of conduct is not credible.
Conclusions of professional organizations
The American Psychological Association notes that stress is greatest before abortion, and relief is the most common emotional response to abortion.  The strongest predictor of a woman's emotional state after abortion is her emotional state before the procedure.
The American Psychiatric Associationstrongly supports safe, legal abortion.  The APA "opposes all...legislation and regulations curtailing family planning and abortion services to any segment of the population."  Moreover, "...freedom to act to interrupt pregnancy must be considered a mental health imperative."  Were abortion a threat to women's emotional well-being, the nation's psychiatrists would not be so supportive.  Of note, the American Psychological Association and American Psychiatric Association have no professional conflicts of interest; their members do not provide abortions.  
Stated-mandated disinformation
When a woman requests an abortion in South Dakota, she must be advised by her physician that the risks of the procedure include:
"Depression and related psychological distress;
 Increased risk of suicide ideation and suicide."
Although these statements are false, the state legislature requires this disinformation be conveyed by physicians.  This violates both the sanctity of the patient-physician relationship and the doctor's ethical obligation to the patient. Consider the physicians' choice: lie to patient to advance the state's political agenda or provide medically accurate information about risks, benefits, and alternatives. Who should decide the relevant information to be discussed during the informed consent process: knowledgeable, licensed physicians or part-time politicians in Pierre?
Summing up
Major medical and psychological associations on both sides of the Atlantic Ocean concur: abortion does not cause mental health problems.  The only dissenting voices today are a few discredited zealots who are paid large amounts of money to spread junk science.The alleged epidemic of emotional problems related to abortion is a phantom; it does not exist.  On the other hand, the psychological harms of unwanted childbearing are all too real.

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One of the world's leading abortion scholars, David A. Grimes, M.D. has studied, provided, and taught abortions for over four decades. Former Chief of the Abortion Surveillance Branch at the Centers for Disease Control and Prevention, Dr. Grimes helped to chronicle the public health benefits of legal abortion in the U.S. in the early 1970's, making several discoveries that improved its safety. Working with the CDC and the World Health Organization, he has conducted abortion research in the U.S. and overseas.
Dr. Grimes has published more than 130 articles on abortion in peer-reviewed journals, including The New England Journal of Medicine, The Journal of the American Medical Association, The Annals of Internal Medicine, and The British Medical Journal.  He was an editor of the first two editions of the National Abortion Federation textbook on abortion and has been appeared in the Los Angeles Times as well as on the Donohue Show, Montel Williams, Sally Jesse Rafael, Nightline, and Good Morning America.
Dr. Grimes has received numerous awards for his contributions to women's health, including a Commendation Medal from the U.S. Public Health Service, The Christopher Tietze Award from the National Abortion Federation, and the Alan Guttmacher Award from the Association of Reproductive Health Professionals. He received the Distinguished Service Award from the American College of Obstetricians and Gynecologists in 1997, was elected to membership in the Institute of Medicine of the National Academies of Science, and was made an Honorary Fellow of the Royal College of Obstetricians and Gynecologists in the U.K.
Dr. Grimes resides in North Carolina.
Every Third Woman in America: How Legal Abortion Transformed Our Nation is available for purchase at Amazon, Barnes and Noble, and Lulu.
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