People have been arguing for decades over whether abortion endangers a woman's mental health. Now, a new study could settle the debate.
Choosing to have an abortion is not an easy decision, and scientists have put a lot of effort into trying to find out whether women are harmed by that choice. This new study, in the New England Journal of Medicine, says they are not.
Robert Blum, an expert on reproductive health at the Johns Hopkins Bloomberg School of Public Health, did not work on the study, but he has worked in the field for decades.
"This is an extremely, extremely well done study," he said. "There is no evidence that abortion predisposes a woman to psychiatric and mental health problems."
The issue has been a political hot potato since the 1980s. Back then, President Reagan ordered Surgeon General C. Everett Koop to write a report saying that abortions are bad for women's health. Koop sidestepped that duty. But the argument continues, with scientists drawn into debate.
Blum, a former president of the Guttmacher Institute, would like to say goodbye to the political buzz words.
"There is no post-abortion trauma, post-abortion syndrome, or anything of the like," he said.
Danish researchers looked at the health records of 85,000 women who had had first-trimester abortions. Those women were more likely to seek mental health treatment while they were pregnant, but didn't need more help after having the abortion. That's not surprising, says Nada Stotland, a professor of psychiatry at Rush Medical College in Chicago. She says that women considering abortion are often struggling with problems with a partner or family members.
"People have abortions often under troubled circumstances," she said. "You have an abortion because there is a problem."
What makes this study unique is that it looked at women who chose abortions and also looked at women who chose to have the baby. Stotland says this gives us a much better picture of the stresses of abortion and childbirth.
"Above all it really fairly contrasts the outcomes of abortion with the outcomes of pregnancy," she said.
The women who decided to have babies were doing great while they were pregnant. For some, that picture changed when they became mothers. Trine Munk-Olsen, the scientist who led the Danish study, says they saw a sudden spike in new mothers who needed help with severe mental disorders, including psychosis and depression after delivery.
That's true not just in Denmark. As many as 25 percent of new mothers experience post-partum depression. It's a significant public health problem. Blum says that new mothers need much more help.
"We need to acknowledge and provide mental health support for a significant number of women who experience post-partum depression," he said.
The message then is that pregnancy poses mental health challenges for women, whether they choose to give birth or choose to have an abortion. Stotland says that's why women need friends and family to stand by them.
"They might not agree with your decision, that's not the same thing," Stotland said. "They have to support you, they have to know that no one else can make this decision but you."
Although those choices are intensely personal, the debate will no doubt remain political.