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Myths and Facts Concerning Abortions and Mental Health

  • October 29, 2024
  • Patients and Families, Public awareness, Women

In June 2022, the U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization reversed Roe v. Wade, the landmark 1973 decision recognizing a constitutional right to abortion. Following the 2022 decision, the legality of abortion procedures fell under the jurisdiction of state governments, which created a patchwork of legislative mandates across the nation. Some states have since banned or restricted abortion and in some states passed new legislation to protect abortion rights.

It is the long-standing position of the APA that “abortion should be available to pregnant persons as part of standard health care and that decisions about abortion should be made by a pregnant person and their physician . . .. Although the decision to have an abortion is a personal one, access to abortion is a critical component of evidence-based medicine for patients and physicians.” (APA 2024)

The APA Council on Women’s Mental Health has put together a series of Myths and Facts everyone needs to know about abortion and mental health.

MYTH An abortion negatively affects a woman’s mental health.
FACT Women who have had a desired abortion are not more likely to have negative mental health problems than those forced to keep their pregnancy to term or give their babies up for adoption. (National Academies of Sciences, 2018; Major et al, 2008)

In a study of almost 1000 women across 21 states, researchers at the University of California found that those who had abortions were no more likely to report negative emotions, mental health symptoms, or suicidal thoughts than those who were denied an abortion. Five years later, 99% of those who obtained an abortion felt that they had made the right decision, and their most reported emotional reaction was relief. (Biggs et al., 2017)

On the other hand, restricting abortion care when needed or wanted has been shown to increase the risk of mental health more than abortions. The same study found that women who wanted to get an abortion, but were denied one, initially experienced more anxiety symptoms and stress, lower self-esteem, and less life satisfaction than those who received an abortion. Over time, those same women developed more physical health problems than those who received abortions. (Biggs et al, 2017) Additionally, a 35-year-long study found that the denial of abortion leads to an increased risk for negative psychosocial development and mental well-being in adulthood. (Kubicka, et al, 2002)

Simply put, abortion does not lead to mental health harm and there is much evidence that being denied a desired abortion worsens mental health more than undergoing said abortion.

MYTH Women who have had abortions are at a higher risk of being depressed.
FACT Women who undergo an abortion are not at a higher risk of developing depression than women after a delivery. (Biggs et al, 2017; Kubicka, et al, 2002; Ogbu-Nwobod, et al 2022)

MYTH Abortion leads to “post abortion traumatic stress syndrome.”
FACT No evidence has been found to support the existence of this condition. This purported condition is not recognized as an official diagnosis by either the American Psychiatric Association or the American Psychological Association.

MYTH Women on psychiatric medication can stop the medication during pregnancy.
FACT It has been shown repeatedly that periods without medication treatment leads to worsening of symptoms, treatment difficulties, and poor outcomes. Many of us on the APA Council for Women’s Mental Health practice Reproductive/Perinatal Psychiatry, which includes a careful assessment of a woman’s mental health and medication history. The use of medication in pregnancy is a considered shared decision-making process, as untreated mental health conditions pose risk to the mother, the health of the pregnancy, and the child. Some of these include: poor prenatal care, preterm delivery, low birth rate, higher rates of preeclampsia and gestational diabetes, worse infant health status, low IQ, slower language development, and tragic outcomes such as maternal suicide or infanticide. (Hutner et al, 2001) Children of actively depressed mothers have a higher chance of being neglected, failing to thrive, of developing ADHD, or developing depression and anxiety. (NRC and IOM 2009)

MYTH The abortion process is dangerous and life threatening.
FACT It has been repeatedly proven over time that an abortion is a safe medical intervention. Pregnancy and childbirth pose a much greater risk to a woman's health and life than a legal abortion. (Raymond and Grimes, 2012)

MYTH Abortions lead to infertility and are an impediment to future fertility.
FACT An abortion does not lead to an increased risk of infertility. In fact, a woman can get pregnant immediately after an abortion. (National Academies of Sciences, 2018) In addition, people denied abortions are more likely to live in poverty, and their children are more likely to live in poverty. These children are less likely to bond well with their mothers, which is associated with poorer outcomes in the short-term and later in life. These children are also more likely to have social, emotional, and mental health problems over time, and are more likely to be hospitalized for psychiatric problems than their siblings or than children whose pregnancies were planned. Enabling people to postpone childbearing is associated with better outcomes for children. (Foster 2022; Foster et al, 2018)

By the APA Council on Women’s Mental Health
Eman El Gamal, M.D., member
Priya Kumar-Kaparaboyna, M.D., member
Iremide P Obasan, medical student, guest
Ludmila De Faria, M.D., Chair

References

  • American Psychiatric Association. 2023. Position-Abortion-Reproductive-Rights 
  • American Psychiatric Association. 2023. Position Statement on Abortion, Family Planning, Legislative Intrusion, and Reproductive Decisions 
  • American Psychiatric Association. 2024. Resource Document on the Role of Psychiatrists in the Post-Roe Era. Prepared by the Council on Psychiatry and Law; Council on Women’s Mental Health; Council on Children, Adolescents, and Their Families; Ethics Committee; Council on Consultation-Liaison Psychiatry; and Council on Minority Mental Health and Health Disparities. Authors: Nancy Byatt, D.O., Nina Bihani, M.D., and Paul S. Appelbaum, M.D.
  • Biggs, M. A., Upadhyay, U. D., McCulloch, C. E., & Foster, D. G. (2017). Women's Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion: A Prospective, Longitudinal Cohort Study. JAMA psychiatry, 74(2), 169–178. https://doi.org/10.1001/jamapsychiatry.2016.3478
  • Foster DG. New abortion bans will increase existing health and economic disparities. (2022). Am J Pub Health;112(9):1276–1277. doi: 10.2105/AJPH.2022.306993.
  • Foster DG, Biggs MA, Raifman S, Gipson J, Kimport K, Rocca CH. (2018). Comparison of health, development, maternal bonding, and poverty among children born after denial of abortion vs after pregnancies subsequent to an abortion. JAMA Pediatr;172(11):1053–1060. doi: 10.1001/jamapediatrics.2018.1785.
  • Hutner, Lucy A.; Catapano, Lisa A.; Nagle-Yang, Sarah M.; Williams, Katherine E.; and Osborne, Lauren M., "Textbook of Women's Reproductive Mental Health" (2021).
  • Kubicka, L., Roth, Z., Dytrych, Z., et al. (2002). The mental health of adults born of unwanted pregnancies, their siblings, and matched controls: a 35-year follow-up study from Prague, Czech Republic. The Journal of nervous and mental disease, 190(10), 653–662. https://doi.org/10.1097/00005053-200210000-00001
  • Major B. Report of the APA task force on mental health and abortion. (2008). American Psychological Association. https://www.apa.org/pi/women/programs/abortion/mental-health.pdf
  • Ogbu-Nwobodo, L., Shim, R. S., Vinson, S. Y., et al.(2022). Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations. The New England journal of medicine, 387(17), 1613–1617. https://doi.org/10.1056/NEJMms2211124
  • National Academies of Sciences, Engineering, and Medicine. 2018. The Safety and Quality of Abortion Care in the United States. Washington, DC: The National Academies Press. https://doi.org/10.17226/24950
  • National Research Council and Institute of Medicine. 2009. Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Washington, DC: The National Academies Press. https://doi.org/10.17226/12565.
  • Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol. 2012 Feb;119(2 Pt 1):215-9. doi: 10.1097/AOG.0b013e31823fe923. PMID: 22270271.

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