Many anti-abortion advocates claim women’s mental health is at risk if they have an abortion, but new research shows denying access is more detrimental.
If a woman makes the choice to have an abortion, and is told that she can't—she's past the clinic's cutoff gestational date—it seems intuitive that that would be a stressful situation. But research has mostly focused on what happens to a woman's mental health when she does have an abortion, and anti-abortion laws are often propped up by the belief that the procedure can lead to negative mental health effects.
Now the results of a new, five-year study that tracked the mental health of women seeking an abortion—whether they got one or not—over time shows that denying a woman an abortion can have serious mental health effects.
"If our goal is to protect women's mental health, this study certainly doesn't find that denying them an abortion protects their mental health," said lead author Antonia Biggs, a researcher at the University of California San Francisco's Bixby Center for Global Reproductive Health. "It shows that allowing them to have an abortion is more protective of their mental health."
Biggs and her colleagues recruited women at 30 abortion facilities in 21 states across the US who were seeking an abortion between 2008 and 2010, according to the study published Wednesday in JAMA Psychiatry. These women were interviewed one week after seeking an abortion, and then again semi-annually for five years, totaling 11 interviews, to assess their mental health over time. Though they started out with a group of 1,132 participants, it's hard to retain that many people for such a long study. Still, by the end they had five years of data from 558 women.
These women were divided into three categories: those who had an early term abortion, those who got an abortion but were cutting it close (within two weeks before the cut off point, which varies from state to state but generally sits around 20 weeks), and those who just missed the gestational cut-off point (by up to three weeks) and were denied an abortion. The women who were denied an abortion were further divided into two categories: those who ended up giving birth (the majority), and those who miscarried or got an abortion elsewhere.
Using a standard measure of mental stress and even after controlling for past histories of mental health, the researchers found that women who were denied an abortion experienced a spike in anxiety and a drop in self esteem and life satisfaction immediately after being turned away—noticeably more than the women who got their abortions.
When it came to depression, there wasn't a significant difference between the groups and, over time, all of the women saw improved mental health. This is counter to a common anti-abortion claim that women who get an abortion will have negative mental health consequences many years later.
"The idea is it would be triggered by, for example, another fertility event," Biggs told me. "We [tracked mental health over] five years, and the trend we're seeing is a general improvement in mental health over time. We have no reason to think that all of a sudden the direction would switch."
Nine states—Kansas, Louisiana, Mississippi, Nebraska, North Carolina, South Dakota, Texas, and Utah—have laws requiring women seeking an abortion to receive counseling that warns them it could have a negative impact on their mental health, according to the Guttmacher Institute. And this is a common claim among anti-abortionists: that abortions cause women mental stress, depression, and anxiety. But the research supporting these claims has largely been refuted, or is based on comparisons to women who completed wanted pregnancies—two groups that are inherently different.
By comparing groups of women who all wanted an abortion, but who didn't all receive one, and following them for such a lengthy period of time, researchers have a stronger body of evidence for what the mental effects of abortion really look like. And the evidence doesn't support denying access to women seeking an abortion, it supports increasing access for women who have made this choice. As we face a potentially rocky future of reproductive health rights in the US, having data like this helps support those working to improve access and fight misinformation.