The choice of having an abortion or getting the pregnancy terminated is in the hands of the pregnant woman. While the opponents of abortion may claim that pregnancy termination leads to emotional distress and various other psychological problems, it may vary from one person to another. Yes, it can have psychological consequences that may be greater than its physical impact, however, it does not affect a woman’s mental health or well-being in the long term.
Women may have questions that should be answered by their doctor and nurses should be able to establish whether support is needed before and after termination. Although abortion procedures are relatively safe, they can still cause physical complications if the pregnancy has advanced to a later stage.
Taking a Look at the Findings (pregnancy termination)
At the Bixby Center for Global Reproductive Health, a prospective study was conducted on women from 30 different abortion facilities. For tracking their psychological well-being, these women were interviewed twice a year over 5 years. A total of 956 women were a part of this study. These women were divided into 3 different groups depending upon various factors.
1st group – women who had successfully undergone pregnancy termination (as they were within the facility’s gestational limit)
2nd group – women who wanted to have an abortion but were denied as they were 3 weeks beyond the facility’s gestational limit. This group was further divided into multiple other groups that consisted of women who ended up having an abortion elsewhere or had a miscarriage and women who gave birth.
3rd group – women who received a first-trimester abortion
These women were tested on various psychological factors such as a measure of depression, anxiety, self-esteem, and life satisfaction. Factors such as age, marital status, race, history of mood disorders, history of child abuse, and drug abuse were also taken into consideration.
Each of these groups was compared according to their depressive symptoms and results were recorded. It was observed that women with first-trimester abortion and others who were within the facility’s gestational limit experienced fewer initial depressive symptoms than women who were denied an abortion.
Talking about levels of anxiety, women who sought abortion elsewhere and women who ended up giving birth had immediate symptoms than women who received an elective termination.
At the end of the study, it was observed that women who had an elective pregnancy termination showed positive mental health outcomes than women who were denied an abortion. Furthermore, in all the cases, symptoms of depression and anxiety decreased and levels of self-esteem and life satisfaction increased over time.
No evidence was found that could tell that women who underwent pregnancy termination had a heightened risk of experiencing depression, anxiety, and other psychological issues.
These are just the findings of one comprehensive study. It doesn’t mean that abortion cannot have a psychological impact on the woman. With nearly 200,000 abortions taking place every year (in the UK), even small psychological effects could be detrimental for some women.
A comprehensive assessment is carried out only when a woman is undergoing termination or has undergone one. Pregnancy termination is performed in two ways – medical and surgical.
Medical abortion involves the use of an MTP Kit that contains 1 tablet of Mifepristone 200 mg (an antiprogestational steroid) and 4 tablets of Misoprostol 200 mcg (to increase uterine contractions). This process can either take place at the clinic or at the patient’s home.
On the other hand, surgical abortion is performed at the clinic as it involves the use of surgery to remove the pregnancy tissue from the uterus. It is a one-stage procedure that gets completed within 10-20 minutes.
Women are often given the choice of termination depending upon the availability of services and the stage of pregnancy.
Factors Responsible for Negative Psychological Consequences
There’s evidence that suggests that some women are at a greater risk of experiencing psychological consequences than others and there are certain factors that can influence this.
In Norway, women have an unconditional right to termination before the 12-week gestational period. A Norwegian study of 80 women found that women who had been pressurized by their partners to have an abortion had a negative psychological effect on them. Emotional distress continued for a period of 6 months.
Yet another study comparing the mental health of women post-abortion and post-miscarriage found that the mental health of women undergoing termination was poorer before the termination procedure. Elevated levels of anxiety were found in the termination group which continued for the next 5-year follow-up period.
A study conducted on 615 women undergoing surgical termination in their first-trimester found that women with positive self-regard were able to cope effectively post-abortion. Women with low self-esteem needed the support of their partners and therapy to cope after the procedure.
It has been observed that low self-esteem, late-gestation termination, prior psychiatric illness, less stable relationships, less support from partners, and conflict with cultural beliefs can negatively influence the mental health of a woman after pregnancy termination.
“There can be instances when women may find the experience to be negative and need help and healing. Nurses should be made aware of the risk factors that could lead to psychological consequences”, says Dr. Mae Jemison, senior consultant gynecologist at Hisblue. “Abortion facility centers should make sure that help is made easily accessible to women at their time of termination”, she adds on.
Women’s feelings after abortion vary and there aren’t any major pieces of evidence that indicate that pregnancy termination is itself responsible for mental health problems. Studies do stress on the fact that women would benefit from psychological support after termination.
According to the Guttmacher Institute, 9 states in the US currently require that women seeking an abortion should receive counseling regarding the negative psychological effects they may experience after termination.
Given the risk factors that influence this, it is unlikely that a woman may go through depression, anxiety, and have any psychiatric disturbances unless she has a history of any of those or has undergone a traumatic event in the past. Moreover, it is the right of every woman to choose what’s best for her. The decision of having the pregnancy terminated shouldn’t be forced upon her by her partner and she should seek help (if such a case arises) regarding the same.
The opponents of abortion coming up with such studies that indicate that abortion may lead to adverse psychological outcomes is the basis for all the policies that have been set up in various countries that restrict access to abortion. However, women need to be educated on the fact that the right to termination is one’s own choice. If counseling and help are needed post-abortion, the same should be provided by the team of abortion facility centers.
Author: Mae Jemison
Short bio: Dr. Mae Jemison is a senior gynecologist and obstetrician who specialises primarily in Women’s health. She deals with a wide range of issues, including pregnancy and childbirth, menstrual and fertility issues, polycystic ovarian syndrome (PCOS), sexually transmitted infections (STIs), hormonal disorders, and urological problems. Dr. Mae is currently working with Hisblue as a consultant gynecologist and helps women trying to terminate their unwanted or unplanned pregnancies.
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