Published June 21, 2022
Any day now, the Supreme Court could overrule Roe v. Wade, and thus allow us to protect unborn children and their mothers from the harms of abortion. In our forthcoming book, Tearing Us Apart, we argue that among its many harms, abortion poses significant risks to women, including the risk of emotional and psychological damage.
Most pro-choice activists, however, reject the idea that women ever suffer after undergoing an abortion. If abortion supporters acknowledge post-abortion regret at all, they dismiss it as the result of the supposed stigma surrounding abortion, which they claim causes women to feel guilty when they would otherwise be relieved.
Often, defenders of legal abortion cite one particular study, the Turnaway study, to claim that women who obtain abortions don’t suffer from subsequent mental-health challenges, as Annie Lowrey argued in the Atlantic last week. The Turnaway study reported that women who have an abortion are not more likely than those denied the procedure to experience depression, anxiety, or suicidal ideation. But the study has faced substantial and well-deserved criticism, including for the fact that it had poor participation rates and a shocking 83 percent attrition rate — a high rate of women dropping out of the study.
As a result of non-responses and drop-outs, the final survey included only a small percentage of the women who began the study, increasing the possibility of self-selection bias toward women who were less affected by having had an abortion. The cohort also excluded demographic factors known to increase the risk of adverse mental-health outcomes, such as the stage of pregnancy at which a woman obtained an abortion. There is a clear correlation, for instance, between abortions later in pregnancy and a higher rate of adverse mental-health outcomes.
Meanwhile, the best studies come to a rather different conclusion. As we report in our book, the largest existing quantitative analysis of mental-health risks associated with abortion found that post-abortive women had an 81 percent higher risk of mental-health problems — ranging from decreased self-esteem to severe guilt, depression, and even suicide — when compared with women who had not had an abortion. Dr. Aaron Kheriaty, most recently professor of psychiatry and human behavior at the University of California Irvine School of Medicine — and our colleague at the Ethics and Public Policy Center — has explained in expert testimony why abortion affects women so profoundly, offering this example of a woman who’d had an abortion:
I recall also a minor that I treated in therapy for several years. I first met her when she was hospitalized on our adolescent inpatient psychiatric unit after a suicide attempt.
The year prior she had undergone an abortion. As is the case for many teenage girls who have abortions, she was pressured by her parents — in this case her father — who argued that abortion was her only option. This patient described to me her experiences with her unintended pregnancy in detail. She recalled lying in bed with her hand on her belly, feeling a deep bond and connection with her unborn child. When I asked her about her decision to have an abortion, she stated in cold and clear language: “I killed my baby.”
This was a young woman who was raised in a pro-choice household. Religious instruction was not a part of her upbringing, and she did not consider herself a religious or pro-life person. There seemed to be no reason for her, given the culture and her family upbringing, to adopt an anti-abortion attitude. Her shame and regret over her abortion stemmed neither from religious values, nor from others accusing her of wrongdoing. It stemmed from her own experience of the maternal bond she had formed with the unborn life inside her during her unintended pregnancy.
Rarely do abortion supporters show themselves willing to seriously consider stories such as this one. But ample data suggest that the young woman Kheriaty referenced is far from alone in her suffering. The largest quantitative analysis of mental-health risks associated with abortion was published in the British Journal of Psychiatry in 2011 by Priscilla Coleman of Bowling Green State University. Coleman surveyed data from 22 existing studies on women who had abortions and their mental-health outcomes. The studies included in Coleman’s review had surveyed a total of 877,181 women, 163,831 of whom had undergone an abortion. All five negative outcomes Coleman measured rose steeply after women had an abortion: Anxiety disorders increased by 34 percent, depression increased by 37 percent, alcohol abuse and suicidal behaviors increased by more than 100 percent, and marijuana abuse increased by more than 200 percent. These results remained the same even after controlling for prior psychiatric-health problems.
In her more recent work, Coleman surveyed 75 studies conducted between 1993 and 2018 examining the link between abortion and subsequent mental-health problems and found that two-thirds of the studies demonstrated an increased risk of mental-health complications after abortion. A majority of the studies deemed highly reliable by Coleman’s scoring rubric — including factors such as sample size and attrition rate — found an association between abortion and later mental-health problems.
Coleman’s research has even been replicated by pro-abortion scholars such as David Fergusson, whose 2013 meta-analysis with John Horwood and Joseph Boden found that “abortion was associated with small to moderate increases in risks of anxiety, alcohol misuse, illicit drug use/misuse, and suicidal behavior.” The researchers set out to disprove Coleman’s findings — hypothesizing that abortion might actually reduce the mental-health risks of pregnancy — but found instead, as Coleman did, that there is a significant link between abortion and negative mental-health outcomes.
The problem of debilitating abortion regret is so pervasive that the pro-life movement has dedicated a large amount of its resources to operating ministries that help women heal after abortion. Solidarity with these women is especially important considering that, more often than not, abortion activists ignore, dismiss, or even attack them. It is easier to defend abortion if you pretend that women who choose abortion are always happy with their decision. For the abortion activist, women who feel otherwise are just collateral damage.
Ryan T. Anderson is the president of the Ethics and Public Policy Center. Alexandra DeSanctis is a visiting fellow at the Ethics and Public Policy Center. They are the co-authors of the forthcoming book Tearing Us Apart: How Abortion Harms Everything and Solves Nothing, from which this piece is adapted.