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Research Blog: Having an abortion doesn’t negatively impact mental health. You know what does? Being denied an abortion

By Laura Hooberman

In the event that you’ve somehow been mercifully spared from the onslaught of news stories over the past month pertaining to the drastic curtailing of reproductive freedoms across the U.S., allow me, for a moment, to ruin your day (sorry): in early May, Georgia signed into law, a so-called ‘heartbeat bill.’ This bill will outlaw abortions after only six weeks into pregnancy, before many people are even aware that they are pregnant.[1] This initiative followed in the footsteps of similar legislation passed earlier this year in Kentucky and Mississippi and proceeded a bill passed in Louisiana just a few weeks ago banning abortion after six weeks.[2] This wave of bans, moreover, has gone beyond ‘heartbeat bills’ (and incidentally, here’s why this term is inaccurate). In mid-May, the Alabama state senate approved a highly restrictive legal measure which would outlaw abortion at all stages of pregnancy (with exceptions for cases when the pregnant person’s life is at risk, but not for instances of rape or incest) and criminalize doctors who perform abortions.[3]

It is important to note that none of these laws have taken effect – yet. They have already faced, and will continue to face, formidable legal pushback from organizations like the ACLU, and, weirdly, Netflix. Abortion, as of this writing in June of 2019, is a legal right in the United States. This remains true, even in light of the decades of initiatives spearheaded by opponents of reproductive rights which have served to make abortion virtually inaccessible for wide swaths of people. But these wave of bans, more brazen, transparent, and extreme in scope than previous attempts to limit abortion access, suggest that abortion rights opponents are feeling particularly emboldened – and I wonder why? – and have identified this moment as their opportunity to topple Roe v. Wade once and for all.

There’s a lot to be mad about here. Personally, I’m mad that those states which actively seek to limit access to abortion also have some of the worst maternal healthcare outcomes in the country. I’m mad that Alabama governor Kay Ivey described the state’s ban on abortion as “a powerful testament to Alabamians’ deeply held belief that every life is precious” [4] when the egregious brutality of the state’s prison system was just highlighted in The New York Times. And as a student of psychology, I have a particular anger reserved for the argument that restricting access to abortion functions in the service of supporting the psychological health of pregnant people. This argument has been used in support of so-called pregnancy crisis centers,’ mandatory waiting periods before obtaining abortions, and now is being implicated in the argument in favor of abortion bans.

Given that my support for abortion rights exists as an expression of my belief in the sanctity of physical autonomy and self-determination as fundamental human rights, I have a vested interest in understanding how abortion impacts the mental health of pregnant people. And fortunately, research provides us with answers to many of the questions that surround this topic.

In 2017, researchers at the University of California, San Francisco, published an analysis of results from The Turnaway Study, a longitudinal (i.e., research that occurs over an extended time frame – often years) study which sought to examine the short and long-term mental health effects of 1) receiving an abortion, and 2) being ‘turned away’ from a clinic when seeking an abortion (participants in the study who were denied care were denied because they were just beyond the facility’s gestational limit).[5] 956 participants were recruited into this study between January, 1, 2008 and December 31, 2010 from 30 abortion facilities across 21 U.S. states. They were interviewed one week after seeking an abortion and either receiving the abortion or being turned away, and then were interviewed semi-regularly over the next five years. During each round of interviews, the researchers presented participants with six measures of mental health and well-being: two measures of depression, two measures of anxiety, and one measure each of self-esteem and life satisfaction.

The results? Researchers found that after one week, those who were denied an abortion reported more anxiety symptoms, lower self-esteem and lower life satisfaction. Over time, psychological well-being improved for both groups, converging such that there were no significant mental health differences between people who received an abortion and those who did not. This study thus offers a meaningful contribution to earlier research which has found no connection between abortion and posttrauamtic stress[6], depression or anxiety[7], or lower self-esteem or life satisfaction[8], and offers important evidence against the argument that these symptoms, among individuals who receive abortions, might simply evolve later on.

Abortion is a complicated topic, and it makes sense that people might have complicated feelings about it. But that doesn’t give anyone license to make unsubstantiated claims about the impact of abortion on mental health. So if anything I’ve written here makes you mad, remember: there are ways to help.

 

[1] North, A. & Kim, C. (2019, May 30). The heartbeat bills that could ban almost all abortions, explained. Vox. Retrieved from: https://www.vox.com/policy-and-politics/2019/4/19/18412384/abortion-heartbeat-bill-georgia-louisiana-ohio-2019

[2] North, A. (2019, May 30). Louisiana just passed a near total abortion ban. It was written by a democrat. Vox. Retrieved from: https://www.vox.com/2019/5/30/18645952/louisiana-abortion-ban-heartbeat-bill-edwards

[3] Williams, T. & Blinder, A. (2019, May 14). Lawmakers Vote to Effectively Ban Abortion in Alabama. The New York Times. Retreived from: https://www.nytimes.com/2019/05/14/us/abortion-law-alabama.html

[4] Arciga, J. (2019, May 15). Alabama Gov Kay Ivey Signs Near-Total Abortion Ban Bill Into Law. The Daily Beast. Retrieved from: https://www.thedailybeast.com/alabama-gov-kay-ivey-signs-near-total-abortion-ban-bill-into-law

[5] Biggs, M.A., Upadhyay, U.D., MucCulloch, C.E. & Foster, D.G. (2017). Women’s Health and Well-being 5 Years After Receiving or Being Denied an Abortion. JAMA Psychiatry, 74(2), 169-178

[6] Biggs, M. A., Rowland, B., McCulloch, C. E., & Foster, D. G. (2016). Does abortion increase women’s risk for post-traumatic stress? Findings from a prospective longitudinal cohort study. BMJ open, 6(2), e009698.

[7] Foster, D. G., Steinberg, J. R., Roberts, S. C., Neuhaus, J., & Biggs, M. A. (2015). A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one. Psychological medicine, 45(10), 2073-2082.

[8] Biggs, M. A., Upadhyay, U. D., Steinberg, J. R., & Foster, D. G. (2014). Does abortion reduce self-esteem and life satisfaction?. Quality of Life Research, 23(9), 2505-2513.

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