There’s No Such Thing As Post Abortion Syndrome (PAS)

747910_self_portrait_2Anti-choice protesters who stand outside of abortion clinics are all about the lies and misinformation. They shout at patients and try to convince them that they’re about to face certain peril if they walk through the doors of the Planned Parenthood. Aside from the lie that abortion causes breast cancer, anti-choicers like to tell women that they’ll have serious psychological impacts if they have an abortion.

Post-abortion syndrome (PAS) is not an actual medical diagnosis. According to the National Abortion Federation:

Many people are interested in learning about the possible effects of abortion on women’s emotional well-being, and several hundred studies have been conducted on this issue since the late 1970s. Unfortunately, much of the research on women’s psychological responses to abortion can be confusing. Nonetheless, mainstream medical opinions, like that of the American Psychological Association, agree there is no such thing as “post-abortion syndrome.”

Since the early 1980s, groups opposed to abortion have attempted to document the existence of “post-abortion syndrome,” which they claim has traits similar to post-traumatic stress disorder (PTSD) demonstrated by some war veterans. In 1989, the American Psychological Association (APA) convened a panel of psychologists with extensive experience in this field to review the data. They reported that the studies with the most scientifically rigorous research designs consistently found no trace of “post-abortion syndrome” and furthermore, that no such syndrome is scientifically or medically recognized.

I caught up with Dr. Nancy Russo, Professor of Psychology at Arizona State University and an expert on the subject of women’s mental health and abortion, to ask her if there was any validity to the claim that abortion causes depression. Dr. Russo’s short answer was, “no. Absolutely none.” But I still asked for a little clarification.

“What you have to understand is that abortion is a complex issue, and it’s entirely dependent on a multitude of factors,” explains Russo. “Women who get pregnant when they are too young or if they already have too many children are probably also at risk for other factors that contribute to mental health: poverty, education, a history of violence or sexual abuse. The more risk factors involved, the more likely a woman is to experience unintended pregnancy. All of those factors themselves can contribute to depression. So if you’re not looking at those factors when you’re trying to determine if an abortion causes depression, your data is going to be skewed.” Russo also said that women who have physical health problems will also have a tendency to experience depression and that this must be taken into consideration when you are analyzing the data.

“The other thing to consider,” says Russo, “is women who have abortions late in pregnancy because of a fetal anomaly or other health complications. These are women who intended to carry the child to term, who have fantasized about a baby, knitted it little booties, and then the pregnancy is terminated. Their reaction to the abortion is going to be much different than someone with an unintended pregnancy.”

I asked Russo to describe the mental health impact that an unwanted pregnancy can cause for a woman who does not obtain an abortion. Russo says, “in the mental health field we talk about acute, versus chronic, stressors. An acute stressor goes away, and a chronic stressor is long-term. Abortion can be an acute stressor, but it’s an event that has an end. Pregnancy is a chronic stressor, and caring for a child is a long-term stressor because you have to take care of this child until it’s an adult. If you ask any mother, she’ll tell you that raising a child is stressful. Most will then follow up and say that it’s worth it. But it’s very clear that the risk of an unwanted pregnancy contributing to depression is higher than the risk of an abortion contributing to depression.”

So where do these studies about abortion and depression or “post abortion syndrome” come from, and why do they have so much cultural currency? Most of this “pseudo-science” comes from a guy named David Reardon. Mr. Reardon does not have an actual PhD. He has a degree from a cracker jack correspondence school that is not actually accredited. In the 1990s Reardon started a campaign called the Jericho Plan. The idea was to change the framework of the abortion debate so that abortion opponents would focus on the so-called negative impacts that abortion poses to women so that anti-choicers couldn’t be accused of being anti-woman. He openly stated that his goal was not to make abortion illegal, but to make it inaccessible because doctors would be afraid to perform abortions because they didn’t want to get sued for medical malpractice.

According to Dr. Russo, “Reardon started self-selecting women who said that they had had an abortion, and that they were experiencing depression. He sat them down and said that this was their doctors’ fault, for not telling them about the risks of having an abortion. His whole goal was to get these women to sue their doctors. And there has also been a move to criminalize abortion providers. But this is pseudo-science. Twenty percent of American women experience depression. Reardon didn’t control for things like experiences of violence or sexual abuse. He was specifically looking for women who were depressed.”

“All of the medical evidence shows that even a wanted pregnancy can have an impact on a woman’s mental health. That’s why family planning is so important. Women who are able to space their pregnancies at least two years in between have babies with healthier birth weights. Women with fewer children are less likely to have children with disorders. And the more children a woman has, the more resources have to get stretched to provide for everyone’s needs. Every child should be wanted and well cared for,” argues Russo.

Dr. Russo concluded the interview with this important caveat. “Women aren’t asking for abortions under random circumstances. They’re seeking abortions because they don’t want or can’t care for a child. We need to listen to women. This issue is so complex. Who gets to decide if a pregnancy is the right decision? It is the woman’s responsibility to care for that child, so it is her choice. The most important thing to remember is that women vary in their responses to abortion. And there’s no magic formula to figure out how abortion or pregnancy will impact a woman’s mental health. You have to look at who is seeking the abortion, why they’re seeking the abortion, and the response from society. Once you control for all of those factors, there is absolutely no medical evidence that abortion causes depression.”

Photo credit: stock.xchng

Comments

  1. I worked for an abortion provider in southern California for 14 years. The overwhelming response we saw, day after day, was relief and gratitude.

    And many years ago, C. Everett Koop, US Attorney General under Reagan, and staunch pro-choice foe, acknowledged this in his report.

  2. Annaleigh says:

    I saw a presentation by a couple philosophers analyzing all the research and taking Reardon to task on this as well. Their publication will be in Bioethics, the cite for which is:

    http://www.ncbi.nlm.nih.gov/pubmed/19594725?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

  3. freewomyn says:

    @ JJ – Yeah, I think that the documentaries I’ve watched about women who sought abortion pre-Roe demonstrate that relief is the overriding emotion for a lot of patients.

    @ Annaleigh – thanks for the link. I’ll definitely check that out. Tomorrow I’ll be reviewing a new study from the Harvard Review of Psychiatry on the topic. But I think it’s always good to get as much info as possible.

  4. JP Prichard says:

    I remember the relief after the first abortion. And being numb after the second. The dread and helplessness of the third.

    We didn’t WANT her to be pregnant. We were looking for anything that might tell us it was ok to abort. When she found a medical book telling us that “it” was a lump of tissue, like a mole or hangnail (That’s what the book said, I’m not making this crap up), we’d found our rationale.

    It wasn’t until several years later that I saw what a 9 week fetus (in a jar at a college campus) looks like, and a few more after that when I heard the heartbeat of my firstborn at 9 wks also.

    Which is right about when the hallucinations started.

    I would have had a problem at the time of the abortions – I DIDN’T KNOW WHAT I WAS DOING. If I did know, I would have changed my mind. Just like 70% of abortion-minded women do when they see ultrasounds beforehand. Because it shows the truth – they aren’t just pregnant women, they are women carrying around another human with them.

    You’re right, there is no definable PAS according to the APA. Instead, my psychiatrist diagnosed me with PTSD due to my abortion experiences.

    Is everyone that experiences abortion going to experience PTSD? No, no more than every combat soldier would. Some can deal with what they have done; some can’t. Either way, the ones that refuse to acknowledge what they have done leave the question unanswered for another day, don’t they?

  5. Mrs. Mastro says:

    I am always amazed by the degree to which people are vested in the bullshit that is PAS. Of course abortion can have negative psychological consequences–our culture is saturated with images of motherhood as an ideal; images of pregnant women, the myth of 2.2 kids, picket fence + dog. We are inundated with voices that tell women that this is what we should want, what we should have. And if we don’t have it or want it, we are abnormal.

    But the reality is that abortion’s alternatives have consequences of their own–your interview covers some of it. Having a child you don’t want or can’t afford is clearly difficult, both in the short term and in the long term.

    As a mother, I can not even begin to imagine the trauma that would result if I had a baby and gave it up for adoption. That pain, I must venture to say, would last a life time.

    A long-time friend of mine had a high school girlfriend who got pregnant. She, without his consent, gave their baby up for adoption. That was just over 18 years ago. Not a day goes by that he doesn’t wonder if the baby grew up happy and healthy. I can only imagine that the mother’s pain is worse.

    Check out Rickie Solinger’s “Beggars and Choosers” — it’s a great book in general. In particular, you might be interested in the chapter on Post Adoption Syndrome.

    Like abortion, adoption is the best choice for some women. Neither is ideal, but they each have their costs and benefits.

  6. freewomyn says:

    @ JP – I’m not saying that some people don’t change their minds about abortion. But as Dr. Russo pointed out, there is no uniform reaction or response to abortion. And my question to you would be this – did you have experiences with mental health issue before your abortion? Because the best predictor of mental health post-abortion is mental health pre-abortion.

    @ Mrs. Mastro – good point. I’ll definitely check out that book.

  7. Tiffany Lamoreaux says:

    @ JP – I’m curious as well, are you refering to an abortion you had or a girlfriend? The way you have written your repsonse it makes it sound as if you weren’t even the one having the abortion….so can PAS happen for those not having the experience too? That would be an even farther stretch of a cockamanie syndrom.

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