Source: British Medical Journal, 324: 151-152

Medical Journal Finds Clinical Depression Linked to Abortion

Springfield, IL -- This week's prestigious British Medical Journal reports
that women who abort a first pregnancy are at greater risk of subsequent
long term clinical depression compared to women who carry an unintended
first pregnancy to term. Publication of the study coincides with
anniversary events related to the Supreme Court's January 22, 1973 Roe v.
Wade decision legalizing abortion.

Data from a national study of American youths, begun in 1979, was used to
conduct the research. In 1992, a subset of 4,463 women were surveyed
about depression, intendedness of pregnancy, and pregnancy outcome. A
total of 421 women had had their first abortion or first unintended
delivery between 1980 and 1992.

An average of eight yeas after their abortions, married women were 138
percent more likely to be at high risk of clinical depression compared to
similar women who carried their unintended first pregnancies to term.
Among women who were unmarried in 1992, rates of high risk depression were
not significantly different. The authors suggest that the lack of
significance in unmarried women may be explained by the higher rate of
nonreporting of abortions among unmarried women. Compared with national
averages, unmarried women in this study report only 30 percent of the
expected abortions compared with married women, who report 74 percent of
the expected abortions. This may make the results for married women more
reliable, say the authors. Another explanation is that unmarried women who
are raising a child without the support of a husband experience
significantly more depression than their married counterparts.

Since shame, secrecy, and thought suppression regarding an abortion are
all associated with greater post-abortion depression, anxiety, and
hostility, the authors conclude that the high rate of concealing past
abortions in this population (60 percent overall) would tend to suppress
the full effect of abortion on subsequent depression. Unreported abortions
would result in women who experience depression following an abortion
being misclassified as delivering women.

"Given the very high rate of concealment of past abortions "the fact that
significant differences still emerged suggests that we are just catching
the tip of the iceberg," said David C. Reardon, Ph.D., the study's lead
author.

Reardon, the director of the Elliot Institute in Springfield, Illinois,
says the study's findings are consistent with other recent research that
has shown a four to six fold increased risk of suicide and substance abuse
associated with prior abortion. He says the findings are also important
because this is the first national representative study to examine rates
of rates of depression many years after an abortion, on average
approximately eight years later in this sample.

The data set used was the same as that used by feminist psychologist Nancy
Russo of Arizona State University, whose examination of a self-esteem
scale revealed no significant difference between aborting women and women
who carried to term. Russo concluded that the absence of difference in
self-esteem scores in this large national data set proved that abortion
has no "substantial and important impact on women's well-being."

According to Reardon, Russo's much publicized study has frequently been
used to support the claim that, on average, abortion has no significant
effect on women's mental health. The Elliot Institute's new analysis of
the same data set reveals that significant differences do exist.

"The most serious flaw of the Russo study is that the authors did not even
comment on the extraordinarily high rate of concealment of past abortions
in the sample," Reardon said. "Women who do not want to mention a past
abortion are most likely the ones who will have unresolved feelings of
shame, guilt, or grief."

Reardon says that another problem with the prior analysis was that Russo's
team relied solely on a measure of self-esteem that is not sensitive to
post-abortion stress. He says the examination of depression scores is more
relevant to the known negative reactions to abortion.

"Russo's previous analysis of this data set was methodologically weak and
was frankly a poor basis on which to build the claim that abortion has no
measurable effect on women's well- being," he said. "The results of our
reexamination of this data set-especially in combination with other
studies showing higher rates of suicide, substance abuse, and other mental
health disorders associated with prior abortion-shows that the 'no effect'
hypothesis should be rejected. Something is going on here. Where there is
this much smoke, despite the problem of high concealment rates, there is
likely to be a fire beneath the haze."

Another important htmlect of this study, says Reardon, is that is one of
only a few studies to use any pre-pregnancy psychological score as a
control variable. The most commonly used control variable used in
regarding emotional reactions is "pre-abortion" evaluation on the day of
the abortion when the woman is in the crux of emotional distress. This is
why a pre-pregnancy score is much more useful than a pre-abortion score
for evaluating the independent effect of abortion on long term emotional
reactions.

Asked what the practical implications of this study are for physicians,
Reardon said: "We recommend that physicians should routinely inquire about
the outcome of all the patient's pregnancies. The simple question, 'Have
you experienced any pregnancy losses such as miscarriage, abortion,
adoption, or stillbirth_' may be sufficient to give women permission to
discuss unresolved issues related to prior pregnancy losses. Physician's
should remember that there are few social contexts in which women feel it
is appropriate to discuss unresolved feelings about prior pregnancy loss.
Many patients will appreciate the opportunity to discuss their pregnancy
losses with an empathetic person and may welcome referrals for additional
counseling."

The new study was funded by the Elliot Institute, a non-profit
organization that is involved in research and education regarding
post-abortion complications and also promotes outreach and counseling
programs for women. Reardon is the author of numerous books on
post-abortion issues, including The Jericho Plan: Breaking Down the Walls
Which Prevent Post-Abortion Healing and Making Abortion Rare: A Healing
Strategy for a Divided Nation. His newest book, Forbidden Grief: The
Unspoken Pain of Abortion, co-authored with Theresa Burke, will be
published in March of 2002. Information on these titles and other
research conducted by Dr. Reardon and the Elliot Institute can be found at
www.afterabortion.org.

REFERENCED STUDIES:

Reardon DC, Cougle JR. Depression and unintended pregnancy in the National
Longitudinal Survey of Youth: a cohort study British Medical Journal, 324:
151-152. Full text available at http://www.bmj.com.

Russo NF, Zierk K. Abortion, childbearing, and women's well-being.
Professional Psychology: Research and Practice, 1992; 23: 269-280.