Women Denied Abortions Report Worse Mental Health Outcomes

A longitudinal 5-year study that tracked women seeking abortions found that women who were turned away had worse mental health outcomes than those that received an abortion. The results, published in JAMA Psychiatry, contradict warnings of lasting negative psychological consequences from abortion that can be found in some informational literature discouraging the procedure.

The study participants were 956 women who presented to abortion facilities seeking to terminate their pregnancies. Researchers assigned them to the near-limit group if they received an abortion while within 2 weeks of the facility’s gestational limit, the first-trimester group if they had an abortion in the first trimester of pregnancy, or the turnaway group if they were denied an abortion due to being up to 3 weeks beyond the gestational limit. The women denied abortions were further divided into the turnaway-birth group, consisting of those who eventually gave birth, and the turnaway-no-birth group of women who miscarried or later had an abortion elsewhere.

Researchers assessed the participants’ anxiety, depression, self-esteem, and life satisfaction using self-reported answers to scales for each of these outcomes. They also recorded a number of potential covariables such as age, race, education, and history of mental illness. The women were then reassessed using the same scales in 10 waves of follow-up over the next 5 years.

Analysis of mental health outcomes found that the women who were denied an abortion, especially those in the turnaway-no-birth group, experienced higher levels of anxiety symptoms and more cases of anxiety 1 week after they were turned away. The turnaway groups also had lower reported self-esteem and life satisfaction at this baseline point.

However, these outcomes improved rapidly, and by 6 to 12 months after the initial interview, the turnaway groups had anxiety and well-being levels similar to those of the women who had received abortions. Over the 5-year study period, all of the women showed significant improvements in self-esteem and life satisfaction over time, except for those in the first-trimester abortion group, whose relatively high levels of initial well-being remained steady.

The study concluded that “during a 5-year period, women receiving wanted abortions had similar or better mental health outcomes than those who were denied a wanted abortion.” It did not find any evidence that would justify laws requiring that women seeking abortions be advised about potential mental health consequences.

A controversial example of these warnings can be found in an informational pamphlet recently updated by the Texas Department of Health, called “A Woman’s Right to Know,” which Texas law requires doctors to provide to women before a scheduled abortion. It includes a section on mental health risks like depression and suicidal thoughts, and states that women have reported “sexual dysfunction, avoidance of emotional attachment, flashbacks, and substance abuse” after their abortion.

Furthermore, a recently added section of this pamphlet, “Breast Cancer Risk,” has been criticized for its potentially misleading statement that women who give birth are less likely to develop breast cancer, but an abortion will not provide this increased protection. While the link between giving birth and reduced breast cancer risk has been proven, multiple studies have found no association between having an abortion and the risk of breast cancer.