Study Linking Abortion to Mental Health Problems Is Flawed

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A psychiatry journal has distanced itself from a controversial and widely cited study it published in 2009 linking abortions with mental health problems in women.

The original study by Dr. Priscilla Coleman of Bowling Green State University and her colleagues, published in the Journal of Psychiatric Research, suggested that abortion was associated with long-term mental health problems like panic attacks, depression, substance abuse and post-traumatic stress disorder. Seven states have since used the study to support laws that require women seeking abortions to be counseled on the mental health risks. As it turns out, the study was highly flawed.

One of the fundamental errors that plagues Coleman’s study is that the researchers did not distinguish whether mental health problems occurred before or after abortion. Indeed, in many cases, mental illness preceded abortions, weakening the argument that abortion can increase women’s mental health risks. In a commentary, the journal said the 2009 paper “does not support assertions that abortions led to psychopathology.”

Further, in a letter [PDF] to the editors of the Journal of Psychiatric Research, Dr. Julia Steinberg of the University of California at San Francisco and Dr. Lawrence Finer of the Guttmacher Institute in New York say that after re-analyzing the data used in Coleman’s study, they found “untrue statements about the nature of the dependent variables and associated false claims about the implications of the findings.”

MORE: Why Abortion is Less Risky Than Childbirth

Coleman has acknowledged statistical errors, and in response to criticisms, has claimed that her team used data on lifetime incidence of mental illness in hopes of capturing as many cases of mental health problems as possible. She also released a corrigendum (a statement of error and correction), which continues to link abortion to mental illness, but Dr. Steinberg and Dr. Finer argue that her findings were still not scientifically supported.

In their letter, Dr. Steinberg and Dr. Finer conclude:

The paper and corrigendum contain misleading and erroneous information that serves to confuse the relationship of abortion and mental health even more, and reveals the invalidity of the original analyses. These deficiencies are fundamental analytical errors that were incorrectly presented in the original paper and perpetuated in the corrigendum, not a scholarly difference of opinion.

“This is not a scholarly difference of opinion; their facts were flatly wrong. This was an abuse of the scientific process to reach conclusions that are not supported by the data,” Dr. Steinberg said in a statement. “The shifting explanations and misleading statements that they offered over the past two years served to mask their serious methodological errors.”

MORE: Abortions Are More Common in Countries that Outlaw Them

In 2011, a similar study on abortion and mental health reported no connection between the procedure and risk of mental disorders. The Danish study relied on national medical data on 365,550 teens and women who had an abortion or delivered their first child between 1995 and 2007. In the 12 years under consideration in the study, 84,620 women had an abortion and 280,930 had a baby. Healthland’s Bonnie Rochman reported:

Using the registry statistics, researchers were able to analyze the rate of mental-health visits before and after abortion and delivery. The women in the study did not have a history of psychiatric problems that merited a hospital stay.

Interestingly, women who decided on abortion had more psychiatric disorders than women who gave birth; data shows they tend to come from lower-income households and have higher rates of accidental pregnancy.

Yet their rate of mental-health visits budged only slightly post-abortion: 1% had sought psychiatric help nine months before the abortion while 1.5% did so afterwards.

What did raise the rate of psychiatric problems? Having a baby. Among first-time mothers, 7 out of 1,000 women were treated for mental-health issues within a year after giving birth, compared with only 4 out of 1,000 women before baby. That makes sense, Rochman reported, since the most common complication of pregnancy is postpartum depression.