Pro–choice researchers writing in the August issue of the Archives of General Psychiatry have acknowledged that some women experience post-abortion syndrome (PAS). The research team, led by Dr. Brenda Major, diagnosed PAS among 1.4 percent of a sample of women who had abortions two years previously. Critics of abortion are elated by this admission but insist the researchers have only spotted the "tip of the iceberg."
"Even at the low rate identified in this study, the impact is tremendous," said Dr. Vincent Rue, who first proposed PAS as a variant of posttraumatic stress disorder (PTSD) in 1981. "With 40 million abortions since 1972, this would translate into 560,000 cases of PAS."
Rue also notes that many women in the study reported psychiatric disorders that are less severe than full–blown PAS. Twenty percent of the women in the Majors study experienced clinical depression. Also, when asked if they would do it all over again, 31 percent reported that they would not have chosen abortion or were uncertain. "Since ambivalence is a good predictor of postabortion problems, " said Rue, "it is likely that many of these women are having post–abortion symptoms that simply fall short of full–blown PAS."
Unlike Rue, the Major's research team focused on the absence of problems among the majority of post–abortive women. They concluded that "most women do not experience psychological problems or regret about their abortion two years post–abortion, but some do. Those who do tend to be women with a prior history of depression."
Dr. David Reardon, who directs a post–abortion research and education organization known as the Elliot Institute, sees this association with prior depression as evidence of the need for abortion providers to provide better screening and counseling. "Clearly, this study shows that abortionists should be screening for a history of depression," he said. "It also confirms a large body of earlier research that shows that prior psychological problems are more likely to be made worse by abortion, not better."
Reardon says that Major's study has merit, but he insists that it is inappropriate to conclude that abortion is a benign experience for most women. "The biggest shortcomings of this study are the high dropout and refusal rates," he said. "Even though women were offered payment to participate, 15 percent of the women who were initially approached refused to participate, and 50 percent of those who originally participated refused to participate in follow–up interviews. Research has found that those women who are most likely to experience negative post–abortion reactions are also least likely to participate in post–abortion research."
This criticism is supported by a recent study which found that women who declined to participate in post–abortion follow–up interviews most closely matched the characteristics of those women who experienced the most post–abortion distress. Dr. Hanna Sderberg, the lead author of that study, reported that "for many of the women, the reason for non–participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer very often given was: 'I do not want to talk about it. I just want to forget'."
Conducting interviews one year after the abortions, Sderberg's research team found that approximately 60 percent of the women in their sample of 854 women had experienced emotional distress after their abortions. This distress was classified as "severe," warranting professional psychiatric attention, among 16 percent of the women. In addition, over 70 percent stated that they would never consider an abortion again if they faced an unwanted pregnancy.
Reardon and Rue agree that several other findings reported by Major's team also deserve greater attention. "Major's study clearly demonstrates the presence of delayed reactions," Reardon said. "She found that negative feelings and dissatisfaction with the abortion decision increased with time–even among her final, lower–risk population. In addition, only a minority of women reported positive emotions, and on average the women reported no beneficial effect from their abortions. This general ambivalence about their abortions, combined with a trend toward increasing negative reactions, contradicts the claim that abortion is generally beneficial to women."
Though Major and her colleagues focused mostly on the psychological effects of abortion, they also found that 17 percent of women experienced physical problems such as bleeding or pelvic infection associated with the abortion. "This rate is much higher than abortion providers admit," Rue said.