Critics Question Study Linking Abortion, Mental Health Problems

By Patrick Goodenough | July 7, 2008 | 8:05 PM EDT

( - New research linking abortions in young women to mental health problems is causing a stir, as family planning advocates try to play down the results -- despite researchers' assertions that the study is the most comprehensive ever of its kind.

Professor David Fergusson, a psychologist and epidemiologist who headed the study, said Wednesday he was not surprised at the fuss.

"It's a very sensitive and emotive subject. People have cherished beliefs that they do not like being challenged."

Although he describes his own views on abortion as "pro-choice," Fergusson said the research evidence was clear: "There's a distinct possibility - more than a distinct possibility - that abortion may have mental health consequences."

He expected both sides of the debate to try to use the research results in "an attempt to use science to back up ethical positions."

While in the case of pro-lifers Fergusson said that meant possibly exaggerating the results, in fact most response so far has come from the opposing camp, calling the findings into question.

Fergusson and colleagues at the Christchurch School of Medicine and Health Sciences in New Zealand have tracked 1,265 women in a longitudinal study since their birth in mid-1977. The women are now 28 and the study is continuing.

Recently the team turned its attention to the issue of abortion and possible effects.

Of the 1,265 participants, more than 500 had fallen pregnant at least once by the age of 25. Of that group, 90 had had an abortion.

Of those who had an abortion, 42 percent suffered from major mental health problems at a subsequent stage, with symptoms including depression, suicidal tendencies and alcohol and drug abuse.

Fergusson said that rate was 35 percent higher than in the case of those who continued with their pregnancies, and almost double the rate of those who had not been pregnant.

The results were printed this week in the London-based Journal of Child Psychiatry and Psychology.

Fergusson said he had sent the research paper to four journals - two of them in the U.S. - before it was accepted by the British publication.

Previously he has had papers accepted "first time every time," but he suspected that because of the "highly controversial" subject matter of the latest one, some journals had been reluctant to take it.

Critics hit back

The new study could be used to undermine the most common legal basis for abortions in several countries.

In New Zealand, under a law enacted the same year the Christchurch study participants were born, the overwhelming majority of abortions are approved on the grounds that continuing with the pregnancy poses a risk to the mother's mental health.

With this law in place, the abortion rate has climbed from 8.5 (out of every 1,000 women aged 15-44) in 1980, to 21 in 2003, with a small drop to 20.5 in 2004.

A similar situation exists in neighboring Australia.

Pro-life campaigners argue that "mental health" is a broad, vague and hard-to-disprove justification, and a statutory abortion supervisory body in New Zealand called last November for the wording of the country's laws to be tightened, saying it had "come to have a de-facto liberal interpretation."

Fergusson said there was little evidence to suggest that abortion improves mental health. "This study suggests possibly the opposite."

But critics were quick to call the research into question.

"The results do not mean that abortion causes depression in young women," said Christine Read of the Family Planning division in Australia's New South Wales state.

A representative of the New Zealand Family Planning Association said women could also suffer from mental problems from continuing with an unwanted pregnancy.

Read argued that the study "looks at only a very small number of young women" and did not take into account the "social context" of the decision to have an abortion.

Fergusson said of the reaction: "It's always possible to invent alternative hypotheses to explain away the evidence -- but just because you invent such alternative hypotheses, doesn't mean that you have explained it away."

He acknowledged that the numbers were "relatively small," but countered that "this is probably the most comprehensive study [carried out to date], with the scope of variables and mental health outcomes considered."

Responding to the second charge, he said there were two parts to the argument. The first related to background -- "whether for example young women prone to mental health seek abortions, and then of course continue to have mental health problems."

He said the study was able to eliminate many of those possibilities because it took into account circumstances prevailing before the women had abortions, and adjusted the findings accordingly.

"We knew about a woman's childhood, her exposure to sexual abuse, medical history and so forth. We were able to take such things into account."

The second part of the argument had to do with the actual decision to have the abortion, in which many factors could play a part.

"We have not fully studied what part of the process of getting the abortion was associated with the mental health outcomes - the actual procedure or the context in which the procedure took place."

Fergusson said the women would be resurveyed at age 30, and those who had abortions would then be asked more about the circumstances, their feelings at the time, and their beliefs.

"The rational thing to do is to conduct further research to examine the extent to which abortion does lead to adverse reactions."

Right to Life New Zealand said it hoped the research would result in the government passing a measure ensuring that women considering abortions are informed of the risks beforehand.

See Earlier Story:
Distress Caused by Abortion Can Linger for Years, Study Says (Dec. 14, 2005)

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Patrick Goodenough
Patrick Goodenough
Spencer Journalism Fellow

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