Abortion care does not lead to depression, anxiety, or low self-esteem, and people who are able to end an unwanted pregnancy experience better mental health than those denied care, according to a first-of-its-kind study out Wednesday.
The study published in JAMA Psychiatry, a peer-reviewed journal published by the American Medical Association, upends a pervasive anti-choice narrative that insists abortion care exacts a toll on a person’s mental health and well-being.
“We see no evidence of emerging mental health problems after having an abortion,” said Dr. M. Antonia Biggs, lead author of the study and a researcher with the Advancing New Standards in Reproductive Health program at the University of California, San Francisco.
“The study suggests that expanding access to abortion, not restricting it, is what is going to protect women’s mental health,” Biggs told Rewire in a phone interview.
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At least 14 states force pregnant people to undergo in-person counseling before receiving abortion care, often dispensing information that lacks any scientific basis. More than half of states require delays, although research indicates people don’t seek to end a pregnancy without being sure of the decision.
Biggs said this is the first study to follow for five years a group of women with unwanted pregnancies. The study included 956 women from 30 abortion facilities in 21 states who were first interviewed one week after seeking an abortion. Some of the women were able to end their pregnancies, and some could not for various reasons, such as gestational limits on abortion care.
The team analyzed the women’s levels of depression, anxiety, self-esteem, and life satisfaction over the next five years.
The authors found that women who wanted to terminate their pregnancies but were unable to do so reported greater anxiety and lower self-esteem immediately after being turned away.
Biggs suggests their distress likely stemmed from being denied a wanted medical procedure—abortion care—along with a host of social and emotional challenges women may experience when they learn they’re pregnant and decide they are unable to carry the pregnancy to term.
“Some common reasons for seeking an abortion were financial, partner-related, concerns about existing children, and housing insecurity,” she said. “It may be a time of reckoning where women realize they’re not in a financial place to raise a child, or [their] partner is not someone they want to raise a child with at this time.”
In the five years after the women were denied care, the authors found that respondents’ self-esteem and life satisfaction rebounded while their depression waned.
“I was surprised how resilient and adaptive women were,” Biggs said.
The study builds on research indicating that abortion care doesn’t put people at greater risk for post-traumatic stress, depression, anxiety, or low self-esteem, nor does it worsen their life satisfaction. But this is the first longitudinal study following women for five years after they had sought abortion care.
Major research from the American Psychological Association, the Johns Hopkins Bloomberg School of Public Health, and the Academy of Medical Royal Colleges have discovered few, if any, differences in mental health between women who ended their pregnancies and those who gave birth. A national study on self-esteem and depression in teenagers found that adolescents who chose abortion care were “no more likely to become depressed or have low self-esteem” than those who gave birth.
Many states force abortion providers to tell pregnant people myths in an attempt to dissuade them from abortion care. Five states tell patients that abortion care increases the risk of breast cancer, six states claim that a fetus is a person, and 12 states push the debunked claims of fetal pain, as the Journal of the American Medical Association recently noted.
“These findings do not support policies that restrict women’s access to abortion on the basis that abortion harms women’s mental health,” the authors of the JAMA Psychiatry study note.
“I hope that people will look at this evidence and agree that we have good solid evidence that abortion doesn’t cause mental health harm,” Biggs said. “We should use this evidence to make sure we provide women with accurate and up-to-date information.”