Psychological aftermath of abortion
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* L.L. deVeber
* Ian Gentles

William Fisher and associates,1 in their article on women undergoing repeat induced abortion, state, “Evidence also does not indicate that women seeking repeat abortion are psychologically maladjusted.”

Although this statement is not directly connected to the main study reported by Fisher and associates, we feel that it might mislead readers about psychological problems after abortion. Consider the following material from the literature:

*   A recent study sponsored by the College of Physicians and Surgeons of Ontario compared 41 000 women who had undergone induced abortion with a similar number who had not undergone abortion2 and found 5 times more hospital admissions for psychiatric problems among the women who had had abortions. This short-term study was conducted at 3 months after the abortions and did not address long-term effects or problems among women who were not admitted to hospital after abortion.

*   In a study reported in this journal in 2003, Reardon and colleagues3 found a significantly higher risk of psychiatric admissions among lower-income women who had undergone induced abortions.

*   In the course of our own research, we have found numerous reports of significant problems among women who have had an abortion. For example, a study from Finland4 showed a 6-fold greater incidence of suicide among women who had had an induced abortion than among women with normal pregnancies. In fact, many of over 70 scientific articles that we reviewed for a recent publication5 reported various degrees of psychological problems after abortion.

*   Increasing numbers of postabortion counselling services are being developed in North America and around the world. The largest in the United States is Project Rachel, which has many chapters, including several in Canada.6 Thousands of women are being helped by these services, sometimes long after the abortion, but there are undoubtedly many more who do not go for help.

*   The Healing Choice postabortion counselling service, which is pro-choice, estimates that at least 10% of women who have undergone an abortion need counselling for psychological problems associated with the procedure.7

On the basis of this evidence we can conclude that many women suffer problems after abortion. Given that follow-up after abortions is often lacking or short-term only, further research is needed in this area. Even if just 10% of women who have had an abortion are experiencing these problems, this represents a substantial public health issue, considering that each year more than 100 000 abortions are performed in Canada.8

## References

1.  1. Fisher WA, Singh SS, Shuper PA, Carey M, Otchet F, MacLean-Brine D, et al. Characteristics of women undergoing repeat induced abortion. CMAJ 2005;172(5):637-41.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNzIvNS82MzciO3M6NDoiYXRvbSI7czoyMDoiL2NtYWovMTczLzUvNDY2LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  2. Ostbye T, Wenghofer EF, Woodward CA, Gold G, Craighead J. Health services utilization after induced abortions in Ontario: a comparison between community clinics and hospitals. Am J Med Qual 2001;16(3):99-106.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NToic3Bham0iO3M6NToicmVzaWQiO3M6NzoiMTYvMy85OSI7czo0OiJhdG9tIjtzOjIwOiIvY21hai8xNzMvNS80NjYuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

3.  3. Reardon DC, Cougle JR, Rue VM, Shuping MW, Coleman PK, Ney PG. Psychiatric admissions of low-income women following abortion and childbirth. CMAJ 2003;168(10):1253-6.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTY4LzEwLzEyNTMiO3M6NDoiYXRvbSI7czoyMDoiL2NtYWovMTczLzUvNDY2LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

4.  4. Gissler M, Hemminki E, Lonnquist J. Suicides after pregnancy in Finland, 1987-94: register linkage study. BMJ 1996;313(7070):1431-4.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MzoiYm1qIjtzOjU6InJlc2lkIjtzOjEzOiIzMTMvNzA3MC8xNDMxIjtzOjQ6ImF0b20iO3M6MjA6Ii9jbWFqLzE3My81LzQ2Ni5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=) 

5.  5. Ring-Cassidy E, Gentles I. *Women's health after abortion: the medical and psychological evidence.* 2nd ed. Toronto: deVeber Institute for Bioethics and Social Research; 2003.
    
    

6.  6. Thorn V. Project Rachel: faith in action, a ministry of compassion and caring. In: Mannion M, editor. *Post abortion aftermath.* Kansas City (MO): Sheed and Ward; 1994. p. 144-63.
    
    

7.  7. Depuy C, Dovitch D. *The healing choice: your guide to emotional recovery after abortion.* New York: Fireside; 1997. p. 58.
    
    

8.  8. Induced abortions by area of residence of patients (hospitals and clinics). Ottawa: Statistics Canada; 2005 Mar 30. Available: [http://www40.statcan.ca/l01/cst01/health40a.htm](http://www40.statcan.ca/l01/cst01/health40a.htm) (accessed 2005 May 13).