Studies - General Research

January/February 2006: Abortion Research

Abortion and Substance Abuse Link Often Overlooked (Women’s Health Review, 1/06) 

New Zealand Study: Abortion in Young Women and Subsequent Mental Health (JCPP, 1/06)

Sleep Disorders Increase After Abortion (Sleep, 1/06)

For more information on Abortion Research, click “Abortion” in the left menu, then “Published Abortion Studies”.

ABORTION AND SUBSTANCE ABUSE LINK OFTEN OVERLOOKED. A new research review published in Current Women’s Health Reviews highlights the growing body of evidence that abortion is linked with increased rates of substance abuse among women.

Substance abuse has increased in the past three decades in the United States, but author Priscilla Coleman, a researcher and professor of Human Development and Family Studies at Bowling Green State University, notes that “awareness of female substance abuse as an emerging public health concern is of relatively recent origin.”

According to the article, rates of alcohol dependence among women are now comparable to that of men, and “drug dependence has increased steadily among girls and women in recent years and for some drugs, the increases have exceeded the increases among boys and men.” Although smoking rates among both sexes have decreased, the decline in smoking rates among women tapered off in the 1990’s, while it increased among adolescent girls during that same period.

Studies of substance abuse among women show that they are more inclined than men to begin abusing drugs, alcohol, and tobacco as a way of coping with traumatic life events, including physical or sexual abuse, illness, and family problems.

Women who abuse substances are also less likely than men to seek treatment and more likely to be involved in an abusive relationship; to suffer alcohol-related diseases or death; to struggle with feelings of guilt, self-blame, and low self-esteem over their substance abuse; and to experience more depression, anxiety, and symptoms of post-traumatic stress disorder (PTSD).

“It is clear that women who abuse substances are more likely to have suffered from multiple past and current challenging life situations and there is emerging evidence that women use substances as a means of coping more frequently than men,” Coleman wrote.

Colman noted that several recent studies have suggested an association between having an abortion and using or abusing drugs, alcohol and tobacco. In a number of studies have shown women who have abortions are two to five times more likely to be at risk of subsequent substance use compared to women who have not had abortions. Other studies have found that women with a history of abortion are subsequently at increased risk for depression, generalized anxiety disorder, suicidal tendencies, poor bonding with and parenting of later children, and psychiatric hospitalization.

Dr. David Reardon, a post-abortion expert and director of the Elliot Institute research organization, said that there are at least 21 published studies have found a link between induced abortion and substance abuse.

Reardon served as lead author on several studies on abortion and substance abuse—including a 2004 study that was the first to compare substance abuse rates among women with unintended first pregnancies—and also collaborated with Coleman on two studies finding that women who had undergone an abortion were more likely to engage in substance abuse during a subsequent pregnancy.

“Many women who have experienced abortion have unresolved emotional issues related to their abortion,” he said. “Substance abuse can provide an easily accessible way to self-medicate their pain and numb their emotions. Unfortunately, however, substance abuse only leads to further difficulties—both in terms of their own well-being and problems in their families and other relationships—and can lead to a further breakdown in mental health.”

Coleman noted that risk factors may be shared both by women who abort and those who engage in substance abuse and said that researchers need to focus on identifying which variables are more likely to lead a woman to have an abortion. She called for more qualitative, interview-based research with both women and others in their lives who may have been involved in the abortion decision.

“Due to a variety of political, social, and ideological factors, the topic of induced abortion does not seem to have received the focused research attention it deserves. . . .” she wrote. “In the interest of the millions of women who annually undergo one of the most common surgical procedures available in the United States and elsewhere in the world, more substantive, well-controlled research should be a priority.”

Both Coleman and Reardon encourage greater awareness of link between abortion and substance abuse among abortion providers, health care professionals, substance abuse counselors, and others who work with women. They believe substance abuse counselors should ask women seeking treatment about their reproductive history in order to “give women permission” to talk about unresolved abortion grief.

Coleman said that while many mental health professionals are open about encouraging women who have suffered miscarriage to express their emotions as a way to foster healing, abortion is often not treated the same way. This failure to address abortion may be due to either fear of probing a sensitive personal issue or to an assumption that women won’t experience any emotional conflicts over a medical procedure they requested.

“If treatment for substance abuse or other mental health problems fails to address underlying factors such as abortion, the treatment may be ineffective and women are likely to continue to turn to substances such as drugs or alcohol to cope,” Reardon said. “If mental health professionals are truly serious about addressing this public health concern, they need to gain a greater understanding of this issue and provide women with the resources to resolve their past abortions.”

Citation:

PK Coleman, “Induced Abortion and Increased Risk of Substance Abuse: A Review of the Evidence,” Current Women’s Health Reviews, 1:21-34 (2005).
Springfield, IL, January 20, 2005

The full text of Dr. Coleman’s review is available online at http://www.bentham.org/cwhr/sample/cwhr1-1/D0003W.pdf
For information on other studies linking abortion and substance abuse, visit

http://www.afterabortion.info/news/subabuse3.htm

http://www.afterabortion.info/news/subabuse2.htm

http://www.afterabortion.info/news/subabuse.htm

http://www.afterabortion.info/news/SubstAbuse AJOG.html

http://www.afterabortion.info/news/RueTrauma.htm

The above news release, along with other news on recent studies related to abortion complications, is posted at www.afterabortion.info/news

 

 

Abstract — NEW ZEALAND STUDY: ABORTION IN YOUNG WOMEN AND SUBSEQUENT MENTAL HEALTH (1/06)

David M. Fergusson1, L. John Horwood1, and Elizabeth M. Ridder1

Background: The extent to which abortion has harmful consequences for mental health remains controversial. We aimed to examine the linkages between having an abortion and mental health outcomes over the interval from age 15-25 years.

Methods: Data were gathered as
part
of the Christchurch Health and Development Study, a 25-year longitudinal study of a birth cohort of New Zealand children.

Information was obtained on: a) the history of pregnancy/abortion for female participants over the interval from 15-25 years; b) measures of DSM-IV mental disorders and suicidal behaviour over the intervals 15-18, 18-21 and 21-25 years; and c) childhood, family and related confounding factors.

Results: Forty-one percent of women had become pregnant on at least one occasion prior to age 25, with 14.6% having an abortion.

Those having an abortion had elevated rates of subsequent mental health problems including depression, anxiety, suicidal behaviours and substance use disorders. This association persisted after adjustment for confounding factors.

Conclusions: The findings suggest that abortion in young women may be associated with increased risks of mental health problems.

[ABSTRACT, Journal of Child Psychology and Psychiatry, Volume 47 Page 16  – January 2006, doi:10.1111/j.1469-7610.2005.01538.x, Volume 47 Issue 1]

Abortion researcher confounded by study

In the emotionally charged debate over abortion, no one could accuse Professor David Fergusson of ideological bias.

He is “pro-choice” personally, but he admits his latest research – which suggests a strong link between abortion and mental illness – is liable to be used and misused.

Researchers found that at age 25, 42 per cent of women in the study group who had had an abortion also experienced major depression at some stage during the past four years.

This was nearly double the rate of those who had never been pregnant and 35 per cent higher than those who had chosen to continue a pregnancy.

“Those having an abortion had elevated rates of subsequent mental health problems, including depression, anxiety, suicidal behaviours and substance use disorders,” said the researchers, whose study has been published in the Journal of Child Psychiatry and Psychology.

The study – the largest of its kind internationally – is the latest analysis to come out of the Canterbury Health and Development Study, which has followed the progress of 1265 children born in Christchurch from mid-1977.

Professor Fergusson, who leads the project, said the paper was declined by a number of journals, he suspects because of the “controversial” nature of the topic. “We went to four journals, which is very unusual for us – we normally get accepted the first time.”

He knew that by publishing the paper, he and the group would be throwing themselves into a vicious political arena, and their science would be claimed as “proof” of a certain ideology by one side, and damned by the other. The draft paper was sent to a number of organisations for comment and analysis.

The Abortion Supervisory Committee, which supervises all legal and compliance aspects of terminations, concluded that it would be undesirable to publish the results in their “unclarified” state as they would be used as “a political football”.

In a letter to the committee in June 2004, Professor Fergusson said he was fully aware of  “the circus” that publication would provoke. But it would be “scientifically irresponsible” not to publish the results just because they were controversial, he wrote in the letter, released under the Official Information Act.

“To provide a parallel to this situation, if we were to find evidence of an adverse reaction to medication, we would be obliged ethically to publish that fact,” he told NZPA.

But he had no regrets about entering the debate because he believed that women’s health was at stake.

“The fact is that abortions are the most common medical procedure that young women face – by the age of 25, one in seven have had an abortion – and the research into the costs and benefits have been very weak. This is because the debate between the pro-life and pro-choice has, in a sense, driven the science out.

“It verges on scandalous that a surgical procedure that is performed on over one in 10 women has been so poorly researched and evaluated, given the debates about the psychological consequences of abortion.”

…The scientists working in the area mainly came from a “pro-life” perspective, and they were often accused of making conclusions based on “weak evidence and strong faith.” But “no one can accuse me of that”, he said this week with a laugh.

“I’m pro-choice but I’ve produced results which, if anything, favour a pro-life viewpoint.

“It’s obvious I’m not acting out of any agenda except to do reasonable science about a difficult problem.” The study has already been criticised for “not being completely conclusive”, which he finds irritating.

“Because it’s not ‘completely conclusive’, then they say we know nothing. “But no science is completely conclusive – it’s cumulative. Our study is strongly suggestive of a link between abortion and developing mental illness.

“What people should be saying is, ‘This is interesting … we need to invest more to answer this important question’.” The researchers expected to find no evidence of harmful effects of abortion. But they found the opposite.

Professor Fergusson said the results could not be argued away by assuming the women involved already had mental health problems or “a pre-disposition”. “We know what people were like before they became pregnant. We take into account their social background, education, ethnicity, previous mental health, exposure to sexual abuse, and a whole mass of factors.”

The study participants will be interviewed again next year, at age 30, and researchers plan to ask them more detailed questions about abortions.

“I want to ask whether they think it’s had an effect on their mental health, and if so, how,” said Professor Fergusson. “We also want to know more about the context of abortions and unwanted pregnancy, and add more to the picture.”

The implications for the whole legal structure for abortion are huge.
Under the 1977 Contraception, Sterilisation and Abortion Act every abortion requires two “certifying consultants” to approve it on certain grounds, usually that a woman’s mental health would be endangered by continuing with the pregnancy.

Of the 18,211 abortions performed in New Zealand in 2004, about 98 per cent were carried out for this reason.

Professor Fergusson said the idea behind the law that abortion was a mental health issue was “based on a conjecture”. No one had examined the actual costs and benefits.

“If the legislation was based on health grounds, you would naturally think this would lead to monitoring of people who had had abortions.” But, he said, the health aspect was always secondary to personal choice. – NZPA [5Jan06, By Ruth Hill, APN Holdings NZ Ltd]

Medical studies revealing abortion complications are extremely difficult to find in the American peer-reviewed literature.  This doctor in New Zealand is running into the same problem.

Following are comments by Dr. Nate Hoeldtke of American Assoc. of Pro-Life Obstetricians and Gynecologists [AAPLOG]:
“Here is an interesting article about a recent research paper on abortion and mental health from New Zealand. You may not have heard that it was rejected from a significant number of medical journals, although by its study design, at least, it appears to be one of the best longitudinal studies on this controversial issue to date.

“It always is interesting to me that one of the medical indications that has always been given for allowing abortion is to protect the mental health of women, yet to my knowledge there has NEVER been a study demonstrating that abortion has provided any mental health benefit for even one woman.

“For instance, the Irish Supreme Court has ruled that a woman has right to an abortion in Ireland if there is a
threa
t to her life, including the risk of suicide related to the pregnancy. Yet, all the data suggests that a woman who gets an abortion may be more likely to commit suicide than one who doesn’t get an abortion. We have study after study suggesting mental health problems associated with having an abortion, and no one seems interested in doing anything about it.” 

 

 

SLEEP DISORDERS INCREASE AFTER ABORTION. Study of 56,284 May Link Sleep Problems to Abortion Trauma. 

A new study published in Sleep, the official journal of the Associated Professional Sleep Societies, has found that women who experienced abortion were more likely to be treated for sleep disorders or disturbances compared to women who gave birth.

The researchers, David Reardon of the Springfield, Ill.-based Elliot Institute and Priscilla Coleman of the University of Bowling Green, examined medical records for 56,284 low-income women in California who gave birth or underwent an abortion in the first six months of 1989.

Researchers examined data for medical treatment for these women from July 1988 to June 1994 and excluded women who had been treated for sleep disturbances or disorders in the 12 to 18 months prior to abortion or delivery.

The findings showed that, up to four years following abortion or delivery, women who underwent abortions were more likely to be treated for sleep disorders following an induced abortion compared to a birth.

The difference was greatest during the first 180 days after the end of the pregnancy, when aborting women were approximately twice as likely to seek treatment for sleep disorders. 

Significant differences between aborting and child bearing women persisted for three years.

Numerous studies have shown that trauma victims will often experience sleep difficulties.  The authors believe their findings support a growing consensus that some women may have traumatic reactions to abortion.

A study published in the Medical Science Monitor in 2004, found that 65% percent of American women studied experienced multiple symptoms of post-traumatic stress disorder (PTSD), which they attributed to their abortions, and over 14 percent reported all the symptoms necessary for a clinical diagnosis of abortion induced PTSD.

That study also found that 23% of the women reported sleeping difficulties they attributed to their abortions and 30% reported nightmares.

According to Reardon, a co-author of both studies, the prior study was limited by its reliance on women’s self reported symptoms. “This new record-based study examines actual treatment rates for sleep disorders which have been confirmed by the treating physicians and it also has the advantage of employing an appropriate control group.”

Reardon pointed out that the new study was limited by the fact that the authors did not have access to data on sleep disorders among women who had not been pregnant. He said more research is needed to see if women who have abortions are more likely to experience specific symptoms of sleep disturbance and whether those symptoms may be markers for PTSD and other psychiatric reactions.

Other recent studies have found that women with a history of abortion are subsequently at increased risk for depression, generalized anxiety disorder, substance abuse, suicidal tendencies, poor bonding with and parenting of later children, and psychiatric hospitalization.

Reardon and Coleman encourage mental health care providers to regularly inquire about prior pregnancy loss.  Doing so, Reardon says, will “give women permission” to discuss unresolved grief issues and may thereby improve treatment of sleep disorders, anxiety, and other psychiatric problems linked to abortion.
# # #
Sources:
DC Reardon and PK Coleman, “Relative Treatment Rates for Sleep Disorders and Sleep Disturbances Following Abortion and Childbirth: A Prospective Record Based-Study,” Sleep 29(1):105-106, 2006.

VM Rue et. al., “Induced abortion and traumatic stress: A preliminary comparison of American and Russian women,” Medical Science Monitor 10:SR5-16, 2004.
[ Springfield, IL, 25 January 2006, www.afterabortion.info/news]