Studies - General Research

Detrimental Effects of Adolescent Abortion (1977 – 1990)

Several older studies are briefly described below. They are posted on this website in an effort to show how much information and research have been available – and ignored – for decades.


Detrimental Effects of Adolescent Abortion 

It is of particular importance to identify abortion risk factors in adolescents not only for counseling and public policy reasons, but also to assist judges to determine whether or not an abortion may be in the "best interests" of an adolescent. Over one-fourth of the abortions in the U.S. are performed on women under 20 years of age, yet few studies compare adolescents with adults in their ability to cope with abortion.

Campbell, Franco and Jurs (1988) in a study at the Medical College of Ohio compared 35 women who had their abortions as teenagers with 36 women who had abortions after the age of 20.

They found that teenagers were significantly more likely to report marital difficulties in their family of origin, to attempt suicide after abortion, to have severe nightmares following abortion, and to be less likely to report being coerced into abortion. In addition, the adolescents had significantly higher scores on scales measuring antisocial traits, paranoia, drug abuse, and psychotic delusions.

The authors concluded that adolescents are more likely to use immature defenses such as projection, denial or "acting out" after abortion and that these immature coping defenses might become permanent.

Barglow and Weinstein (1973) observed the effects of abortion in adolescents compared with adults and concluded that two major factors distinguish the adolescent emotional response to abortion. First, the abortion decision is more often controlled by parents, peer group or sexual partners. Secondly, developmental immaturity contributes to ambivalence about the decision, to a distorted perception of the procedure, and to a variety of pathological reactions.

Other important differences have also been found. Lewis (1980) found that adolescents are less likely to consulr with a professional regarding their pregnancies and are more likely to see their pregnancy decision as externally 'compelled'. Smith (1973) found that teenagers are more likely than adults to be ambivalent about their abortion decisions and have an abortion at a later stage of gestation.

Margolis et al (1971) also observed ambivalence and guilt following abortion more often in young women under 18 years of age than in those who were older.

Franz and Reardon (1990) completed a study of 252 women from a support group for women (Women Exploited by Abortion) who suffered negative effects of abortion. Thus, the women were self selected by joining the support group. The subjects' abortion had occurred an average of 10 years earlier…

Adolescents, defined as women of less than 20 years of age, were significantly more likely to report greater severity of psychological stress, to feel they were misinformed during counseling, and to prefer to keep the baby. The fact that adolescents were more likely to report receiving misinformation could be due to the fact that adolescents have a greater difficulty in understanding and integrating complex information, such as that involving a decision to abort. It is possible that correct information was given or inferred but the adolescents did not understand it…

Barglow and Weinstein (1973) also found that adolescents in particular "forgot" detailed information on abortion procedures carefully given only minutes before which was attributed to being overwhelmed by anxiety and overstimulation of the experience.

Other findings from this study have implications for counseling adolescents considering abortion. A report of "worsened self image" was significantly related to being least satisfied with the choice at the time, being least satisfied with the services at the time of abortion, feeling extreme pressure to have the abortion, having the least well-thought-out decision, believing they had received the least information, and very much wanting to keep the baby…

The abortion experience could delay the development of an identity. Counseling procedures should not pressure adolescents into the abortion decision or make them feel they don't have adequate time and information to make an informed decision…

The younger the woman was at the time of her abortion, the longer the time until she sought help for post-abortion problems…the younger the woman at the time of her abortion, the least satisfied she was later…data indicate that adolescents are less apt to want to abort.

This was largely confirmed in the total sample of 252 women as 84% said that their pregnancy would not have resulted in abortion if they had been encouraged differently. (Reardon, 1987) This may be typical for young people who often have less actual control over their lives than adults.

The lack of control appears to be associated with longer periods spent in denial and with greater psychological stress. A failure to accept the reality of the abortion experience has been shown to interfere with natural grieving processes, which in turn has been associated with post abortion psychological problems. Thus, adolescents may be at greater risk for problems following abortion than older women….

Women who reported being rushed the most to have the abortion (i.e. one week or less to decide) also reported the greatest severity or psychological problems.

Adolescent Body Image
Adolescents tend to be strongly dependent on environmental feedback to establish their sense of who they are and the impression they make on others. Thus, the adolescent personality tends to be heavily dependent on external sources for assurance of its qualities and characteristics…

Adolescent Egocentrism
Due to adolescent egocentrism and adolescent social environment may have reality only in so far as it provides her wiht feedbcak abour her own personality…The adolescent girl who has had an abortion may find it very difficult to admit personal responsibility for problems. She will be inclined to blame others for her unhappiness, because she couldn't possibly be responsible herself…If she is engaging in self-destructive behavior, she will deny that the root cause may be her abortion experience.

An examination of the effects of an adolescent decision to abort suggests that it could destroy the young person's ability to mature and grow in a normal way.

The adolescent is naturally inclined to be self-involved and egocentric, which pre-disposes a teenager to have an abortion.

The adolescent is not able to conceptualize the long-range implications of the abortion decision or to take responsiblity for them, (Piaget, 1954) and thus, is in a position to deny both the responsibility for her actions and the negative after-effects because she can so easily deny all personal involvement. Because of her interior dichotomy, 'others' influence on her inner self is the scapegoat, while her outer self hides the guilt under day-to-day activities.

Normal grieving is required for the maturing of the individual which requires a passage of time. A mature developmental level requires self-control and self-responsibility which allows for realistic assessment of one's actions.

A delay between the abortion event and the emergence of post abortion syndrome may well be related to developmental changes in the individual woman.

To encourage the adolescent to abort therefore may lead to delays in normal maturational processes.

[Wanda Franz, Ph.D., Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]


Adolescents Report Increased Isolation, Repeat Pregnancy Following Abortion

Thirty eight of 50 girls aged 15-20 (average 17.5) were studied via a questionnaire and an interview with a psychiatrist and social worker two years following their abortion at Montreal Children's Hospital.

Thirty seven percent of the girls' fathers were absent by death or separation. Despite relationships of 6 months or more in most instances 37% of the girls broke up with the putative fathers following abortion. Thirty-two of the 38 (84%) remained in school or on the job and 32 of 38 reported contraceptive use, as opposed to only 2% reported use prior to the abortion.

The girls reported they felt mentally older and made statements such as: "I feel older than girls my age"; "I can make decisions now"; "I feel tougher now"; "I have to take care of myself, my boyfriend will not look after me"; "I think of the consequences befoe I do something now". Eighteen percent of the girls had a repeat pregnancy, including those who did not participate in the study.
The authors suggested "a high degree of emotional disturbance for the repeaters".
Follow-up of 50 Adolescent Girls Two Years After Abortion, Cvejic, et al, Canadian Medical Association Journal, vol. 116, January 8, 1977, pp.44-46.  [Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]

Adolescents Replace Pregnancies Following Abortion

In a study of 40 Chicago adolescents in 1976-77 those who had previously had an abortion, miscarriage, or other infant or fetal loss conceived again shortly after their previous loss.

Twenty-five said they had purposely become pregnant again as a replacement for the previous loss. Thirteen did not admit to planning the subsequent pregnancy but avoided contraception even though they were aware of the consequences of doing so.
It was concluded that adolescents who do not fully address the process of mourning after abortion, miscarriage or infant loss may face a greater risk of subsequent pregnancy.

Adolescent Mourning Reactions to Infant and Fetal Loss, Nancy Horowitz, Social Casework, November 1978, pp. 551-559. [Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]

Repeat Abortion Harmful to Adolescents

Nearly 50% of the abortions in the U.S. are repeat abortion. Increasing moral and social deterioration as well as increased psychological conflicts have been observed in women with each additional abortion.

Increased isolation, confusion, poor decision-making, deteriorating relationships, increased drug abuse, increased smoking, increasing psychiatric hospital admissions and a decline in religious affiliation have been noted.

Special Issue on Repeat Abortion, Association for Interdisciplinary Research Newsletter, vol. 2, no. 3, Summer 1989…

A 1984 New York City study of 31,207 teenagers found that those who had experienced one prior abortion were approximately 4 times more likely to terminate a subsequent pregnancy by abortion. The Social and Economic Correlates of Pregnancy Resolution Among Adolescents in New York City by Race and Ethnicity: A Multi Variant Analysis, Joyce, Am J Public Health 78 (6): 626 June 1988.

In another study of teenage abortion, 404 women were followed through medical records of a Los Angeles hospital over a 5 year period.  Thirty-eight percent had a previous abortion, and 18% had 2 abortions within the same year.

Incidence of Repeat Abortion, Second Trimester Abortion, Contraceptive Use and Illness Within a Teenage Population, Rena Bobrowsky, PhD thesis, Univ of S California (1986); Dissertation Abstracts Int'l 47(9), March 1987. [Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]

Coerced Abortion in Adolescence Risks Serious Psychological Problems

An immature teenager is especially vulnerable if she values her pregnancy and is given an abortion under pressure. She is very likely to:
    a) develop severe post-operative depression that necessitates working through her loss as if after a bereavement
    b) withdraw from her peers and completely isolate herself
    c) deny the reality of her pregnancy and abortion
    d) develop depressive equivalents such as acting-out, difficulties at school, anti-social and aggressive behavior
    e) run away from school and.or home or university
    f) attempt to commit and occasionally succeed in committing suicide (these girls are said to become accident prone and may resort to alcohol, drugs or self-mutilation) and/or…
    g) identify with the fetus and become ridden with guilt, shame and rage toward herself, her parents, her sexual partner, the doctor, and the hospital/abortion center.

Counselling of Patients Requesting an Abortion, Joyce Dunlop, The Practitioner, vol 220: 847-852, June 1978.


A poignant story of a coerced abortion of an adolescent who valued her pregnancy and the severe, long-lasting problems that resulted is found in Beyond Choice, Don Baker, Multonomah Press: Portland OR (1985).
[Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;] 


Anniversary Reactions – Adolescent Mourning on the Perceived Date of Birth

In a study at the Medical College of Ohio, of 71 women in a patient led support group who had poorly assimilated their abortion experiences, 42% had clearly reported abortion anniversary reactions.

Fifty percent had their abortions as adolescents. Psychological Profile of Dysphoric Women Post Abortion,

K Franco et al, J of American Medical Womens Assoc, 44(4):113-115, July/Aug 1989.

Anniversary reactions may include depression, sadness, or crying or abdominal cramping motivated by incomplete or abnormal grieving over the loss of the child. Anniversary reactions may be very traumatic.

In one cae, a 17 year-old girl attempted to kill herself wile driving under the influence of alcohol and an overdose of aspirin tablets and smashed her car repeatedly into a bridge overpass damaging the car beyond repair. The date of the incident was on the perceived birth date of the aborted child. In another instance, a 16 year-old girl took an overdose of Tylenol tablets as part of a suicide attempt and was brought to the ER of the hospital. Her suicide attempt corresponded to the apporximate date her aborted child would have been born.

The author stated that the cases raise the question of possible motive for guilt: "Should the patient's perceived death of the fetus during abortion be punished by suicide?" and "Does a real or perceived anniversary or birthday reactivate internal or interpersonal conflicts?"

Adolescent Suicide Attempts Following Elective Abortion: A Special Case of Anniversary Reaction, Tischler, Pediatrics 68 (5): 670, Nov 1981. [Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]   

Immature Coping Defenses Used Following Adolescent Abortion

In a study at the Medical College of Ohio of women in a patient led post abortion support group who had poorly assimilated their abortion experiences, researchers compared differences in the 35 women who had their abortions as teenagers with 37 women who had their abortions after the age of 20.

They found that teenagers were significantly more likely to report parental marital difficulties, to attempt suicide following abortion (29% vs. 13%), and to have severe nightmares following abortion (80% vs. 43%).

In addition, the teenage aborters had significantly higher scores on the Millon Clinical Multiaxial Inventory (MCMI) scales measuring  antisocial traits, paranoia, drug abuse and psychotic delusions.

The authors concluded that adolescents were more likely to use immature defenses such as projection, denial or "acting out" and that these immature coping defenses might become permanent defense mechanisms. Abortion in Adolescence, N Campbell, K Franco, S Jurs, Adolescence, vol XXIII, no. 92: 813-823, Winter 1988. [Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]   

Abortion is Risk Factor in Adolescent Suicide Attempts

A 1985 study by researchers at the University of Minnesota of 3636 Minnesota rural high school students (grades 9-12, average age 16.3) found that if a girl had undergone an abortion within the last 6 months she was 10 times more likely to have attempted suicide than if she had not had an abortion in that period (4% of attempters had abortion vs. 0.4% of non-attempters).

If a girl had an abortion any time previously in her lifetime, she was about 6 times more likely to have attempted suicide compared with girls who had not aborted (4% of attempters had abortions vs. 0.7% of non-attempters).

Girls attempting suicide in general were more likely to be depressed, recently broken up with their boyfriend, have come from disrupted, chaotic home environments and to have exhibited poor judgment in their use of birth control, moral decisions, and academic achievement.

According to Dr. Barry Garfinkel [chief author of the study, head of child and adolescent psychiatry, University of Minnesota] the most important factors in teen suicide are impulsiveness, anger, and anxiety.

The more tension, the more likely it is that adolescents will end their lives.

At a press conference announcing the study results, Dr. Garfinkel was quoted as saying, "All too often we take these events (abortions) as either producing an alleviation of stress or of being helpful to young people, and I think we have to re-examine the issues."

Stress, Depression and Suicide: A Study of Adolescents in Minnesota, Barry Garfinkel et al in Responding to High Risk Youth, Minnesota Extension Service, University of Minnesota (1986); Suicide, Minnesota Daily, 29Oct1986, p.3,16.

[Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]



Abortion Increases Risk of Adolescent Infection

Induced abortion by aspiration curettage (the most common method) is directly implicated in post-abortion infections such as endometritis (inflammation of the uterine wall) or (PID) Pelvic Inflammatory Disease (inflammation of the female genital tract).

Adolescents are at a particularly high risk especially when unrecognized STD such as chlamydia or gonorrhea are present at the time of the abortion. The abortion procedure stimulates the spread of the unrecognized STD into the uterine cavity causing the infection.

Also, instruments used during the abortion procedure may introduce microorganisms into the uterine cavity or fetal remains following the abortion may also cause infection. Culture and Treatment Results in Endometritis Following Elective Abortion, Burkman, et al, Am J Obstet Gynecol 128: 156 (1977, Genital Infections Women Undergoing Therapeutic Abortion, Avonts and Piot, Europ J Obstet Gynecol Reprod Biol, 20: 53 (1985).

Over one million U.S. women annually experience an episode of pelvic inflammatory diesease (PID) with 16-20% of cases in teenagers. Acute PID is a major direct cause for infertility, chronic pelvic pain, ectopic pregnancy, or even death. PID and its Sequelae in Adolescents, Washington et al, J Adolescent Health Care 6: 298 (1985).

The reported incidence of untreated PID following abortion is 0-13% in Scandinavian studies.  If chlamydia tracholmatis is present at the time of abortion, the incidence of untreated PID is 10-37%. Sexually Transmitted Diseases, Holmes, Mardh et al, McGraw-Hill (1989) p. 598-599. Women age 15-19 are 2 1/2 times more likely than women 25-29, and five times more likely than wome

n 30-34 to acquire PID when chlamydia or gonorrhea is present in the cervix. Id.

A Johns Hopkins Hospital study found that teenagers 17 years or less were 2.5 times more likely than women 20-29 to acquire endometritis following abortion. The incidence of untreated endometritis following abortion ranges from 3.5% to 14.7% according to Johns Hopkins Hospital Studies.

Morbidity Risk Among Young Adolescents Undergoing Elective Abortion, Burkman et al, Contraception, vol 30: 99-105 (1984); Post-abortal Endometritis and Isolation of Chlamydia, Trachomatis, Barbacci M et al, Obstet Gynecol 68: 686 (1986).
[Association for Interdisciplinary Research in Values and Social Change Newsletter, vol 3, no 3, Fall 1990;]