Manifold problems in a recent New York Times article
On June 12 the New York Times published an article by graduate student Joshua Lang, “What Happens to Women Who Are Denied Abortions?” Mr Lang is currently enrolled in UC Berkley’s Joint Medical Program, a five-year Master of Science/Medical Doctorate Program. Sadly, Lang’s desire to push a political agenda was apparently the most salient force behind his shoddy piece. Like many before him, Lang tries to dismiss more than 100 peer-reviewed studies revealing an increased risk of mental health problems by focusing on one counter study that has yet to generate any peer-reviewed publications. Lang interviewed me last fall for over an hour and he clearly understood the science.
According to Mr Lang, “There is no credible research to support a ‘post-abortion syndrome’, as a report published by the American Psychological Association in 2008 made clear. Yet the notion has influenced restrictive laws in many states.” This statement actually indirectly affirms the strength of the published evidence regarding abortion as a risk factor for mental health problems, because the evidence presented in courts continues to trump the APA conclusions. The vast majority of research studies on the psychological implications of abortion do not address a “Post-Abortion Syndrome”. Instead, researchers examine abortion as a risk factor in mental illnesses that are identified by mainstream professional organizations.
The results of hundreds of studies published in leading peer-reviewed medicine and psychology journals over the past three decades indicate that abortion is a substantial contributing factor to women’s mental health problems, including depression, anxiety, substance use disorders, and suicidal thoughts and behaviors. This evidence has quite reasonably influenced informed consent legislation in many states. In upholding the South Dakota law in 2012, the US Court of Appeals relied upon this body of data.
A critique of the 2008 APA report is posted at the website of the World Expert Consortium for Abortion Research and Education (WECARE), a group of 10 credentialed scientists working to bring accurate information to a public in dire need of evidence-based facts concerning abortion.
Among dozens of other peer-reviewed studies, Lang ignores the results of a meta-analysis entitled “Abortion and Mental Health: A Quantitative Synthesis and Analysis of Research Published from 1995-2009” that I published in the British Journal of Psychiatry (BJP) in 2011. Meta-analyses have much more credibility than the results of individual empirical studies or narrative reviews, such as the APA’s 2008 report. In a meta-analysis, the contribution or weighting of any particular study to the final result is based on objective scientific criteria (sample size and strength of effect), as opposed to an individual’s opinion of what constitutes a strong study. The BJP sample consisted of 22 studies and 877,297 participants (163,880 experienced an abortion). Results revealed that women who aborted experienced an 81 percent increased risk for mental health problems. When compared specifically to unintended pregnancy delivered, women were found to have a 55 percent increased risk of experiencing mental health problems. This review offers the largest quantitative estimate of mental health risks associated with abortion available in the world.
Many women who make the decision to abort do so without a thorough understanding of the procedure. A number of peer-reviewed studies have revealed that feeling misinformed or being denied relevant information often precipitates post-abortion difficulties. Moreover, there is considerable evidence that a high percentage of women walking into abortion clinics are conflicted about the choice. In another study I published with colleagues in the Journal of Medical Ethics, we found that 95 percent of a socio-demographically diverse group of women wished to be informed of all possible complications associated with drugs, surgery, and/or other forms of elective treatments, including abortion.