Hello everyone! I hope you are all doing well and finding happiness in your lives. I am certainly happy that spring break is upon me, meaning that I only have to work and study for my healthcare finance midterm. Actually, I'm sort of stressed out. But at least I don't have to go to class.
What is on my mind lately in the world of reproductive health politics is the recent de-bunking of the Coleman et. al. study that claimed there was a causal link between abortion and mental health problems in women. The study was published in 2008 in the Journal of Psychiatric Research, which I'm not familiar with but would assume is a legitimate and hopefully peer-reviewed journal. I had heard about this study before, and wondered about how it came to its conclusions. The other research on the same topic was unable to find a causal link, so I found it odd that this one did.
According to the Guttmacher Institute, the study was officially found to be void based on analytic errors. Apparently, Coleman and her fellow researchers did not identify whether the mental health disorder was diagnosed before or after the abortion procedure, and proceeded to lump these women into the same group. They then found that a large number of women with mental health disorders had also had abortions (diagnosed before or after the procedure), and after controlling for current life situations that could account for the disorders, they concluded that the abortions caused the mental health diagnoses.
Uh, what?
There is a lot more detail to get into about the events surrounding this de-bunking, but such information can be found elsewhere (see the bottom of this post for some links). What makes me the saddest about all of this is that we base so much of our decisions as a country on science, and hold "evidence" that is published in journals in the highest regard. We create legislation and programs from this evidence that in turn affects millions of people. Of course, we need to support women in their decisions to have abortions and understand their mental health needs both before and after the procedure, but we can't allow this kind of bad science to dictate how we think about women who have had, or will have abortions.
Yes, abortion is an incredibly difficult decision that nobody wants to make, and such a situation can definitely have repercussions for some people. However, the body of evidence that already exists about mental health and abortion (and physical health and abortion for that matter) shows that abortion really does not cause marked distress in women. In public health school we learn that it is a body of evidence that allows us to conclude that something has a causal relationship, not one or two studies by the same author.
Other studies have shown that the women who do have complicated mental health reactions after their abortions were struggling with mental health issues prior to having the procedure. According to further research on populations who have mental health diagnoses, these same reactions occur after other difficult events in their lives. This is telling, as it shows that it is not so much about the abortion as it is about a person whose coping abilities may be compromised. We need to re-frame this issue as supporting women with mental health issues through all of the difficult times in their lives, not just abortion.
Of course, women without mental health diagnoses who have abortions need support too, because it can often be a difficult, guilt-inducing, and isolating experience. We should be offering support for every woman who has an abortion to help her maximize her recovery, whether she is having a reaction complicated by a prior diagnosis or a more common mix of contradictory emotions. But, we should absolutely not be operating on the premise that abortion is an experience that will always lead to complicated outcomes.
To conclude, scaring women with junk science is bad. Not making a distinction in your study between diagnoses made before an abortion and after an abortion, and then claiming that abortion causes mental health problems is abhorrent indeed. I am so glad this study has been debunked, but what of others? It is my most sincere wish that this example motivates journals to re-evaluate their screening processes, to make sure that science stays as unblemished as possible for the benefit of all of us. What do you think?
Further reading:
Read the Guttmacher article here
And the original Coleman study here
And the letter from the scholars who found the study to be flawed here
And another Guttmacher article about abortion reactions and the evidence behind them here
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