By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
The November 20, 2023, headline from Psychiatry Advisor made me think I’d found something: “Over One-Third of Women With an Abortion History Experience Depression.” As I looked at the study more closely, though, I determined that I had, but just not what the authors and reporters seemed to think was the story.
Let me explain.
The study, “Global prevalence of post-abortion depression: systematic review and Meta-analysis,” authored by a team of Ethiopian medical researchers led by Natnael Atnafu Gebeyehu, appeared in the October 26, 2023, edition of BMC Psychiatry.
The researchers looked at over six hundred studies from all over the world, eventually selecting 15 as suitable for meta-analysis–that is, having the appropriate information, statistically rigorous results, being as free as possible of bias, etc.
Combining data from Germany, Denmark, the Netherlands, Lithuania, Kosovo, Jordan, Iran, China, and Australia, researchers said that they’d found more than a third (34.5%) reporting post-abortion depression.
Some studies reported depression as low as 8.6% (Demark and Kenya) while one (Turkey) reported a figure as high as 85%.
They claimed that closer analysis showed that there was some regional and economic variation in the data, with areas of Asia (37.5%) and the Eastern Mediterranean (43.1%), as well as lower middle income strata (42.91%), showing higher rates of depression than others. After all was said and done, though, researchers found depression after abortion in all geographic and demographic areas.
That all sounds serious and sobering. But when I looked more carefully at the study, I found that their study included and mixed together data about induced abortion with spontaneous abortion or miscarriage. Their thesis, valuable in its own right, was that pregnancy loss of any sort was traumatic, whether the abortion was intentional (e.g., chemical or surgical abortion) or not (as in the loss of a wanted child through miscarriage).
I knew that this wouldn’t settle the critics who claim that post-abortion depression is a myth or at most a temporary, fleeting phenomena experienced by just a handful of women already dealing with some latent psychological disorders.
The mixing of the data by the researchers gave detractors an all-to-easy out that it was miscarriage – grief at the loss of a wanted child – that was providing the problematic result.
But a closer look at the data shows that wasn’t the case.
Depression still tied to abortion
It’s not what the researchers intended, and it isn’t explicitly brought forward in their analysis. But when sorted out, what the studies show is that it was a much lower incidence of grief over a miscarriage that gave an overall lower percentages of women with depression.
Studies that focused on abortion tended to show higher rates of depression.
There were three studies in the researchers’ list which showed depression rates under 10% – ones from Denmark (8.6%), Germany (8.9%), and Kenya (8.6%). But the titles of each of these – addressing “recurrent pregnancy loss” (Denmark. 2014), “spontaneous abortion” (Germany, 2017), and “post miscarriage” (Kenya, 2018)–make it clear that it was unintentional miscarriage, not induced abortion, that was the object of those studies.
Any woman who has had a miscarriage knows that these can be traumatic and that some element of this pain may never leave you. Some of this is surely reflected in the reports of depression found in these studies.
But even though some might be haunted by questions wondering what, if anything, they could have done differently, generally, these are not accompanied by the sort of guilt and anxiety that comes from an explicit decision to abort–to consent to the killing of one’s own child.
The researchers’ confusion of categories, mixing miscarriages and abortions, leads to some uncertainty as to what data their selected studies contain. But the titles of studies which specifically use the term “post-abortion” or “induced abortion” all point to a rate of depression of at least 22.5% (China, 2021) or as high as 54% (Iran, 2018), averaging out to 31.4% when data is taken as a whole.
All the data taken from the studies related to miscarriage yield a percentage less than half that, with 15.6% reporting depression after the pregnancy loss.
It may not be what researchers set out to prove, but their meta-analysis tends to lend support to abortion is much more likely to lead to depression than miscarriage.
There is some other data that broadens our understanding of the relation between pregnancy loss and depression, but does not fit neatly in the standard abortion or miscarriage frameworks.
Though neither the title nor the abstract makes clear exactly what the conditions were, a 2019 study from Turkey examining “therapeutic” abortions found depression in 85% of subjects. The term “therapeutic,” though, implies that these were abortions performed for emergency health conditions, which certainly would have been traumatic for all involved.
A 2017 study the researchers turned up from Germany found 10.8% suffering from depression after abortions for a “fetal anomaly.” That many women would have strong reactions to abortions recommended by doctors after the discovery of some sort of genetic disability that might be incompatible with a long life is not surprising. Yet, again, this is a somewhat different situation than a standard abortion in which the woman feels directly culpable for the decision to end the life of the child.
Evidence of the connection remains
We would have to be able to see and analyze each of the studies used by the researchers (and perhaps some of those they rejected) in considerably more detail to get a full and accurate picture of the extent and depth of depression connected to induced abortion.
But what we do have here is sufficient to tell us that many women do indeed have a serious and significant reaction to the loss of a child, whether from miscarriage or abortion but far more in the latter than the former.
Every study at which the authors looked showed at least some connection.
And though negative psychological aftermath may be found in both situations, abortion appears to lead to depression much more frequently than miscarriage.
Abortion advocates may get rid of the baby but cannot so easily erase the memory of the child from women’s hearts and minds.