Last Wednesday the Supreme Court ruled that a lower court was wrong to strike down a state law requiring parental notification for adolescent abortions. In its first abortion case in five years, the court unanimously decided that the lower court went too far in permanently blocking a New Hampshire statute that requires that at least one parent be told before a minor daughter ends her pregnancy. An appeals court must now reconsider the law.
When it does, it may want to consider a crucial medical question that, if conclusively answered, could illuminate the entire legal debate over teenage abortion: How does abortion affect teenage girls’ health, most notably their emotional and psychological wellbeing?
Last May, in a case that illustrates just how fundamental this question is, Circuit Court Judge Ronald Alvarez ruled that a 13-year old Florida girl would be granted the abortion she had requested after running away from her foster home and getting pregnant.
The Florida Department of Children and Families argued against permitting the procedure, but, after delaying a decision in order to have a psychologist assess her "competency," Judge Alvarez concluded that the teen was in good mental health and that she "would not be physically or psychologically harmed by the procedure." The girl aborted the following day.
Unfortunately, the judge’s conclusion about the girl’s mental health discounted the most significant factor concerning the relationship between abortion and psychological health: the abortion effect. Research increasingly shows that women, especially adolescents, who obtain an abortion are at higher risk of a variety of negative psychological effects than those who give birth. Moreover, those negative effects can often be linked directly to the abortion experience itself.
In other words, it is not just "at risk" or emotionally unstable women who suffer adversely from abortion, but "healthy" women, too.
Of course, attempting to determine the precise relationship between abortion and psychological health can be difficult. Simply finding a link between two or more variables might be suggestive, but unless causality can be established, it is rarely compelling. To do so one must account for enough other factors that are associated with depression. While it may be tempting to say that a depressed woman’s psychological problems were caused by a prior abortion, if she was depressed before the abortion, one could not infer that the abortion itself caused the depression. The key is to ask: “Have I accounted for enough other factors that are associated with depression?” When attempting to determine the psychological effects of abortion, other factors include a predisposition to depression, relationship measures, socioeconomic status, physical health, religiosity and a host of other variables.
By holding these significant variables constant, a researcher can begin to isolate the direct effect of abortion on psychological health.
It’s been nearly 20 years since Surgeon General C. Everett Koop concluded that research on the psychological effects of abortion was entirely inadequate for drawing any general conclusions about either the efficacy or dangers of abortion. Today, while Planned Parenthood and other abortion advocates maintain that the emotional effects of abortion are “largely positive,” the experiences of an increasing number of women refute the refrain that having an abortion is as simple as having your tonsils removed.
There have been at least a dozen studies in peer-reviewed journals that point to a significant link between abortion and depression. Most recently, a study of the entire population of Finland published in December’s "European Journal of Public Health" found that the suicide rate among women who had abortions was six times higher than that of women who had given birth in the previous year.
Further, in a brand new longitudinal study of New Zealand youth appearing in this month’s "Journal of Child Psychiatry and Psychology," researchers found that having an abortion as a young woman increased the risk of a variety of mental health problems, including depression and suicidal tendencies, by 35 percent compared to those young women who continued with their pregnancies.
Though there is a consensus within the research community that some women experience clinical levels of depression post-abortion, there certainly is no agreement on whether abortion, in fact, causes depression. Indeed, there have been major studies showing no statistically significant link. An October article in the "British Medical Journal" found no important difference in the depressions scores of women who aborted their first pregnancies and those who carried their first pregnancies to term.
These differing conclusions highlight the need for a nonpartisan longitudinal study on the psychological effects of abortion. In 2004, Representative Joe Pitts introduced the Post-Abortion Depression Research and Care Act, which provides the National Institutes of Health $15 million to study the emotional impact of abortion on women. It would have also created a program to fund the development of treatment programs for women who suffer emotionally after an abortion. While the bill enjoyed bi-partisan support in Congress, it died at the end of the last legislative session.
Though it is still unclear whether or not the courts will rule that a parental notification law constitutes an undue burden on a woman’s right to choose, what has become crystal clear is the need for Congress to pass the Post-Abortion Depression Research and Care Act so that we may begin to determine whether the real undue burden isn’t being placed on the increasing number of women who experience depression after abortion.