LONDON — Emma Beck hanged herself on the eve of her 31st birthday. The note the talented British artist left revealed the depth of her grief.
“Living is hell for me. I should never have had an abortion,” she wrote. “I see now I would have been a good mum. I told everyone I didn’t want to do it, even at the hospital. I was frightened, now it’s too late. I want to be with my babies; they need me, no one else does.”
Beck’s suicide in 2007, six months after aborting twins, and the inquest that followed in February this year, have intensified the controversy about the risk to women of psychological harm from abortion.
And on March 14, Britain’s Royal College of Psychiatrists issued a surprising statement that women could be at significant risk for psychiatric disorders following abortion.
To give informed consent, the college added, women must be more clearly informed of possible risks to their mental health.
The new statement challenges the decades-old consensus among professional mental health bodies that the psychological risks of abortion are less than those of continued pregnancy.
The college’s previous 1994 statement said “there is no evidence in such cases of an increased risk of major psychiatric disorder or of long-lasting psychological distress.”
Even for women identified at high risk of psychiatric disorders and undergoing later abortions, the college previously said aborting was “the least detrimental alternative.”
In Great Britain, as much as 90% of the nearly 200,000 annual abortions are officially done to preserve the mother’s “mental health.”
But the college of psychiatrists’ new statement calls the current research base “inconclusive” and suggests that abortion information leaflets may need updating and abortion staff may need new training about potential psychiatric problems.
“It is certainly a move in the right direction,” said Margaret Cuthill of the Glasgow-based British Victims of Abortion. “We see the women who are dealing with physical and emotional problems after their abortions. They are traumatized.”
In Scotland where the early abortion pill RU-486 is the leading abortion method, Cuthill said she sees women who “have been told that they will be expelling a blob of jelly and they go home and miscarry a tiny baby. They are really overcome with unexpected grief and guilt. For many, many years these women have been told that their grief is not real,” Cuthill said.
British Victims of Abortion fields calls from only about 40 post-abortive women each month, but Cuthill expects that number to grow. Project Rachel, one of the first post-abortion healing groups in the U.S., grew from 18 weekend retreats in 1999 to more than 600 annually in 47 states and 17 countries.
But more than grassroots movements, recent studies have likely influenced the Royal College of Psychiatrists’ turnabout. A large Finnish study published in the British Medical Journal in 1996 found a six-fold increased risk of suicide rates among women who had had abortions.
Another study published in the American Journal of Orthopsychiatry in 2002 examined 173,000 California state health records and found that women were 63% more likely to receive mental care in the 90 days following an abortion than giving birth. They are also significantly more likely to be treated in the four years the study followed for mental illness including neurotic depression, bipolar disorder and schizophrenia.
And in 2006, a major longitudinal study at the Christchurch School of Medicine in New Zealand found that women at 25 years of age who had an abortion were subsequently more likely to suffer “depression, anxiety, suicidal behaviors and substance use disorder.”
“This evidence is not yet strong enough to conclude that abortion has harmful effects on mental health,” David Fergusson, lead researcher of the Christchurch Health and Development Study, said. “Equally, it would be premature to dismiss this possibility.”
The Royal College of Psychiatrists’ statement, he thinks, fairly “acknowledges the possibility of harmful effects without drawing dogmatic conclusions.”
For its part, the American Psychiatric Association has held the same policy on abortion since 1977. It states that an “unwanted pregnancy” can cause long-term mental harm to a woman and her unwanted child and so the association opposes all efforts to restrict any abortion and “affirms that the freedom to act to interrupt pregnancy must be considered a mental health imperative.”
The association did not respond to the Register’s questions about the Royal College of Psychiatrists’ new statement.
The American Psychological Association is releasing a new report on abortion and mental health this summer.
“Well-designed studies must distinguish the impact of abortion per se from the stress of the unwanted pregnancy,” American Psychological Association spokeswoman Kim Mills said. “Research conducted by our members and others has shown that for most women, abortion, in and of itself, is not associated with negative mental health consequences. Furthermore, an APA policy resolution adopted in 1969 identified access to abortion as a mental health issue.”
Philip Ney, a psychiatrist in Victoria, British Columbia, who has written extensively on post-abortion mental health, says that the British college may well be motivated by another concern — liability.
“Precedents have been set in successful suits brought against abortionists for lack of informed consent,” Ney said, adding that medical bodies that authoritatively dismiss risks may find themselves in future lawsuits.
There have been three cases of post-abortion mental health damages brought forward in the U.K., says Ellie Lee, a pro-abortion senior lecturer on social policy at the University of Kent in Canterbury, who has written on the subject.
But each has been dismissed and future claims would stand very little chance in Britain, according to Lee.
Lee is dismissive of the idea that abortion can traumatize mothers of unborn children
“To say that because some woman regrets her abortion later on in life means that she would have been better off to have been made to have the baby at that point is just stupid,” says Lee. “Abortion is messy business. That’s life. The fact is, most women just have their abortion and get on with it.”
Lee claimed that organizations like Marie Stopes International, Britain’s largest abortion agency, ensure that women are fully informed about all the potential consequences of abortion.
“I think that Marie Stopes and the British Pregnancy Advisory Service who provide more than 50% of the abortions in the U.K. do a fantastic job informing women,” said Lee. “They are very, very careful and have procedures in place to identify women who are pressurized or otherwise at risk. I just wonder if the [Royal] college members have even seen their literature.”
In fact, mental health effects of abortion are scarcely alluded to in patient leaflets or on those groups’ websites. Marie Stopes International’s patient leaflet does not even mention mental health risks, and states “there is no evidence at all that a straightforward abortion has any effect on future fertility or any other aspect of general health.”
David Reardon, a leading American researcher on post-abortive health at the Elliot Institute in Springfield, Ill., said the key issue for the medical community should be extending help to women who clearly are at risk of suffering from abortion.
Said Reardon, “If we can identify the woman who is most at risk of psychological damage from abortion — and we can — we have a duty to make sure she has all of the relevant information and she is truly consenting.”
Before long, advocates of abortion-on-demand everywhere will have to follow the British psychiatrists’ lead and acknowledge the evidence that abortion can cause grave psychological trauma to women, Reardon predicts.
Said Reardon, “You can only go so far dismissing post-abortive women’s experiences before you start to look really cold and uncaring.”
Celeste McGovern is based in