Abortion and Mental Health - Revision history

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	===PAS Summary==		===PAS Summary==
	'''Post-abortion syndrome''' (PAS) is a term proposed to describe cases of [[post-traumatic stress disorder]] which may be attributable to [[abortion]].<ref>Speckhard, A. & Rue, V. [http://www.annespeckhard.com/publications/Postabortion_syndrome.pdf Postabortion Syndrome: An Emerging Public Health Concern] Journal of Social Issues, Vol.48, No. 3, 1992, pp.95-119 </ref><ref>Rue VM, et al.[http://www.ncbi.nlm.nih.gov/pubmed/15448616?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Induced abortion and traumatic stress: a preliminary comparison of American and Russian women.] Med Sci Monit. 2004 Oct;10(10):SR5-16. Epub 2004 Sep 23. </ref><ref name=Gomez>{{cite journal \|author=Gómez Lavín C, Zapata García R \|title=Diagnostic categorization of post-abortion syndrome \|journal=Actas Esp Psiquiatr \|volume=33 \|issue=4 \|pages=267–72 \|year=2005 \|pmid=15999304 \|doi=}}</ref> <ref>Major, B., Cozzarelli, C., Cooper M.L., Zubek, J., Richards, C., Wilhite, M., Gramzow, R.H. (2000). [http://www.ncbi.nlm.nih.gov/pubmed/10920466?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Psychological responses of women after first-trimester abortion.] Arch Gen Psychiatry. 57(8):777-84.</ref>		'''Post-abortion syndrome''' (PAS) is a term proposed to describe cases of [[post-traumatic stress disorder]] which may be attributable to [[abortion]].<ref>Speckhard, A. & Rue, V. [http://www.annespeckhard.com/publications/Postabortion_syndrome.pdf Postabortion Syndrome: An Emerging Public Health Concern] Journal of Social Issues, Vol.48, No. 3, 1992, pp.95-119 </ref><ref>Rue VM, et al.[http://www.ncbi.nlm.nih.gov/pubmed/15448616?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Induced abortion and traumatic stress: a preliminary comparison of American and Russian women.] Med Sci Monit. 2004 Oct;10(10):SR5-16. Epub 2004 Sep 23. </ref><ref name=Gomez>{{cite journal \|author=Gómez Lavín C, Zapata García R \|title=Diagnostic categorization of post-abortion syndrome \|journal=Actas Esp Psiquiatr \|volume=33 \|issue=4 \|pages=267–72 \|year=2005 \|pmid=15999304 \|doi=}}</ref> <ref>Major, B., Cozzarelli, C., Cooper M.L., Zubek, J., Richards, C., Wilhite, M., Gramzow, R.H. (2000). [http://www.ncbi.nlm.nih.gov/pubmed/10920466?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Psychological responses of women after first-trimester abortion.] Arch Gen Psychiatry. 57(8):777-84.</ref>

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	The research also compared pre-operative data on the women who agreed to participate in the one year followup and data on women who refused to participate, who represented approximately one-third of all women who had abortions at the hospital. Based on socio-demographic factors, reproductive history and reasons given for the abortion, the researchers concluded that women who are most likely to experience negative post-abortion reactions are also least likely to participate in post-abortion research.<ref>Söderberg, H., Andersson, C., Janzon, L., & Sjöberg, N-O. (1998). [http://www.ncbi.nlm.nih.gov/pubmed/9550203?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Selection bias in a study on how women experienced induced abortion.] European Journal of Obstetrics & Gynecology and Reproductive Biology, 77:67-70.</ref> According to Söderberg, "for many of the women, the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer very often given was: ‘I do not want to talk about it. I just want to forget'." <ref>Uban women applying for induced abortion: Studies of epidemiology, attitudes and emotional reactions by Hanna Soderberg, M.D., Departments of Obstetrics and Gynecology and Community Medicine, Lund Universtiy, University Hospital, Malmo Sweden 1998. page 15</ref>		The research also compared pre-operative data on the women who agreed to participate in the one year followup and data on women who refused to participate, who represented approximately one-third of all women who had abortions at the hospital. Based on socio-demographic factors, reproductive history and reasons given for the abortion, the researchers concluded that women who are most likely to experience negative post-abortion reactions are also least likely to participate in post-abortion research.<ref>Söderberg, H., Andersson, C., Janzon, L., & Sjöberg, N-O. (1998). [http://www.ncbi.nlm.nih.gov/pubmed/9550203?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Selection bias in a study on how women experienced induced abortion.] European Journal of Obstetrics & Gynecology and Reproductive Biology, 77:67-70.</ref> According to Söderberg, "for many of the women, the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer very often given was: ‘I do not want to talk about it. I just want to forget'." <ref>Uban women applying for induced abortion: Studies of epidemiology, attitudes and emotional reactions by Hanna Soderberg, M.D., Departments of Obstetrics and Gynecology and Community Medicine, Lund Universtiy, University Hospital, Malmo Sweden 1998. page 15</ref>

	===Gissler===		===Mika Gissler===
	A record-based study of [[Finnish]] women found that in the year following a pregnancy outcome the rate of suicide following abortion was 34.7 per 100,000 compared to 5.9 per 100,000 for women who gave birth, 18.1 per 100,000 for women who had miscarriages, and 11.4 per 100,000 for women who had not been pregnant in the prior year. <ref>Gissler M, Hemminki E, Lonnqvist J. [http://www.ncbi.nlm.nih.gov/pubmed/8973229?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Suicides after pregnancy in Finland: 1987-94: register linkage study.] BMJ 1996;313:1431-4)</ref>		A record-based study of [[Finnish]] women found that in the year following a pregnancy outcome the rate of suicide following abortion was 34.7 per 100,000 compared to 5.9 per 100,000 for women who gave birth, 18.1 per 100,000 for women who had miscarriages, and 11.4 per 100,000 for women who had not been pregnant in the prior year. <ref>Gissler M, Hemminki E, Lonnqvist J. [http://www.ncbi.nlm.nih.gov/pubmed/8973229?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Suicides after pregnancy in Finland: 1987-94: register linkage study.] BMJ 1996;313:1431-4)</ref>

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	The controversy over abortion and mental health is fueled by the potential effects this issue may have on the political and judicial debate over abortion. In it's most recent ruling on abortion, <I>Gonzales v Carhart</I> the majority opinion indicated that abortion was "fraught with emotional consequences." The minority opinion, however, while acknowleding that "for most women, abortion is a painfully difficult decision" insisted there is no reliable evidence that women who regret their abortions suffer from "[s]evere depression and loss of esteem."<ref>Gonzales v Carhart. 2006</ref>		The controversy over abortion and mental health is fueled by the potential effects this issue may have on the political and judicial debate over abortion. In it's most recent ruling on abortion, <I>Gonzales v Carhart</I> the majority opinion indicated that abortion was "fraught with emotional consequences." The minority opinion, however, while acknowleding that "for most women, abortion is a painfully difficult decision" insisted there is no reliable evidence that women who regret their abortions suffer from "[s]evere depression and loss of esteem."<ref>Gonzales v Carhart. 2006</ref>

	~~<references/>~~

	~~====Proposed Intro====~~
	The relationship between [[abortion]] and [[mental health]] has been an area of political and scientific controversy. <ref name="WT1">Warren Throckmorton. [http://findarticles.com/p/articles/mi_hb5244/is_200601/ai_n19631833 "Abortion and mental health."] Washington Times. January 21, 2005. archives only. Reprinted [http://www.drthrockmorton.com/article.asp?id=177 here] </ref><ref name="Bazelon"/><ref name="now">[http://www.pbs.org/now/shows/329/index.html "Post-Abortion Politics"] NOW with David Brancaccio on PBS</ref> While most experts agree that some women have significant negative emotional reactions related to abortion, the incidence rate, severity, and causes are not fully understood.<ref name="RCP1"/><ref name="Coleman"/> <ref name=wilmoth/>

	A number of studies have concluded that abortion is associated with no more psychological risk than carrying an unwanted pregnancy to term. Other studies have reported a [[association (statistics)\|statistical correlation]] between abortion and negative psychological effects, though no studies have found a [[causality\|causal relationship]].<ref name="newscientist"/><ref name="Mooney"/><ref>[http://links.jstor.org/sici?sici=0014-7354(199001%2F02)22%3A1%3C36%3AD%3E2.0.CO%3B2-N Family Planning and Perspectives] by Nancy Adler</ref> Pre-existing factors in a woman's life, such as emotional attachment to the pregnancy, lack of social support, pre-existing psychiatric illness, and conservative views on abortion increase the likelihood of experiencing negative feelings after an abortion.<ref name="APA89">{{cite journal \|author=Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE \|title=Psychological responses after abortion \|journal=Science \|volume=248 \|issue=4951 \|pages=41–4 \|year=1990 \|pmid=2181664 \|doi=}} An [http://www.sciencemag.org/cgi/content/abstract/248/4951/41 abstract] of this article is available for free, and the full text is available for a fee.</ref><ref name="APArelease">American Psychological Association. "APA research review finds no evidence of 'post-abortion syndrome' but research studies on psychological effects of abortion inconclusive." Press release, January 18, 1989.</ref><ref>[http://findarticles.com/p/articles/mi_qa3634/is_199707/ai_n8772240 Abortion study finds no long-term ill effects on emotional well-being]</ref>

	In a 1990 review, the [[American Psychological Association]] has found that "severe negative reactions [after abortion] are rare and are in line with those following other normal life stresses."<ref>[http://links.jstor.org/sici?sici=0014-7354(199001%2F02)22%3A1%3C36%3AD%3E2.0.CO%3B2-N Family Planning and Perspectives] by Nancy Adler</ref> The 2008 Britian's Royal College of Psychiatrists issued an official report stating that abortion may expose women to significant mental health risks.<ref name="RCP1"/>

	The existence of "post-abortion syndrome" is not recognized by any medical or psychological organization.<ref name="Grimes">{{cite journal \|author=Grimes DA, Creinin MD \|title=Induced abortion: an overview for internists \|journal=Ann. Intern. Med. \|volume=140 \|issue=8 \|pages=620–6 \|year=2004 \|pmid=15096333 }} Key summary points: ''"Abortion does not lead to an increased risk for breast cancer or other late psychiatric or medical sequelae."'' On p. 624, the authors state: ''"The alleged 'postabortion trauma syndrome' does not exist."''</ref> Some [[pro-choice]] advocates have argued that the effort to popularize the idea of a "post-abortion syndrome" is a tactic used by pro-life advocates for political purposes.<ref name="Bazelon">[http://www.nytimes.com/2007/01/21/magazine/21abortion.t.html?pagewanted=1&ei=5088&en=5092fc3344065aec&ex=1327035600&partner=rssnyt&emc=rss&adxnnlx=1190370959-M3NVF8bZOGTDu468IEZo8g Is There a Post-Abortion Syndrome?] By [[Emily Bazelon]]. Published in the ''[[New York Times Magazine]]'', [[January 21]] [[2007]]. Accessed [[January 11]] [[2008]].</ref><ref name="Mooney">[http://www.washingtonmonthly.com/features/2004/0410.mooney.html Research and Destroy], by Chris Mooney. Published in ''[[Washington Monthly]]'', October 2004.</ref><ref name="stotlandreview">{{cite journal \|author=Stotland NL \|title=Abortion and psychiatric practice \|journal=J Psychiatr Pract \|volume=9 \|issue=2 \|pages=139–49 \|year=2003 \|pmid=15985924 \|doi=}} ''"Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae."''</ref><ref name=stotland_1404747>Stotland NL. The myth of the abortion trauma syndrome. JAMA. 1992 Oct 21;268(15):2078-9. PMID 1404747.</ref>

	== Post-Abortion Syndrome ==		== Post-Abortion Syndrome ==

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	~~==Draft Short Summary==~~
	The issue of abortion and mental health is very controversial. In 1989, Surgeon General C. Everett Koop reported that no definitive conclusions could be made regarding either the positive or negative mental health effects related to abortion because all available research at that time was too methodlogically flawed.<ref>[http://query.nytimes.com/gst/fullpage.html?res=50DE2DC143DF932A25752C0A96F948260&sec=&spon=&pagewanted=1 Koop's Stand on Abortion's Effect Surprises Friends and Foes Alike] THE NEW YORK TIMES January 11, 1989 </ref> A year later, a team of psycholgists with the American Psychological Association published their own review of the literature. They concluded that the "The weight of the evidence does not pose a psychological hazard for most women" but also noted that "case studies have established that some women experience severe distress or psychopathology after abortion." They also noted that certain groups of women were at higher risk of experiencing negative reactions, including: "women who are terminating pregnancies that are wanted and personally meaningful, who lack support from their partner or parents for the abortion, or who have more conflicting feelings or are less sure of their decision before hand."<ref name="APA89">Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. Psychological responses after abortion. Science, April 1990, 248: 41-44.</ref>		The issue of abortion and mental health is very controversial. In 1989, Surgeon General C. Everett Koop reported that no definitive conclusions could be made regarding either the positive or negative mental health effects related to abortion because all available research at that time was too methodlogically flawed.<ref>[http://query.nytimes.com/gst/fullpage.html?res=50DE2DC143DF932A25752C0A96F948260&sec=&spon=&pagewanted=1 Koop's Stand on Abortion's Effect Surprises Friends and Foes Alike] THE NEW YORK TIMES January 11, 1989 </ref> A year later, a team of psycholgists with the American Psychological Association published their own review of the literature. They concluded that the "The weight of the evidence does not pose a psychological hazard for most women" but also noted that "case studies have established that some women experience severe distress or psychopathology after abortion." They also noted that certain groups of women were at higher risk of experiencing negative reactions, including: "women who are terminating pregnancies that are wanted and personally meaningful, who lack support from their partner or parents for the abortion, or who have more conflicting feelings or are less sure of their decision before hand."<ref name="APA89">Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. Psychological responses after abortion. Science, April 1990, 248: 41-44.</ref>

	In a 1992 review of research on abortion and mental health lead editor concluded that "[t]here is now virtually no disagreement among researchers that some women experience negative psychological reactions postabortion," and that the issues of disagreement are centered on (1) how prevelant negative reactions are, (2) the severity of negative reactios, (3) determination of what level of negative reactions consitutes a public or mental health problem, and (4) how severe reactions should be classified.<ref>Wilmoth G. [http://www.ncbi.nlm.nih.gov/sites/entrez Abortion, Public Health Policy, and Informed Consent Legislation. J Social Issues.] 48(3):1-17 (1992).</ref>		In a 1992 review of research on abortion and mental health lead editor concluded that "[t]here is now virtually no disagreement among researchers that some women experience negative psychological reactions postabortion," and that the issues of disagreement are centered on (1) how prevelant negative reactions are, (2) the severity of negative reactios, (3) determination of what level of negative reactions consitutes a public or mental health problem, and (4) how severe reactions should be classified.<ref>Wilmoth G. [http://www.ncbi.nlm.nih.gov/sites/entrez Abortion, Public Health Policy, and Informed Consent Legislation. J Social Issues.] 48(3):1-17 (1992).</ref>

	In the subsequent ten years, case-control studies have found that abortion is associated with higher rates of psychiatric treatment<ref name=cmaj>Reardon DC, et al, Psychiatric admissions of low income women following abortion and childbirth. CMAJ 168:1253-6, 2003.</ref><ref>Coleman PK, et al. State-funded abortions vs. deliveries: A comparison of outpatient mental health claims over five years. American Journal of Orthopsychiatry, 2002, Vol. 72, No. 1, 141-152.</ref><ref name="berkl"		In the subsequent ten years, case-control studies have found that abortion is associated with higher rates of psychiatric treatment<ref name=cmaj>Reardon DC, et al, Psychiatric admissions of low income women following abortion and childbirth. CMAJ 168:1253-6, 2003.</ref><ref>Coleman PK, et al. State-funded abortions vs. deliveries: A comparison of outpatient mental health claims over five years. American Journal of Orthopsychiatry, 2002, Vol. 72, No. 1, 141-152.</ref><ref name="berkl">Berkeley D, Humphrey PL, Davidson C, Demands made on general practice by women before and after an abortion. JR Coll Gen Pract. 34:310-315, 1984.</ref><ref>Badgley, et.al.,Report of the Committee on the Operation of the Abortion Law (Ottawa:Supply and Services, 1977)pp.313-321.</ref> anxiety,<ref name="NZ">Fergusson DM, Horwood LJ, Ridder EM, Abortion in young women and subsequent mental health. J Child Psychol Psychiatry. 47:16-25, 2006.</ref><ref>Cougle JR, Reardon DC, Coleman PK. Generalized anxiety following unintended pregnancies resolved through childbirth and abortion: a cohort study of the 1995 National Survey of Family Growth. J Anxiety Disord. 2005;19(1):137-42.</ref><ref>Ellen W. Freeman et al., Emotional Distress Patterns Among Women Having First or Repeat Abortions, 55 Obstetrics & gynecology 630 (1980)</ref> depression,<ref name="NZ"/><ref>Cougle JR, Reardon DC, Coleman PK. Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Med Sci Monit. 2003 Apr;9(4):CR105-12.</ref><ref name=cmaj/>alcohol use,<ref>Drower SA, Nash ES, Therapeutic abortion on psychiatric grounds. S. Afr Med J 54:604-8, 1978.</ref><ref>Reardon DC, Ney PG, Abortion and subsequent substance abuse. Am J Drug Alcohol Abuse 26:61-75, 2000.</ref><ref name="subst1">Priscilla K. Coleman et al., History of Induced Abortion in Relation to Substance Use During Pregnancies Carried to Term, 187 Am. J. Obstetrics & Gynecology 1673 (2002);</ref><ref>Elizabeth R. Morrissey & Marc A. Schuckit, Stressful Life Events and Alcohol Problems Among Women Seen At a Detoxication Center, 39 J. Stud. Alcohol 1559, 1567, 1570 (1978);</ref>, post-traumatic stress disorder,<ref name="majorcoz">Major B, Cozzarelli C, Cooper ML, Zubek J, Richards C, Wilhite M, Gramzow RH. Psychological responses of women after first-trimester abortion. Arch Gen Psychiatry. 2000 Aug;57(8):777-84.</ref><ref>Suliman S, Ericksen T, Labuschgne P, de Wit R, Stein DJ, Seedat S (2007). "Comparison of pain, cortisol levels, and psychological distress in women undergoing surgical termination of pregnancy under local anaesthesia versus intravenous sedation". BMC Psychiatry 7: 24.</ref><ref>Rue VM, Coleman PK, Rue JJ, Reardon DC. Induced abortion and traumatic stress: A preliminary comparison of American and Russian women.Med Sci Monit, 2004 10(10): SR5-16.</ref> drug use,<ref name="NZ"/>,<ref>Reardon DC, Coleman PK, Cougle JR. Substance use associated with unintended pregnancy outcomes in the National Longitudinal Survey of Youth. Am. J. Drug and Alcohol Abuse. 2004; 26(1):369 - 383.</ref><ref name="subst1"/> increased requests for medical treatement and worsening of general health,<ref name="berkl"/><ref>Ney PG, Fung T, Wickett AR, Beaman-Dodd, Effects of pregnancy loss on women's health. Soc Sci Med 38: 1193-1200, 1994.</ref><ref>Truls Ostbye et al., Health Services Utilization After Induced Abortions In Ontario: A Comparison Between Community Clinics and Hospitals, 16 Am. J. Med. Quality 99 (2001).</ref><ref>Warren B. Miller et al., Testing a Model of the Psychological Consequences of Abortion, in <I>The new civil war: the psychology, culture, and politics of abortion.</I> 235, 244 (Linda J. Beckman & S. Marie Harvey eds., 1998).</ref> suicidal thoughts<ref name="NZ"/><ref>Christopher Morgan et al., Suicides After Pregnancy: Mental Health May Deteriorate as a Direct Effect of Induced Abortion, 314 BRIT. MED. J. 902 (1997).</ref> completed suicides, <ref>Gissler M, Hemminski E, Longuist J, Suicides after pregnancy in Finland. BMJ 313:1431-34, 1996.</ref><ref>Reardon DC, Ney PG, et al, Deaths associated pregnancy outcome; a record linkage study. Southern Med J. 96:834-41, 2002.</ref> and child maltreatment.<ref>Coleman PK et al, Associations between voluntary and involuntary forms of perinatal loss and child maltreatment among low income mothers. Acta Peadiatr 94:1476-83, 2005.</ref><ref>Ney PG, Fung T, Wickett AR, Relationship between induced abortion and child abuse and neglect: four studies. Pre and Perinatal Psychology J 8:43-63, 1993.</ref><ref>The quality of caregiving environment and child development outcomes associated with maternal history of abortion using the NLSY data. J Child Psychology and Psychiatry. 2002; 43(6):743-57. Coleman PK, Reardon DC, Cougle JR.</ref><ref> M. Benedict, R. White, and P. Comely. Maternal Perinatal Risk Factors and Child Abuse, Child Abuse and Neglect, 9:217-224(1985).</ref>
	>Berkeley D, Humphrey PL, Davidson C, Demands made on general practice by women before and after an abortion. JR Coll Gen Pract. 34:310-315, 1984.</ref><ref>Badgley, et.al.,Report of the Committee on the Operation of the Abortion Law (Ottawa:Supply and Services, 1977)pp.313-321.</ref> anxiety,<ref name="NZ">Fergusson DM, Horwood LJ, Ridder EM, Abortion in young women and subsequent mental health. J Child Psychol Psychiatry. 47:16-25, 2006.</ref><ref>Cougle JR, Reardon DC, Coleman PK. Generalized anxiety following unintended pregnancies resolved through childbirth and abortion: a cohort study of the 1995 National Survey of Family Growth. J Anxiety Disord. 2005;19(1):137-42.</ref><ref>Ellen W. Freeman et al., Emotional Distress Patterns Among Women Having First or Repeat Abortions, 55 Obstetrics & gynecology 630 (1980)</ref> depression,<ref name="NZ"/><ref>Cougle JR, Reardon DC, Coleman PK. Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Med Sci Monit. 2003 Apr;9(4):CR105-12.</ref><ref name=cmaj/>alcohol use,<ref>Drower SA, Nash ES, Therapeutic abortion on psychiatric grounds. S. Afr Med J 54:604-8, 1978.</ref><ref>Reardon DC, Ney PG, Abortion and subsequent substance abuse. Am J Drug Alcohol Abuse 26:61-75, 2000.</ref><ref name="subst1">Priscilla K. Coleman et al., History of Induced Abortion in Relation to Substance Use During Pregnancies Carried to Term, 187 Am. J. Obstetrics & Gynecology 1673 (2002);</ref><ref>Elizabeth R. Morrissey & Marc A. Schuckit, Stressful Life Events and Alcohol Problems Among Women Seen At a Detoxication Center, 39 J. Stud. Alcohol 1559, 1567, 1570 (1978);</ref>, post-traumatic stress disorder,<ref name="majorcoz">Major B, Cozzarelli C, Cooper ML, Zubek J, Richards C, Wilhite M, Gramzow RH. Psychological responses of women after first-trimester abortion. Arch Gen Psychiatry. 2000 Aug;57(8):777-84.</ref><ref>Suliman S, Ericksen T, Labuschgne P, de Wit R, Stein DJ, Seedat S (2007). "Comparison of pain, cortisol levels, and psychological distress in women undergoing surgical termination of pregnancy under local anaesthesia versus intravenous sedation". BMC Psychiatry 7: 24.</ref><ref>Rue VM, Coleman PK, Rue JJ, Reardon DC. Induced abortion and traumatic stress: A preliminary comparison of American and Russian women.Med Sci Monit, 2004 10(10): SR5-16.</ref> drug use,<ref name="NZ"/>,<ref>Reardon DC, Coleman PK, Cougle JR. Substance use associated with unintended pregnancy outcomes in the National Longitudinal Survey of Youth. Am. J. Drug and Alcohol Abuse. 2004; 26(1):369 - 383.</ref><ref name="subst1"/> increased requests for medical treatement and worsening of general health,<ref name="berkl"/><ref>Ney PG, Fung T, Wickett AR, Beaman-Dodd, Effects of pregnancy loss on women's health. Soc Sci Med 38: 1193-1200, 1994.</ref><ref>Truls Ostbye et al., Health Services Utilization After Induced Abortions In Ontario: A Comparison Between Community Clinics and Hospitals, 16 Am. J. Med. Quality 99 (2001).</ref><ref>Warren B. Miller et al., Testing a Model of the Psychological Consequences of Abortion, in <I>The new civil war: the psychology, culture, and politics of abortion.</I> 235, 244 (Linda J. Beckman & S. Marie Harvey eds., 1998).</ref> suicidal thoughts<ref name="NZ"/><ref>Christopher Morgan et al., Suicides After Pregnancy: Mental Health May Deteriorate as a Direct Effect of Induced Abortion, 314 BRIT. MED. J. 902 (1997).</ref> completed suicides, <ref>Gissler M, Hemminski E, Longuist J, Suicides after pregnancy in Finland. BMJ 313:1431-34, 1996.</ref><ref>Reardon DC, Ney PG, et al, Deaths associated pregnancy outcome; a record linkage study. Southern Med J. 96:834-41, 2002.</ref> and child maltreatment.<ref>Coleman PK et al, Associations between voluntary and involuntary forms of perinatal loss and child maltreatment among low income mothers. Acta Peadiatr 94:1476-83, 2005.</ref><ref>Ney PG, Fung T, Wickett AR, Relationship between induced abortion and child abuse and neglect: four studies. Pre and Perinatal Psychology J 8:43-63, 1993.</ref><ref>The quality of caregiving environment and child development outcomes associated with maternal history of abortion using the NLSY data. J Child Psychology and Psychiatry. 2002; 43(6):743-57. Coleman PK, Reardon DC, Cougle JR.</ref><ref> M. Benedict, R. White, and P. Comely. Maternal Perinatal Risk Factors and Child Abuse, Child Abuse and Neglect, 9:217-224(1985).</ref>

	Self-esteem scores are not significantly affected by abortion.<ref>Russo NF, Zierk KL. Abortion, childbearing, and women's wellbeing. Professional Psychol Res Pract. 1992;23:269-280.</ref> Students who abort an unintended pregnancy are significantly more likely to complete high school than similar classmates who choose to give birth.<ref>Fergusson DM, Boden JM, Horwood LJ. Abortion among young women and subsequent life outcomes. Perspect Sex Reprod Health. 2007 Mar;39(1):6-12. </ref>		Self-esteem scores are not significantly affected by abortion.<ref>Russo NF, Zierk KL. Abortion, childbearing, and women's wellbeing. Professional Psychol Res Pract. 1992;23:269-280.</ref> Students who abort an unintended pregnancy are significantly more likely to complete high school than similar classmates who choose to give birth.<ref>Fergusson DM, Boden JM, Horwood LJ. Abortion among young women and subsequent life outcomes. Perspect Sex Reprod Health. 2007 Mar;39(1):6-12. </ref>

	It is has not been conclusively shown if the mental health problems staistically associated with abortion are directly caused by the abortion itself, by experiences associated with the unintended pregnancy, or if the abortion related experiences may only serve to aggravate, trigger, or in some manner contribute to pre-existing mental health problems.<ref name="NZ"/> An alternative explanation is that the statistical associations between abortion and psychiatric illnesses are entirely incidental. Along these lines it has been proposed that women who already have mental problems are more likely to have unwanted pregnancies ending in abortion.<ref name="majorcoz"> A number of studies, however, have found that higher rates of post-abortion emotional problems persist even after controlling for prior mental health history.<ref name="NZ"/><ref name=cmaj/>		It is has not been conclusively shown if the mental health problems staistically associated with abortion are directly caused by the abortion itself, by experiences associated with the unintended pregnancy, or if the abortion related experiences may only serve to aggravate, trigger, or in some manner contribute to pre-existing mental health problems.<ref name="NZ"/> An alternative explanation is that the statistical associations between abortion and psychiatric illnesses are entirely incidental. Along these lines it has been proposed that women who already have mental problems are more likely to have unwanted pregnancies ending in abortion.<ref name="majorcoz"/> A number of studies, however, have found that higher rates of post-abortion emotional problems persist even after controlling for prior mental health history.<ref name="NZ"/><ref name=cmaj/>

	Uncertainty and controversy persist because no studies have been able to demonstrate a direct causal connection between abortion and mental illness. But such studies ethically impossible since they would require case-control samples of women to be impregnated and randomly assigned to either have abortions or uninterrupted pregnancies.<ref>Major B. Psychological implications of abortion highly charged and rife with misleading research. Canadian Medical Association Journal, May 13, 2003; 168 (10).</ref>		Uncertainty and controversy persist because no studies have been able to demonstrate a direct causal connection between abortion and mental illness. But such studies ethically impossible since they would require case-control samples of women to be impregnated and randomly assigned to either have abortions or uninterrupted pregnancies.<ref>Major B. Psychological implications of abortion highly charged and rife with misleading research. Canadian Medical Association Journal, May 13, 2003; 168 (10).</ref>

Barb: /* Post-Abortion Syndrome -- An Unpurged Work in Progress */

2016-09-06T19:43:10Z

Post-Abortion Syndrome -- An Unpurged Work in Progress

← Older revision		Revision as of 14:43, 6 September 2016
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	The existence of "post-abortion syndrome" is not recognized by any medical or psychological organization.<ref name="Grimes">{{cite journal \|author=Grimes DA, Creinin MD \|title=Induced abortion: an overview for internists \|journal=Ann. Intern. Med. \|volume=140 \|issue=8 \|pages=620–6 \|year=2004 \|pmid=15096333 }} Key summary points: ''"Abortion does not lead to an increased risk for breast cancer or other late psychiatric or medical sequelae."'' On p. 624, the authors state: ''"The alleged 'postabortion trauma syndrome' does not exist."''</ref> Some [[pro-choice]] advocates have argued that the effort to popularize the idea of a "post-abortion syndrome" is a tactic used by pro-life advocates for political purposes.<ref name="Bazelon">[http://www.nytimes.com/2007/01/21/magazine/21abortion.t.html?pagewanted=1&ei=5088&en=5092fc3344065aec&ex=1327035600&partner=rssnyt&emc=rss&adxnnlx=1190370959-M3NVF8bZOGTDu468IEZo8g Is There a Post-Abortion Syndrome?] By [[Emily Bazelon]]. Published in the ''[[New York Times Magazine]]'', [[January 21]] [[2007]]. Accessed [[January 11]] [[2008]].</ref><ref name="Mooney">[http://www.washingtonmonthly.com/features/2004/0410.mooney.html Research and Destroy], by Chris Mooney. Published in ''[[Washington Monthly]]'', October 2004.</ref><ref name="stotlandreview">{{cite journal \|author=Stotland NL \|title=Abortion and psychiatric practice \|journal=J Psychiatr Pract \|volume=9 \|issue=2 \|pages=139–49 \|year=2003 \|pmid=15985924 \|doi=}} ''"Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae."''</ref><ref name=stotland_1404747>Stotland NL. The myth of the abortion trauma syndrome. JAMA. 1992 Oct 21;268(15):2078-9. PMID 1404747.</ref>		The existence of "post-abortion syndrome" is not recognized by any medical or psychological organization.<ref name="Grimes">{{cite journal \|author=Grimes DA, Creinin MD \|title=Induced abortion: an overview for internists \|journal=Ann. Intern. Med. \|volume=140 \|issue=8 \|pages=620–6 \|year=2004 \|pmid=15096333 }} Key summary points: ''"Abortion does not lead to an increased risk for breast cancer or other late psychiatric or medical sequelae."'' On p. 624, the authors state: ''"The alleged 'postabortion trauma syndrome' does not exist."''</ref> Some [[pro-choice]] advocates have argued that the effort to popularize the idea of a "post-abortion syndrome" is a tactic used by pro-life advocates for political purposes.<ref name="Bazelon">[http://www.nytimes.com/2007/01/21/magazine/21abortion.t.html?pagewanted=1&ei=5088&en=5092fc3344065aec&ex=1327035600&partner=rssnyt&emc=rss&adxnnlx=1190370959-M3NVF8bZOGTDu468IEZo8g Is There a Post-Abortion Syndrome?] By [[Emily Bazelon]]. Published in the ''[[New York Times Magazine]]'', [[January 21]] [[2007]]. Accessed [[January 11]] [[2008]].</ref><ref name="Mooney">[http://www.washingtonmonthly.com/features/2004/0410.mooney.html Research and Destroy], by Chris Mooney. Published in ''[[Washington Monthly]]'', October 2004.</ref><ref name="stotlandreview">{{cite journal \|author=Stotland NL \|title=Abortion and psychiatric practice \|journal=J Psychiatr Pract \|volume=9 \|issue=2 \|pages=139–49 \|year=2003 \|pmid=15985924 \|doi=}} ''"Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae."''</ref><ref name=stotland_1404747>Stotland NL. The myth of the abortion trauma syndrome. JAMA. 1992 Oct 21;268(15):2078-9. PMID 1404747.</ref>

	= Post-Abortion Syndrome ~~-- An Unpurged Work in Progress~~=		== Post-Abortion Syndrome ==

	'''Post-abortion syndrome''' (PAS), is a highly controversial term first proposed by psychologist Vincent Rue to describe a variant of [[post-traumatic stress disorder]] (PAS) where the stressor was a traumatic abortion.<ref>Vincent Rue, "Abortion and Family Relations," testimony before the Subcommittee on the Constitution of the US Senate Judiciary Committee, U.S. Senate, 97th Congress, Washington, DC (1981).</ref> The term "post-abortion syndrome", however, has been popularized by opponents of abortion in such a way that it is more generally understood to refer to any negative emotional or psychological reactions to abortion, not just traumatic symptoms.		'''Post-abortion syndrome''' (PAS), is a highly controversial term first proposed by psychologist Vincent Rue to describe a variant of [[post-traumatic stress disorder]] (PAS) where the stressor was a traumatic abortion.<ref>Vincent Rue, "Abortion and Family Relations," testimony before the Subcommittee on the Constitution of the US Senate Judiciary Committee, U.S. Senate, 97th Congress, Washington, DC (1981).</ref> The term "post-abortion syndrome", however, has been popularized by opponents of abortion in such a way that it is more generally understood to refer to any negative emotional or psychological reactions to abortion, not just traumatic symptoms.

Barb: Created page with "==Draft Short Summary== The issue of abortion and mental health is very controversial. In 1989, Surgeon General C. Everett Koop reported that no definitive conclusions could b..."

2016-09-06T19:41:49Z

Created page with "==Draft Short Summary== The issue of abortion and mental health is very controversial. In 1989, Surgeon General C. Everett Koop reported that no definitive conclusions could b..."

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