Beyond Mental Illness: Emotional Health and Abortion

Mental illness and disease are not much different than physical illness or disease. This approach fits squarely in the medical model: there are doctors and hospitals and diagnoses. There are also risk-factors, treatments and morbidity rates.

If you have a problem, most likely, it has a name, whether it’s cancer or diabetes, depression or schizophrenia. “Health” in this model is the absence of illness or disorder, but it is not a measure of the strength, vitality or fitness of your body, mind and spirit.

The medical model is the one most often used when conducting research about abortion and mental health, including the latest study out of Denmark, just published in the New England Journal of Medicine. This significant project confirms (in great detail and with an impressive pool of data) what many researchers have said before: there is no science that shows an abortion causes mental illness.

While I hope this science is a relief to every woman who worried that, after an abortion, she may wake up one day with a life-threatening illness like bulimia, alcoholism, or obsessive compulsive disorder, it is inadequate for understanding the scope and depth of a woman’s emotional experience when it comes to abortion.

That’s why it is so important to understand the difference between the medical model that’s focused on reducing disease and the well-being model focused on health promotion; what these differences mean for scientific research; and, eventually, what they mean for the development, adoption and promotion of strategies that can effectively enhance the emotional health of women who have had abortions.

Have no doubt: the Danish study answers important scientific questions about cause and effect when it comes to mental health and abortion. Yet, as long as women have abortions, we are going to have feelings about it. Whether our feelings about our abortions are complicated, ambiguous or clear, having them is a natural, normal part of being human. But, our personal feelings have little to do with the medical diagnosis that is a part of mental health research. As the Danish study points out:

“most studies have failed to distinguish between mental health diagnosis such as depression and psychosis and feelings of sadness, loss, or regret, which, although unpleasant, do not necessarily signify a mental disorder.”

Scientific researchers interested in understanding and promoting the emotional health of women who have had abortions would do well to look outside the medical model and towards the growing body of research in Positive Psychology, including the comprehensive volume published by Oxford University Press called The Science of Wellbeing.

The context surrounding a woman’s personal experience with abortion in the United States is quite different than the context within Denmark. For example, most women who have an abortion in the U.S. are already parents, whereas the study suggests otherwise for Danish women.

Also, in Denmark, all health care, including abortions and mental health services are free, which is not the case here. These social and cultural circumstances are significant factors in how a woman feels about her abortion and in her ability to cope afterward. Her family may be a source of pain, or one of strength; her faith, a blessing or a constraint. These are the issues that the science of wellbeing can address, taking us toward a more complete picture of what a woman has and needs to be emotionally well after an abortion.

In 2009, I provided written and oral testimony before the National Institutes of Health(NIH), Office of Women’s Health Research, along with Danielle Thomas and Elsa Valmidiano of Exhale, about the need for more research to promote wellbeing after an abortion. I testified:

“Today, more than ever, there is a great need for sound, thorough research into women’s emotional well-being after an abortion: The abortion procedure is so common, the families and communities impacted are so diverse, the debate around abortion is so loud, and the overwhelming stigma – which, according to NIH’s own definition, ‘threatens psychological and physical well-being, and helps to perpetuate health inequalities within societies’ – is so harmful that it is time for the National Institutes of Health to proactively address the emotional needs of women who have abortions, by using its support and resources to undertake and share sound, thorough research into women’s real experiences.”

Scientific research on emotional health gives us, as women who have abortions, the tools and information we need to promote our own well-being. It can be used to help us better understand the behaviors and practices that build our resilience, strengthen our confidence, and improve our emotional literacy. It can also help providers, caregivers, family and friends to be important sources of emotional support as we build proactive networks of respect and understanding.

It’s good to know that abortion doesn’t cause mental illness. It would be even better to know what’s needed to promote emotional health after abortion.

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Photo by Lorena
Aspen Baker is the founder and executive director of Exhale, an award-winning pro-voice organization. Most recently, Exhale partnered with MTV on their groundbreaking abortion special: "No Easy Decision."

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
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Norma V.

8:29PM PDT on Apr 30, 2011

Education is the key.

send a green star

susan p.

7:38PM PST on Feb 19, 2011

As I see it we are still at odds over a WOMANS RIGHT OVER HER OWN BODY. What needs to be done world wide is to teach better sex education in schools and at and earlier age, and see to it that all forms of BIRTH CONTROL ARE READILY AVAILABLE TO ALL WHO REQUEST IT it's not giving permission for sexual activity it's giving permission to protect themselves!!! Forget its a parent's responsiblity,if they did their jobs right there wouldn't be so many ABORTIONS.Yes I'm a Mother, Grandmother and Greatgrandmother. Don't take Sarah Palins' additude It's alright for my daughter to be a pregnant teenager( they're going to get married) but it's not alright for your teenager. Talk about mental illness!!
We need to stop teaching Guilt which leads to depression,which researchers don't take into account. It's my body and I and only I have the right to take care of it as I see fit
and I will not feel GUILTY about it and NO OTHER WOMAN SHOULD EITHER!!
STOP THE GUILT START THE EDUCATION!!!

Lika S.

11:02PM PST on Feb 16, 2011

I think too often, people say they're depressed, and they're not. We experience difficulty, say such as an abusive spouse or parent, and yes, it causes trauma, but, we live relatively normal out side of the abuse. If it were really depression, it would make it difficult to mentally function in the real world.

If one is mentally ill, it may remain dormant, come out with little prompt, or be triggered by great trauma. So, if a woman has an abortion, and eventually gets diagnosed with mental illness, it's not the abortion that caused it, the illness was already there, the abortion was the trigger, not the cause. There IS a difference.

The less trauma we go through, the more emotional health we have. Just because we're not mentally ill doesn't ensure emotional health... an abused woman can be free of mental illness, but because of her fear and worn down state, is NOT emotionally healthy. Someone living what LOOKS like a perfect life may be mentally ill, and has to put a pretend normal face on... It goes all the way around.

I still say that it's a woman's choice, and if you're going to make the decision, do it ASAP. Once that fetus is viable, it's an unborn baby, and well, it's wrong to force me to keep or abort the pregnancy, regardless of what someone else thinks is good or bad.

Lepidopter P.

5:04PM PST on Feb 16, 2011

Kathy, in answer to your question:
If a pregnant woman is killed, whether it is considered a double murder varies from state to state, and also depends on the stage of her pregnancy.
Not a point of law, but in addition, if a pregnant woman is killed, it is assumed that she intended to carry the pregnancy to completion, and the person who killed the mother prevented that.

It's not murder if the pregnant woman aborts, because it's inside HER body, using HER organs, the food SHE eats, and the air SHE breathes for its survival. The person in whose body it resides is the only person who has the right to have it removed.

I'm glad that you don't regret having your son. Nor do I regret having chosen to have my daughter, despite the difficulties I faced in raising her. But my joy at having her in my life does not mean that having a baby was an experience I ever wanted to repeat.

Kathy P.

8:51AM PST on Feb 16, 2011

Lepidopter Phoenyx
You are so missing the point. I brought my child into this world DESPITE the odd and he is a blessing. He may even change the world someday. Yes, my life was hard... but my son gives me a chance to wipe away the bad and change a life... HIS life. My mother could have aborted me... it would have been easier. But my life was valuable even to her. And the hard times made me the person I am today; I would like to think that it made me more "human" than some. Those struggles gave me perspective. Profound perspective. I knew what it meant to take care of myself. Now I am taking care of my own son, and I have better tools to teach him with than women who don't even CARE about the life inside them.
By the way... you never answered my question... Why is it that a person who kills a pregnant woman is charged with double murder, but if it's the mother killing her own child, it's not murder?

8:00AM PST on Feb 16, 2011

Kathy, then you should also be able to understand why a woman would NOT want to bring a child into any of those situations.

Doug G.

1:41PM PST on Feb 14, 2011

Denmark seems to light years ahead of the prevailing attitudes in this society. That is something that should be looked at here, since people in the U.S.seem to ruminate at length over this subject and stay stuck in attitudes that are often counterproductive.

1:37PM PST on Feb 14, 2011

Absolutely... my biological father was a mean drunk and made sure we stayed in line. I, too, nearly died giving birth to my very large baby.. we BOTH nearly died. It was the most terrifying moment in my memory. And while I am not a single mother, many of my friends are. Yes, I do know what it is like to go hungry. Yes, I do know what it's like to wonder if my child will have enough to eat. And even though it is NONE of your business, yes I DO know what it is like to have to take medication for a mental illness. Not to mention that I also have to worry about my child inheriting the schizophrenia that my father has, the bipolar my brother, two sisters, and mother have, and the depression that I and my father share... and yes, I had my child due to a birth control failure. My doctor did all she could to keep him healthy. So, yes.... I DO understand

11:22AM PST on Feb 14, 2011

cont'd
Are you saying that you DO know what it's like to survive a life-threatening pregnancy, take precautions against getting pregnant again, have your birth control fail, and have to decide between continuing to be a mother to the child you already have, or leaving her motherless in order to have another baby, one that might, in fact die along with you in the processs of being born? Been there, done it. Almost died having my daughter, wasn't going to risk leaving her motherless to ever have another.