Catholic Medical Quarterly Volume 66(3) Aug 2016

Editorial:
Abortion And Mental Health - The Tragic Suicides Of Young Women Following Abortions

Dr Adrian Treloar

Depressed womanThere is good evidence that the sequelae of abortion include depression, substance abuse, self harm, death from all causes as well as death from suicide. There is debate as to whether or not that association is causal. The American Psychiatric Association[1] found that, “it is clear that some women do experience sadness, grief, and feelings of loss following termination of a pregnancy, and some experience clinically significant disorders, including depression and anxiety.” But the expert group did not find “evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.” And it is clear that “prior mental health emerged as the strongest predictor of post-abortion mental health”.

DespairThe Academy of Medical Royal Colleges[2], in their review “Abortion and induced mental health” also found that prior mental health predicted outcome as did pressure to abort and a lack of support. But the report did not find sufficient evidence to conclude that abortion caused some of the poor mental health observed after abortion. It concluded that “When a woman has an unwanted pregnancy, rates of mental health problems will be largely unaffected whether she has an abortion or goes on to give birth”.

FetusHowever Fergusson[3], found that the evidence is consistent with the view that abortion may be associated with a small increase in risk of mental disorders. Other pregnancy outcomes were not related to increased risk of mental health problems.

None of that means that individuals are not hugely harmed by abortion. We were very sad to hear that a 21-year-old student and single mother committed suicide after having an abortion [4]. The inquest into her death heard that Jade Rees, from Oldham, Greater Manchester, had an abortion after her five-month relationship with the father ended and he began dating someone else. She was left devastated after the abortion and the break-up.

‘Small Bump’

Jade hanged herself three weeks after her abortion, leaving a handwritten note for her parents saying that she was suffering after the experience. She wrote a second note for her two-year-old son – “He means everything to me,” she wrote.
According to reports, the young woman played the Ed Sheeran song 'Small Bump', on YouTube through her phone before she took her own life.

In April 2016, just a month before the news of Jade, details emerged of a 15-year-old girl, Ashli Blake, who committed suicide two years after having an abortion when she was just 13. There are also parallels with the case of Emma Beck, who hanged herself the day before her 31st birthday in February 2007 after aborting her baby twins when she was eight weeks pregnant. In her suicide note, Emma beck wrote "I told everyone I didn't want to do it, even at the hospital. I was frightened, now it is too late. I died when my babies died. I want to be with my babies: they need me, no-one else does." [5]

Fetus 2We need to remember that abortion is lethal for the baby involved. But abortion is also, often associated with great harms to the mothers involved as well. And as we counsel and support women who are considering abortion, it is right risks of abortion should be honestly discussed. Cathy Warwick is the Chief Executive of the Royal College of Midwives (RCM) and Chair of Trustees of the British Pregnancy Advisory Service (BPAS). She has called for abortion law liberalisation but also stated that “abortion is part of the role of the midwife ...

The College of Midwives Chief Executive is clearly stating that abortion is central to the very profession that brings life safely into the world. If as she appears to envisage, the midwifery profession develops an even stronger acceptance of abortion, then those midwives and would-be midwives who have a conscientious objection to abortion will become even more heavily excluded from this noble profession.

That will mean that yet more people like Emma Beck will find themselves unsupported at a critical moment. Women, and their babies deserve better.

References

  1. American Psychiatric Association. APA Task Force on Mental Health and Abortion 2008 www.apa.org/pi/women/programs/abortion/mental­health.pdf
  2. Academy of Medical Royal Colleges Induced Abortion and Mental health. A systematic review of the mental health outcomes of induced abortion, including their prevalence and associated factors. December 2011.
    http://www.aomrc.org.uk/wp-content/uploads/2016/05/Induced_Abortion_Mental_Health_1211.pdf
  3. Fergusson D, Horwood L. Boden J. (2008) Abortion and mental health disorders: evidence frowm a 30-year longitudinal study. British Journal of Psychiatry 193, 444–451. http://bjp.rcpsych.org/content/193/6/444
  4. Single mother, 21, hanged herself to Ed Sheeran song Small Bump after being haunted by her decision to have an abortion. Daily Mail 4th April 2016 http://www.dailymail.co.uk/news/article-3522386/Single-mother-21-hanged-Ed-Sheeran-song-Small-Bump-haunted-decision-abortion.html
  5. Artist hanged herself after aborting twins, Daily Telegraph 22nd Feb 2008 http://www.telegraph.co.uk/news/uknews/1579455/Artist-hanged-herself-after-aborting-her-twins.html

 

Dr Adrian Treloar
MRCPsych, FRCP, MRCGP is a Consulant in Old Age Psychiatry.