Does Having an Abortion Cause Long-Lasting Psychological Distress?

Some states mandate that, before being allowed access to abortion, women be “counseled” about purported adverse mental health consequences of the procedure. Is this requirement scientifically justified? The Turnaway Study of 30 abortion clinics (gestational limits from 10 weeks to end of second trimester) in 21 states comprised three groups: 452 women receiving abortions (exclusions included fetal anomaly or demise and maternal health indications) within 2 weeks of the clinics' gestational limits (near-limit group); 231 who were denied abortions within 3 weeks beyond the gestational limit (turnaway group, subdivided into 161 who ultimately gave birth and 70 who miscarried or obtained abortions elsewhere), and 273 who received first-trimester abortions. All participants (mean age, 25; racially/ethnically diverse; primarily single without mental health histories) were telephone-interviewed using validated mental health measures 1 week after seeking abortions and semiannually for 5 years. About 58%, similarly distributed among groups, completed the study.

At baseline, both anxiety and depression symptom scores were lowest for the first-trimester and near-term group and highest for the two turnaway groups; in general, scores improved over time. Scores designating self-esteem and satisfaction with life were initially lowest among the two turnaway groups and later improved; scores for the two other groups improved or remained stable. History of mental health conditions or traumatic life events was the most significant factor associated with excess risk for adverse psychological outcomes following an abortion.