Abortion and Mental Health

This letter is in response to the Viewpoints column in the July 20 issue titled “The Myth of Abortion Trauma Syndrome” by APA President-elect Nada Stotland, M.D. Dr. Stotland wrote that “the assertions of psychological damage, made by legislatures and the [U.S] Supreme Court, are contrary to the scientific evidence.... 'Abortion trauma syndrome' and 'post-abortion psychosis' are inventions disguised to mimic those diagnoses, and they demean that careful process” of crafting the titles and definitions of psychiatric diagnoses.

On the July 20 PBS show “NOW” hosted by David Brancaccio, there was a discussion on the cases of 2,000 women who had certified before a notary public that they had suffered repercussions following their abortions. Among the symptoms they noted were extreme emotional states, tears, guilt, remorse, and depression. At least several suicidal attempts had taken place in this group of 2,000. To assert that abortion does not cause significant, negative psychiatric repercussions in some women, as did Dr. Stotland, who also appeared on this program, boggled my mind. She implied that any negative psychological repercussions following their abortion were due to past problems in their lives and not due to the abortion.

In my experience in 45 years of psychiatric practice, most of my patients had some genetic, cultural, environmental, and personality factors in their background that played a part in their reactions to stress. Abortion can be a difficult and painful decision. To suggest that the responses women portrayed on “NOW” weren't related to their abortion is to deny a likely cause-and-effect relationship. Why isn't it possible that some women are vulnerable to developing an “abortion trauma syndrome”?

Denial can be a very useful and powerful defense mechanism. It permits us to cope and move forward (or backward). I presume that the majority of women who choose abortion are able to move forward and cope. I surmise that there are some others who experience guilt, remorse, ambivalence, or feelings of loss then or later regarding their abortion.

Years ago, I treated a woman who was pregnant and wanted to keep her baby; she ultimately complied with the wishes of others to terminate the pregnancy. If psychiatric symptoms develop following this decision, isn't it reasonable to consider the possibility of a diagnostic category such as“ post-abortion trauma”? I wonder what some of your other readers think.