Mental woes, abortion link found

Depression and substance abuse plagued about half of American women who reported having an abortion, according to a new University of Manitoba study.

The study, published in the current issue of the Canadian Journal of Psychology, suggests there's an association between mental disorders and abortion and that doctors should screen for a history of abortion in women who present with anxiety, mood disorders and substance abuse.

However, local researchers are adamant the findings do not conclude abortion causes mental disorders or drug abuse, saying the study did not examine other contributing factors -- including whether the mental disorder existed before a woman had an abortion.

The study analyzed data collected during interviews with 3,310 women conducted by the National Institute of Mental Health and the National Institute of Drug Abuse in the United States between 2001 and 2003. Layperson interviewers asked women if they ever had an abortion in their lifetime and used guidelines from the World Health Organization to assess mental conditions such as major depression, suicide, alcohol abuse and panic attacks.

Researchers found drug and alcohol abuse was more prevalent among women who reported having an abortion sometime in their life. About 25 per cent of women who had an abortion reported some form of substance abuse in their lifetime, compared to just seven per cent of women who did not have abortions.

The study also found women who had an abortion had an increased likelihood of mood and anxiety disorders, though the relation is weaker and less consistent. Researchers speculate other factors, such as violence and poor social or social support, may contribute to mental disorders.

Women with a household income of $75,000 were more likely to report an abortion than those with household incomes under $25,000.

"It is unclear," said Natalie Mota, a U of M graduate student who was the study's primary author.

"You absolutely cannot say from this data that an abortion causes mental illness. There's an association present, but whether the mental illness comes before or after needs to be further examined."

The study did not examine what portion of the abortions were medically necessary or elective and said "unintended pregnancy itself may be a stressful event that can be a confounding factor in the relation between abortion and mental illness."

Mota speculates the connection between substance abuse and abortion was strong because it's possible women self-medicate with drugs and alcohol following an abortion, though the study did not investigate this.

Mota said it's important the study is not misinterpreted and that people understand researchers found an "association" between mental disorders and abortions, not a "cause and effect" relationship.

"There is a possibility the person was diagnosed with a mental disorder and 20 years passed and they had an abortion," Mota said.

Abortion providers worry the study's findings could be misinterpreted and become fodder for anti-abortion groups.

"I think there are lots and lots of questions about this study and I would like to see some answers to those before I know it has any affect as an abortion provider and the way I provide my service," said Joan Dawkins, executive director of Women's Health Clinic.

Dawkins said women who have experienced violence could have a depressive illness, regardless of whether or not they've had an abortion during their lifetime. Dawkins said any woman who is unsure about whether she will carry a pregnancy to term should receive counselling and information about their options before they make a firm decision. It's a complicated decision, she said, and the study doesn't evaluate issues surrounding abortion, including whether the woman was raped or her family was against it.

jen.skerritt@freepress.mb.ca

Republished from the Winnipeg Free Press print edition May 1, 2010 A8