The American Psychiatric Association currently has a task force in place evaluating the literature evidence for adverse psychological effects of elective abortion. We will carefully evaluate their report when it is available, and we will share our evaluation with you. In the meantime, the Brits are ahead of the APA, and below (excerpted) are news items on their findings, and a copy of the statement itself.
The Sunday Times
March 16, 2008
“Royal College Warns Abortions Can Lead to Mental Illness”
By Sarah-Kate Templeton, Health Editor
Women may be at risk of mental health breakdowns if they have abortions, a medical royal college has warned. The Royal College of Psychiatrists says women should not be allowed to have an abortion until they are counseled on the possible risk to their mental health. This overturns the consensus that has stood for decades that the risk to mental health of continuing with an unwanted pregnancy outweighs the risks of living with the possible regrets of having an abortion.
The Royal College of Psychiatrists recommends updating abortion information leaflets to include details of the risks of depression. “Consent cannot be informed without the provision of adequate and appropriate information,” it says. Several studies, including research published in the Journal of Child Psychology and Psychiatry in 2006, concluded that abortion in young women might be associated with risks of mental health problems.
The controversy intensified earlier this year when an inquest in Cornwall heard that a talented artist hanged herself because she was overcome with grief after aborting her twins. Emma Beck, 30, left a note saying: “Living is hell for me. I should never have had an abortion. I see now I would have been a good mum. I want to be with my babies; they need me, no one else does.”
The College’s revised stance was welcomed by Nadine Dorries, a Conservative MP campaigning for a statutory cooling-off period: “For doctors to process a woman’s request for an abortion without providing the support, information and help women need at this time of crisis I regard almost as a form of abuse,” she said.
Dr. Peter Saunders, general secretary of the Christian Medical Fellowship, said: “How can a doctor now justify an abortion [on mental health grounds] if psychiatrists are questioning whether there is any clear evidence that continuing with the pregnancy leads to mental health problems?”
March 14, 2008
“Royal College of Psychiatrists Position Statement on Women’s Mental Health in Relation to Induced Abortion”
In the government response to the report from the House of Commons Science and Technology Committee on the Scientific Developments Relating to the Abortion Act 1967, the following request was made: “In view of the controversy on the risk to mental health of induced abortion we recommend that the Royal College of Psychiatrists update their 1994 report on this issue.”
The College has undertaken a literature review to inform the following position statement, which includes the recommendation that a full systematic review around abortion and mental health is required. The Royal College of Psychiatrists is concerned to ensure that women’s mental health is protected whether they seek abortion or continue with a pregnancy. Mental disorders can occur for some women during pregnancy and after birth.
The specific issue of whether or not induced abortion has harmful effects on women’s mental health remains to be fully resolved. The current research evidence base is inconclusive – some studies indicate no evidence of harm, whilst other studies identify a range of mental disorders following abortion.
Women with pre-existing psychiatric disorders who continue with their pregnancy, as well as those with psychiatric disorders who undergo abortion, will need appropriate support and care. Liaison between services, and, where relevant, with careers and advocates, is advisable.
Healthcare professionals who assess or refer women who are requesting an abortion should assess for mental disorder and for risk factors that may be associated with its subsequent development. If a mental disorder or risk factors are identified, there should be a clearly identified care pathway whereby the mental health needs of the woman and her significant others may be met.
The Royal College of Psychiatrists recognizes that good practice in relation to abortion will include informed consent. Consent cannot be informed without the provision of adequate and appropriate information regarding the possible risks and benefits to physical and mental health. This may require the updating of patient information leaflets approved by the Royal Colleges, and education and training relevant to health care professionals, in order to develop a good practice pathway. These difficult and complex issues should be addressed through additional systematic reviews led by the Royal College of Psychiatrists into the relationship between abortion and mental health. These reviews should consider whether there is evidence for psychiatric indications for abortion.
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