A termination carries with it a serious risk to a woman's mental health, writes BREDA O'BRIEN
IN BRITAIN, abortion is once again causing controversy, this time because of a proposal to separate abortion provision and abortion counselling.
An amendment to the Health and Social Care Bill, 2011, tabled by Labour MP Frank Field and Conservative MP Nadine Dorries, seeks to ensure that women seeking an abortion are offered independent advice. At present it is the abortion providers such as BPAS or Marie Stopes who provide the counselling.
BPAS carries out 55,000 abortions a year. More than 90 per cent are NHS- commissioned. In its report to the British Charity Commissioners in 2010, BPAS declares, “Our main priority in the coming year is to ‘grow’ our business by utilising and expanding our capacity to treat clients and extending our collaboration with the NHS.’’
“Growing our business” seems a rather cold way to describe what they do to generate the “required surplus profit” which is ploughed back into providing still more abortions. It’s even more strange to see that as a registered charity, its main fundraising activity is abortion.
Predictably, the proposed amendment has caused uproar, with people saying it is just another way of undermining women’s right to choose. Others are adamant that “independent” is code for “faith-based”. Such organisations are immediately suspect, while abortion providers are, naturally, completely unbiased. Yet, on BPAS’s website it is made clear that “Counselling is part of the initial consultation at BPAS during which you will also have a medical screening so that we can asses the stage of pregnancy and medical history to find out which methods of abortion are most suitable for you.”
Rather prosaically Dorries compares it to the wisdom of getting pensions advice from the same adviser as the one who has a vested interest in selling you a pension.
There is little that Dorries and I would agree on other than independent counselling. She is pro-choice, though she supports early abortion only.
However, on this issue, I admire her courage. Her days as a nurse led her to abhor abortions after nine to 12 weeks, and she has campaigned consistently to have the time limit reduced. As a result, she has received death threats. Even if independent counselling is achieved, is “non-directive” the appropriate model? No counsellor acts non-directively when a client is intending harm to herself or others.
So a key question is whether abortion causes harm. There is patently a loss of life involved, a potential 70 or 80 years of life.
But is there potential harm to the woman, specifically to her mental health? A meta-analysis published last Thursday in the British Journal of Psychiatrygives an unequivocal yes.
When compared with women who have had unintended pregnancies but gone on to deliver, women who choose abortion have a 55 per cent higher chance of experiencing mental health problems.
The most common problems experienced by women after abortion are depression, anxiety, substance abuse and self-harm.
Astonishingly, this is the first meta-analysis that has looked at all available studies that pass certain criteria. A meta-analysis is a type of scientific study that analyses pooled data from a number of previous studies.
This one, conducted by Priscilla K Coleman from Bowling Green State University, Ohio, is the largest of its kind and is based on 22 of the most rigorous published studies with a combined number of participants totalling more than 850,000, of whom 163,831 had an abortion. Stringent criteria were applied before a study was included.
The results revealed that the increased risk for anxiety disorders was 34 per cent; for depression it was 37 per cent; for alcohol abuse it was 110 per cent; for marijuana use it was 220 per cent, and for suicidal behaviours it was 155 per cent.
Given our own troubled history, and acrimonious debates about provision of abortion to “prevent” suicide, that latter statistic should give us pause. Although the author says it requires further research, abortion carries with it an increased risk of suicide, when compared to delivering a child.
Some 90 per cent of British abortions are carried out on grounds there is a threat to the mental health or wellbeing of the mother. A medical procedure allegedly being carried out on mental health grounds in itself greatly increases the likelihood of mental health problems.
Coleman also found that 10 per cent of all mental health problems in women were attributable to abortion.
These are quite shocking statistics, and are likely to be hotly disputed.
Coleman also looks at other well-known published studies that have declared there is no mental health threat accruing from abortion, and criticises them sharply. The largest review, by the American Psychological Association Task Force, according to Coleman excluded “dozens of methodologically sophisticated international studies”.
Coleman says the data has important implications for pregnancy counselling. “There are in fact some real risks associated with abortion that should be shared with women as they are counselled prior to an abortion decision.”
People who support a woman’s right to choose should surely have no problem with letting her decide while giving her all the evidence, including risks to her mental health.