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Amp 64 9 863 PDF
Amp 64 9 863 PDF
The authors evaluated empirical research addressing the tion (TFMHA) that APA Council received on August 13,
relationship between induced abortion and women’s men- 2008.1
tal health. Two issues were addressed: (a) the relative risks
associated with abortion compared with the risks associ- Background
ated with its alternatives and (b) sources of variability in
women’s responses following abortion. This article reflects Public debate on the mental health implications of abortion
and updates the report of the American Psychological can be traced to 1987, when then-President Ronald Reagan
Association Task Force on Mental Health and Abortion directed then-Surgeon General C. Everett Koop to prepare
(2008). Major methodological problems pervaded most of a Surgeon General’s report on the public health effects
the research reviewed. The most rigorous studies indicated (both psychological and physical) of abortion. After con-
that within the United States, the relative risk of mental ducting a comprehensive review of the scientific literature,
Koop declined to issue a report; instead, he sent a letter to
health problems among adult women who have a single,
President Reagan on January 9, 1989, in which he con-
legal, first-trimester abortion of an unwanted pregnancy is
cluded that the available research was inadequate to sup-
no greater than the risk among women who deliver an
port any scientific findings about the psychological conse-
unwanted pregnancy. Evidence did not support the claim
quences caused by abortion (Koop, 1989a). In subsequent
that observed associations between abortion and mental
testimony before Congress, Koop stated that his letter did
health problems are caused by abortion per se as opposed not focus on the physical health risks of abortion because
to other preexisting and co-occurring risk factors. Most “obstetricians and gynecologists had long since concluded
adult women who terminate a pregnancy do not experience
mental health problems. Some women do, however. It is
important that women’s varied experiences of abortion be Brenda Major, Department of Psychology, University of California, Santa
recognized, validated, and understood. Barbara; Mark Appelbaum, Department of Psychology, University of
California, San Diego; Linda Beckman, Department of Psychology, Al-
Keywords: abortion, abortion and mental health, psycho- liant International University; Mary Ann Dutton, Department of Psychi-
logical responses to abortion, emotional reactions to abor- atry, Georgetown University Medical Center; Nancy Felipe Russo, De-
partment of Psychology, Arizona State University; Carolyn West,
tion, postabortion mental health Interdisciplinary Arts and Sciences Program, University of Washington,
Supplemental materials: http://dx.doi.org/10.1037/a0017497 Tacoma.
.supp In 2006, the APA Council of Representatives established a Task
Force on Mental Health and Abortion with the authors of this article as
I
members. This article is an update of the 2008 report of that task force.
n 1973, the Supreme Court of the United States legal- Brenda Major’s contributions to this article were supported in part by
ized abortion in the landmark case of Roe v. Wade. grants from the American Philosophical Society and the James McKeen
Although more than 35 years have passed since this Cattell Foundation.
decision, it continues to generate strong emotions as well as Thanks are extended to Julia Cleaver, Rennie Georgieva, and Yelena
Suprunova for library assistance and to Julia Steinberg for statistical
moral and legal controversy. Over the last two decades, one consultation.
aspect of this controversy has focused on the claim that We also thank the staff of the APA Women’s Programs Office for
abortion has negative effects on women’s mental health their support: Tanya Burrwell, Shari Miles-Cohen, Leslie Cameron, Gabe
(Bazelon, 2007; Cohen, 2006; Lee, 2003). This critical Twose, Liapeng Matsau, and Ashlee Edwards.
Correspondence concerning this article should be addressed to
review of research conducted on the mental health conse- Brenda Major, Department of Psychology, University of California, Santa
quences of abortion from 1989 to 2008 evaluates the em- Barbara, CA 93106-0001. E-mail: major@psych.ucsb.edu
pirical evidence for that claim. It is substantially based on,
but also updates, the report of the American Psychological 1
A full copy of the 2008 report of the TFMHA is available online at
Association (APA) Task Force on Mental Health and Abor- http://www.apa.org/pi/wpo/mental-health-abortion-report.pdf