Post-Abortion Syndrome: Yea or Nay?

As you may or may not have heard, there was a recent meta-analytical study that has occurred pertaining to the post-abortion syndrome and literature involved in the subject. It wasn't favorable.

Despite unclear evidence on such a phenomenon, adverse mental health outcomes of abortion have been used as a rationale for policy-making. [ain't that the truth] We systematically searched for articles focused on the potential association between abortion and long-term mental health outcomes published between January 1, 1989 and August 1, 2008 and reviewed 21 studies that met the inclusion criteria. We rated the study quality based on methodological factors necessary to appropriately explore the research question. Studies were rated as Excellent (no studies), Very Good (4 studies), Fair (8 studies), Poor (8 studies), or Very Poor (1 study). A clear trend emerges from this systematic review: the highest quality studies had findings that were mostly neutral, suggesting few, if any, differences between women who had abortions and their respective comparison groups in terms of mental health sequelae. Conversely, studies with the most flawed methodology found negative mental health sequelae of abortion.

Rather telling. Of course, since it was just a study of the quality of previous studies, rather than actual research to give evidence to the contrary, it isn't that worldshaking. But, didn't stop pro-lifers from sloppily pouncing all over it.

First, the JHU researchers don't include any of the major studies showing abortion's link to subsequent substance abuse problems. While studies show women who have abortions are more at risk than those who don't of abusing drugs or alcohol, the JHU authors fail to include a single study on the topic in their review.

Coleman calls that "one of the major mental health concerns of women who have aborted and for women in general" but "no explanation is provided for this blatant omission."

Because those studies weren't relevant, and substance abuse, in the absence of any other indications of mental health problems, is a tangential issue.

Secondly, Coleman says the ranking system the JHU researchers employed ignores two of the most central methodological considerations when conducting reviews of prospective research designs: the percent consenting to participate at baseline and retention of subjects over time.

As Coleman explains, "Obviously when women are more harmed by an abortion they are less inclined to want to continue to participate. Further, women who are suffering from an abortion are likely to have less stable lives and are therefore more likely to be unavailable to be assessed."

Interesting objections. But, by this logic, there is no way of disproving the existence of these women, because they are (conveniently) completely unwilling to affirm their existence to anyone for a period of extended scrutiny. They are like phantoms, apparently; that is the extent of their psychological damage. I'll admit, though, that your objections are fair, and similar problems would conceivably exist among populations of any person with some form of post traumatic stress, or who had been a victim of a crime (rape victims specifically). It would be interesting to see whether these factors were relevant.

Meanwhile, the JHU researchers developed five quality indicators to rank each study analyzed from “Excellent” to “Very Poor” in terms of its quality.

Coleman says these rankings are arbitrary and subjective and points out that the JHU team never explained how a study was given a certain ranking.

Another good point, actually. A lot in the realm of psychology is subjective, even if you toss in numbers to make it seem otherwise, but I would like to see what criteria they had for each to attain a given rating.

She also tells LifeNews.com that she and her colleagues would disagree with the high rankings JHU authors gave to studies showing no abortion-depression link that she believes were of poorer quality.

"There is no way that several of the studies listed as 'Very Good' would have met 4 out of 5 of the quality indicators necessary for the rating if rated by an objective evaluator who was not invested in deriving a conclusion that is consonant with pro-choice ideology," she said.

Do you have any objective evidence of your subjective claim that objective evaluators would side with your assess

Coleman also noted that a seminal study that is highly regarded, conducted by pro-abortion New Zealand researcher David Fergusson in 2006, was only listed as "fair" by the JHU team.

Oooo. Do I get a study to dissect now?

Fergusson's study of 1,265 children born in the 1970s traced women and their pregnancy decisions. Of those having abortions, twice as many women were likely to suffer from severe depression compared to those who had never been pregnant and they were 35 percent more likely to be depressed than those who carried a pregnancy to term.

1. No details about how sampling occurred (i.e. whether socioeconomic backgrounds and religious backgrounds were varied). [Apparently, according to this link, all subjects were born in Christchurch, New Zealand...hell of a random sample...]
2. You already mentioned dropout rates, so that would be interesting information here. [Turns out, only 500 stayed on board, link above].
>3. How were they "traced", and could it not just be that those with such a depression or proclivity for depression is somehow the cause of the abortion, rather the caused by it? Or some other such circumstance which happens to be the reason why we say that "correlation doesn't necessarily mean causation". [He says elsewhere that this was accounted for, but I have yet to find anywhere that mentions how. Let alone anywhere presenting the abstract and such].
4. He is dealing with women who got pregnant and had abortions from an age interval of 15 to 25 (and measures them for depression and suicidal the last time before ending the study at age 21) . There are going to be other factors going on for women who got pregnant that young, including the stress of getting pregnant to begin with.

Finally, as LifeNews.com previously noted with regard to three new studies that were released this week and show abortion's link to adverse mental health outcomes, Coleman says the JHU team didn't include all of the studies it should have to give a proper overall analysis."The review 'missed' numerous high quality studies that meet their inclusion criteria. The result is an extremely biased selection," she said.
And, as it turns, one is the previous paper, and one of the others is one of Coleman's own papers.

The purpose of this study was to examine associations between abortion history and a wide range of anxiety (panic disorder, panic attacks, PTSD, Agoraphobia), mood (bipolar disorder, mania, major depression), and substance abuse disorders (alcohol and drug abuse and dependence) using a nationally representative US sample, the national comorbidity survey. Abortion was found to be related to an increased risk for a variety of mental health problems (panic attacks, panic disorder, agoraphobia, PTSD, bipolar disorder, major depression with and without hierarchy), and substance abuse disorders after statistical controls were instituted for a wide range of personal, situational, and demographic variables. Calculation of population attributable risks indicated that abortion was implicated in between 4.3% and 16.6% of the incidence of these disorders. Future research is needed to identify mediating mechanisms linking abortion to various disorders and to understand individual difference factors associated with vulnerability to developing a particular mental health problem after abortion.

Association being the operative word in all that. I cannot believe that there major complaint is simply that the overlooked some New Zealand papers and Coleman's pet projects. Oh well. It isn't important anyway...