Abortion in First Pregnancy Linked to Higher Use of Mental Health Services

Women whose first pregnancies end in abortion are associated with a higher risk and likelihood of mental health issues than women whose pregnancies ended in live births, a peer-reviewed study found.

The peer-reviewed study, called “A Cohort Study of Mental Health Services Utilization Following a First Pregnancy Abortion or Birth,” was conducted by researchers from the Charlotte Lozier Institute (CLI), the education and research arm of Susan B. Anthony Pro-Life America. The research team analyzed claims data for more than 4,800 Medicaid-enrolled women over a 17-year period, in seven states where state taxpayer funds were used to pay for abortions and where all claims for the whole period were submitted.

“By doing so, the team avoided the limitations of surveys that rely on self-reporting, such as low participation, loss to follow-up, and recall bias. The study, published in International Journal of Women’s Health, is the first to take a comprehensive view of mental health services on an outpatient versus an inpatient basis following abortion,” according to the CLI.

The study found that, compared to women whose first pregnancies ended in live birth, higher rates of use were observed in three mental health service categories for women whose first pregnancies ended in abortion. Among them, outpatient visits were 3.4 times more likely to increase, inpatient hospital admissions were 5.7 times more likely to increase, and days of hospital stay were 19.6 times more likely to increase. 

“A first pregnancy abortion, compared to a birth, is associated with significantly higher subsequent mental health services utilization following the first pregnancy outcome. The risk attributable to abortion is notably higher for inpatient than outpatient mental health services,” the study’s conclusion reads. “Higher mental health utilization before the first pregnancy outcome for birth cohort women challenges the explanation that pre-existing mental health history explains mental health problems following abortion, rather than the abortion itself.”

Tessa Longbons, CLI’s senior research associate and a co-author of the study, said that “the evidence is clear that abortion of a first pregnancy is associated with substantial mental health harms to women.” 

“Women have a right to know this and to understand the extent of these harms before they make such a life-changing decision,” Longbons added. 

James Studnicki, the study’s lead author, public health scientist, and CLI’s vice president and director of data analytics, additionally cited studies from Finland, Italy, China, Germany, Korea, and the United States that have all linked abortion with an increased risk of adverse mental health outcomes including anxiety, depression, and suicide.

“Some researchers insist that any limits on abortion to protect mothers and children create ‘mental health harms,’” Studnicki said. “Our study using years of claims data adds to an extensive body of international, peer-reviewed science showing the opposite – abortion itself has a significant negative impact on several measures of mental health.”

An earlier study in the series found that women whose first pregnancies end in abortion “had more pregnancies, more miscarriages, more than four times as many abortions, and only half as many live births as women whose first pregnancy ended in a live birth,” according to CLI.

The CLI’s Unwanted Abortion Studies have additionally found that a majority of women with a history of abortion report high levels of pressure to abort and describe their abortions as unwanted, coerced, or inconsistent with their own values and preferences.