Article Review

About Article

In 2017, the health and psychological experts Antonnia Biggs, Ushma, Charles McCulloch, and Diana Foster conducted a research and documented it in the article, ‘Women’s Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion. The article was published in December 2016.


 This research aimed at analyzing the mental health of women after a successful abortion or after being denied a chance to have one. The research was done to know if the analogy that abortion has psychological effects on an individual is correct. This research also looked at the need to have counseling and other measures set up to ensure there is no easy access to abortion services.

Over the years, there has been an assumption that abortion causes a lot of psychological effects on the victim. From similar research conducted in 1989, Biggs and Upadhyay wanted to confirm if there is a need for counseling and other measures to be undertaken before one undergoes an abortion. This came up more specifically after the previous research concluded that there is no proof that abortion causes one to get negative mental health issues.

Moreover, the research was done on a longitudinal cohort, containing women who were granted access to get abortions and those who were denied one. This was done with possibilities such as getting pregnant and keeping the baby and getting an abortion, in mind. With other factors being held constant and ensuring not to duplicate the shortcomings from the previous research, the turn away study was able to come up with a conclusion that abortion does not lead to increased chances of depression, anxiety and other cases of posttraumatic stress. Even though there was also a conclusion that these symptoms are delayed and that they may come in the long term. The authors conclude that there is no relationship between abortion and increased mental health issues.

Methods of Research

From this research, there was a collection of data for all 5 years, with abortion clinics in the surrounding areas being used as sites for recruitment of the women. A total of thirty facilities were used for the purpose of this analysis, for the period between January 1, 2008, to December 31, 2010. The first form of communication was done eight days after access or denial to the abortion services, and then for every 6 months for the next 5 years through to January 31, 2016. This communication involved inquiries on their demographics, mental health, their experiences in bearing children and other traumatic events that may have been caused as a result of the abortion.

To be eligible for this, the participants had to be above 15 years and had no medical conditions that required them to seek an abortion. They were women of different gestational stages and various reasons for seeking abortions, therefore making it easier to make a comparison and valid conclusion from the results.

The independent variable for this research was the study group, time bracket for the research, which is the number of years of study after doing an abortion, and the study group. The dependent variables included age, education levels, marital status, history of child abuse or neglect, pre-pregnancy problems, employment status, and any history related to depression or anxiety.


Out of the 3016 eligible participants, only 1132 agreed to take part in the interview. 956 women completed the interview. There was no significant difference seen between people who had a history of mental health issues and depression, with those who did not. Significant differences were observed due to age, marital status, employment status, educational level, and or not limited to drug and alcohol abuse.

The symptoms of depression are different for the different age groups, and they were declining over time. These cases, however, did not reduce for the ones whose abortion desires were turned down by the clinic, as they remained flat over time. In the first interview after being denied an abortion, these women reported higher cases of anxiety compared to the ones who had the abortions done. These cases also decreased with time for those who were given access to abortion and remained significantly flat for those who were denied access. The overall self-esteem for the turn away no-birth groups was higher as compared to the turn away birth group.

Discussion and Conclusion

In the first week, the turn away-no-birth group recorded the lowest levels of self-esteem and the highest levels of anxiety, which went leveled up to the other groups by the end of the first year. These levels are because of the trauma caused when they are seeking an abortion, and its realities when they are turned down, such as an unwanted pregnancy. Gestational age also affects the possibility of getting mental health issues. People who get an abortion at the later stages of pregnancy have more adverse health outcomes compared to the ones who abort in the early stages of pregnancy. Most of the mental health cases observed were linked to childhood trauma and neglect, and the history of one having mental health issues and conditions in the past. ‘Thus, there is no evidence to justify laws that require women seeking an abortion to be forewarned about negative psychological responses. Women considering abortion are best served by being provided with the most accurate, scientific information available to help them make their pregnancy decisions’ (Biggs, Upadhyay, McCulloch & Foster, 2017)



Biggs, MA, Upadhyay UD, McCulloch CE, Foster DG. Women’s Mental Health and Well-being 5 Years After Receiving or Being Denied an Abortion: A Prospective, Longitudinal Cohort Study. JAMA Psychiatry. 2017;74(2):169–178. doi:10.1001/jamapsychiatry.2016.3478