Posted on | March 6, 2012 by Lucia Muchova |
Yesterday the Guttmacher Institute published an article claiming to “decisively debunk” a study published in 2009 in the Journal of Psychiatric Research entitled “Induced abortion and anxiety, mood, and substance abuse disorders: Isolating the effects of abortion in the national comorbidity survey” by Priscilla Coleman and colleagues. The study shows that abortion is associated with an increased risk of a variety of mental health problems such as anxiety and substance abuse.
In their criticism of the study, Lawrence Finer from the Guttmacher Institute and Julia R. Steinberg from the University of California San Francisco raised two main concerns regarding the methodology. The first was related to the weights used in the analysis and was addressed by the study’s authors in a corrigendum published in the same journal in July 2011. The corrections did not significantly change the overall results.
The second issue was raised in relation to the use of lifetime mental health diagnoses, making it more difficult to determine whether mental health problems occurred after an abortion or had been present before. Finer and Steinberg claim that “the use of lifetime diagnoses, which readers are led to believe are 30-day diagnoses, renders the findings meaningless and provides no support for a number of statements that remain in the paper.” They further assert that both the original study and the corrigendum “contain misleading and erroneous information that serves to confuse the relationship of abortion and mental health even more.”
While the Finer, Steinberg critique received a lot of media attention, the response of the study’s lead author, Priscilla Coleman, Professor of Human Development and Family Studies at Bowling Green State University, Ohio, went almost unnoticed. In her Letter to the Editor, Dr Coleman explains:
We did use the life-time estimates hoping to capture as many cases of mental health problems as possible. Our data analysis strategy was quite similar to that employed by Mota and colleagues (2010) in their recent analysis of the NCS Replication data published in the Canadian Journal of Psychiatry.
Steinberg and Finer voiced concern regarding the fact that use of life-time estimates renders it difficult to ascertain whether or not the abortions preceded the documented mental health problems. While this is certainly true, we do know that the majority of mental health problems likely occurred after the abortions based on the following facts: 1) for nearly 70% of the participants in the sample, first abortions occurred by age 21; 2) the average age of women who had aborted when the life-time data were obtained was 32.9 years, and only 4.4% of first abortions occurred after this age; 3) Kessler et al. (2007) reported the median ages of onset for most anxiety, mood, and substance disorders in the U.S. to be between 25 and 53, 25 and 45, and 18 and 29 respectively.
Details on this and other studies of the relationship between abortion and health are becoming available through WECARE- the World Expert Consortium for Abortion Research and Education.
Given that 35 US states mandate counseling for women who seek an abortion, providing accurate information about the risks of abortion on physical and mental health is crucial if these women are to make an informed choice.