Fergusson and Mental Health

The latest effort from David Fergusson was published in the November issue of the British Journal of Psychiatry and, as usual, led to screaming headlines about abortion causing "severe distress". The study says nothing of the kind, but it's certainly hard to counter scary headlines with actual data and information. Alranz tried, with the press statement below, issued on 4 November. 

First, some background:

This is the fourth article on the 1977 cohort of women from Christchurch. The first paper in 2006 was entitled “Abortion in young women and subsequent mental health” and was published in the Journal of Child Psychology and Psychiatry. It reported a possible harmful association between abortion and mental health but also said more research was needed.

The second paper in 2007 was entitled “Abortion among young women and subsequent life outcomes” and was published in the journal Perspectives on Sexual and Reproductive Health. Maybe because this reported some positive outcomes it received less publicity. Women having abortions had advantages in terms of educational and economic outcomes.  

In 2008 Fergusson wrote an editorial entitled “Abortion and mental health” published in the Psychiatric Bulletin calling for more and better research.

A third paper on the cohort in 2008 entitled “Abortion and mental health disorders: evidence from a 30-year longitudinal study” was published in the British Journal of Psychiatry. A finding was that abortion could account for only 1.5 to 5.5 per cent of the overall rate of mental disorders. In the new paper the time line is extended to include interviews at age 30 years. It concludes (not surprisingly) that abortion was associated with both positive and negative reactions. Importantly 90% were satisfied that they had made the right decision and only 2% regretted the decision. This refutes the claim of anti-abortionists that large numbers of women have regrets.

Here's what Alranz sent out about the latest report. 

4 November 2009                       

ALRANZ Questions Study on Mental Health and Abortion

A new study on abortion and mental health contains good news for supporters of safe and accessible abortion, but some of its conclusions overreach the data, the president of the Abortion Law Reform Association, Dame Margaret Sparrow, said today.

“The authors of the new study (led by David Fergusson), as well as the news media, have tended to pluck out and highlight questionable results that seem aimed at undermining abortion access, while downplaying or ignoring clear evidence that women want and benefit from that access,” she said.

One important piece of good news is the report’s refutation of anti-abortion claims that large numbers of women regret their abortions. The Fergusson study finds that “nearly 90% stated that the decision to have an abortion was the correct one, and only 2% reported that they believed the decision to be incorrect”.

On the negative side, Dame Margaret said, we have major concerns at what the report says about the crucial question of the impact of continuing with an unwanted pregnancy.

“Here, the report fudges an important distinction: In claiming that continuing an unwanted pregnancy is linked to fewer mental health problems, the authors appear to include only women who chose to continue their pregnancies, not women who were forced to do so because they could not obtain an abortion,” she said.

Considering that missing data, Dame Margaret said, it was hard to see how the authors could question the legality of abortions carried out on the ground of mental health.

Finally, it is important to note that the report does not link abortion itself with mental health problems, but “distress about the abortion”, recollected retrospectively. Women who did not have “distress” about their abortions had no significant increase in mental health problems, she said.

This raises questions about this “distress”. What caused it? What other stressful events were the women exposed to? The researchers themselves, for example, say they don’t know if it’s related to being a member of a community that views abortion negatively and are careful to state that their conclusions are subject to a number of potential limitations.

END

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