While women who have abortions may experience feelings of grief and loss, they aren't at any greater risk of developing mental health problems like stress, depression, and anxiety over the long haul.
Last year the APA had set up a task force to review all the existing research regarding the negative psychological consequences following abortion.
Psychologist Brenda Major, who headed the task force, said, "The best scientific evidence published indicates that among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have a single elective, first-trimester abortion or deliver that pregnancy."
The APA report disputes previous findings showing that such a link does exist.
"These studies, for the most part, were seriously flawed," as they didn't take into account such things as poverty, history of emotional problems, or previous drug use, all of which increase a woman's odds of developing depression or anxiety.
But then findings apply only to a specific subgroup of those getting abortions: adult women with unplanned pregnancies, choosing to have a single abortion during the first 12 weeks of pregnancy. "The evidence is less clear" for teenagers, women who have multiple abortions, and those who have abortions later in pregnancy, admits Major.
The report concedes: "A teenager who terminates her first pregnancy, for example, may experience different psychological effects compared to an adult woman who terminates a pregnancy after giving birth to several children."
And lingering distress can certainly occur for those who abort later after discovering that their fetus has a severe health problem like a malformed heart.
According to one study cited in the review, those who aborted their pregnancies in these cases were more likely to be grieving months later than were those who gave birth to a healthy baby whose malformation had been misdiagnosed. On the other hand, mothers who gave birth to babies who indeed had irreversible heart problems were the most likely to still be grieving.
Certain factors were found to increase the risk of lingering mental health effects ranging from higher stress levels to anxious feelings to full-blown depression:
• Being pressured into having an abortion when the pregnancy was wanted
• Not having adequate emotional support after the abortion
• Feeling the need to keep the abortion a secret from loved ones because of the stigma associated with it
Well-designed studies that track women who've had abortions through the years are still lacking, writes Deborah Kotz in US News and World Report.
And when she asked Major if there was enough evidence to state firmly that abortions don't cause lasting emotional ramifications, she said she preferred to put it another way: "From the data we have, there's no credible evidence that there appears to be any risk."
The report itself stresses that more focussed research taking into account a whole range of issues attending on an abortion, familial, financial, societal and so on, would help disentangle confounding factors and establish relative risks of abortion compared to its alternatives.
Even so, there is unlikely to be a single definitive research study that will determine the mental health implications of abortion "once and for all" as there is no "all," given the diversity and complexity of women and their circumstances, it says.
"Important agendas for future research are to further understand and alleviate the conditions that lead to unwanted pregnancy and abortion and to understand the conditions that shape how women respond to these life events, with the ultimate goal of improving women's lives and well-being," the report concludes.