11.01.2005

Abortion and Depression

I must apologize for my lack of activity here. Life is going on in other areas in good ways, but I have missed writing.

A new study was released last week about
depression after an unwanted first pregnancy (PDF file). This has everyone in an uproar. The study found that abortion carries a lower risk of depression than does parenting an unwanted first child. This gives the pro-choice camp something to hold over our heads. It also puts the pro-life camp on the defensive. How many of you read the news and thought, "There must be an error! We have to show that women are horribly depressed after their abortions!" Deep breath everyone. In......out..... There. Let's take a closer look at this study.

I must preface this by saying that I am not a statistician. I do not have a Ph.D. I welcome any constructive criticism and look forward to learning more from any of you. I'm sure that many of the things I have issues with are also used in the
Reardon & Cougle study that showed a depression risk following abortion. I'm willing to accept that, and I also believe that, on either side of the fence, researchers are going to be more prone to discovering and reporting the things that further their opinion. How else can you explain such different results based on the same original study?

Basically, in 1979, men and women between the ages of 14 and 24 were selected for a study by the US Department of Labor (called the
National Longitudinal Survey of Youth 1979). These men and women were asked about various aspects of their lives on an annual basis. However, questions that had to do with fertility occurred in 1983, 1984, and then every other year from then on. First pregnancies ranged in occurrence from 1970 to 1992.

For this study, selected information was pulled from the regular, yearly data: Women were sectioned off from male respondents. Then, those who were categorized as having depression were further selected. Out of that group, they further narrowed it down to women who had experienced an unwanted first pregnancy that ended in a live delivery or abortion. The race and the age at first pregnancy were measured. In 1992, measures for education, income, and marital status were gauged. Likewise, the
Center for Epidemiological Studies depression scale (CES-D) was used in 1992 as a means to gauge depression. (PDF file)

There are some flaws in this study. But more than that, there are reasonable explanations to the results that are not taken into consideration.

First off, realize that this study concerns only the first pregnancy. We all know that each pregnancy/abortion/birth is an event all to itself, and any of these events has the potential to spin off in a variety of directions. A first pregnancy that results in parenting could be a happy event, but a subsequent abortion could cause problems. Likewise, an initial abortion could cause no problems while a second abortion does.

Another problem I have with this study is what I call the "snapshot" issue. The test that they used to determine depression can be found
here. (PDF file) It consists of 20 questions that reflect on the past week. Only the test results from 1992 were used for the purposes of this study. Therefore, women who aborted or gave birth in 1970 through 1992 were only questioned about depression in 1992. That's a pretty large time span. The US Dept. of Labor was not looking to pinpoint depression as it relates to abortion/parenting, but rather they were looking at a multitude of factors, one of which was a general inquiry of, "How many of these respondents are dealing with depression at this point in their lives?"

The authors of this study on depression, however, seem to miss the point when they did not allow for a more fluid response to depression. Not to mention that the CES-D only reflects back on the prior week. Depression can come and go. Depression can occur one year and be gone 1 year, 2 years, or 5 years later (etc.). This is a snapshot of what might have occurred in this small sample of women who did not want their first pregnancies. Asking these women to look back at one week in 1992 and broadening that to encompass the entire unwanted pregnancy situation that could have occurred up to 22 years ago is a bit misguided and shows a misunderstanding of post-abortion stress syndrome.

Another issue I have is how depression is linked to socioeconomic status. The mindset that says if you don't have money you must be depressed is upsetting. While it is true that a person's socioeconomic status can relate to depression and overall outlook on life, in this case, using this as a predictor for depression is not accurate. Of course women who do not parent their first pregnancy are going to have more opportunity to continue their education, pursue career goals, put off childbearing, and climb the ladder of socioeconomic success. That does not mean they are happy, however. On the other hand, women that do parent are presented with less time and opportunity to continue with their education or pursue a career. Again, this does not mean that they are depressed. These things are easily explained by time and opportunity, and I do not think that either one clearly establishes a path to depression or happiness.

Lastly, many post-abortive women simply do not struggle with
clinical depression. They have feelings of loss, regret, guilt, etc, but for many of them, this does not steer them toward full-blown depression, and even for the ones that do slip into depression, they often don't stay there for years and years.

With all this being said, the numbers still remain very close - 28.6% of women who gave birth were depressed compared to 24.8% of women who had an abortion. Looking at it another way, out of 1247 women who either aborted (479 of them) or gave birth (768 of them) to a first unwanted pregnancy, 119 women who aborted were depressed, and 220 women who parented were depressed during that one week in 1992 and possibly longer.

What does this tell us? What can we learn from all of this information if we take the results of this study at face value and assume that all things are equal? I think that it shows that when women are faced with sadness after their abortion, they are able to find counseling, healing, and support. I do not think that it finds that feelings of regret and guilt (or depression) occur less often in women who abort compared with women who parent because I do not feel that this was adequately assessed.

However, it does show that we need to double our efforts to reach out to women who decide to give birth to that "unwanted" child. We're reaching those who have had an abortion, but we need to focus just as much on the woman that was into the pregnancy center a year ago, had her baby, and now has no support. Regrettably, quite often when she has made up her mind we are too quick to send her merrily on her way to a life of bliss. I think we need to be sure that she has ongoing support - if not through us then through other local agencies, churches, or support groups. I'll agree with the last sentence in the study, "...if the goal is to reduce women's risk for depression, research should focus on how to prevent and ameliorate the effect of unwanted childbearing, particularly for younger women."

5 comments:

Silent Rain Drops said...

Thank you - you made the study much clearer to me, as I could make no sense out of it on my own.

You also raise excellent questions about the validity of the study and its methodology. I would have fallen within the study parameters if they had asked me - and they didn't - but if they had, I would not have scored for depression in 1992, either. However, in 1994, I started to cut and attempt suicide - this only lasted eighteen months.

Depression may or may not accompany PTSD - it is not a requirement, nor is it the only factor to be measured in determining whether abortion causes psychological harm. I think you described these things very well.

Rose said...

Thanks Julie. :) Reardon did a much better job a day later though, so read that as well if you have time. I hope to be able to summarize the points he raises too. We'll see if life allows it.

I think a lot of the women in this study may have slipped through the cracks as you would have. The questions didn't even allow for "Have you felt depressed in the last 2 years."

Thanks again!

Christina Dunigan said...

My gut reaction to the news of the study was, "That doesn't even pass the common-sense test!"

I once read a study done in California in which researchers polled women who had just undergone normal vaginal deliveries. They asked the women if they'd ever had induced abortions. From this, the researchers concluded -- drum roll -- abortion has no impact on future childbearing!!! That's like going to a public park and asking people on the hiking path if they'd ever been shot. Ask enough, and you'll find a few people who have been shot at some point in their lives. Can you then conclude that there's no link between gunshot wounds and difficulty walking?

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