Opinion editor's note: Star Tribune Opinion publishes a mix of national and local commentaries online and in print each day. To contribute, click here.
The Positive Pregnancies Act, a bill before the Minnesota Legislature that would reform the state's program for the funding of crisis pregnancy centers, has drawn attention to a host of pressure tactics deployed by the state-funded antiabortion facilities through a program established under the Republican administration of former Gov. Tim Pawlenty.
Though the centers often provide maternity goods, these are frequently offered alongside heavy-handed tactics meant to influence a birth decision. Intimidation methods include the use of nonmedical ultrasounds by unlicensed personnel, the promotion of unapproved "abortion reversal" strategies for women taking mifepristone, and false messages about health risks to abortion.
One of these false messages, which would no longer be indirectly subsidized under House File 289, is a decades-old, pseudoscientific assertion that terminating a pregnancy can lead to mental health problems.
Crisis pregnancy centers frequently warn of a so-called "post-abortion syndrome" that purportedly resembles PTSD. My reporting last fall for Forum News Service found that websites for eight of the 27 crisis pregnancy centers funded by Minnesota taxpayers made reference to either this pseudo-diagnosis or the need for counseling due to abortion.
"[T]here are emotional and mental side effects to abortion," a state-funded center in Sauk Centre advises. "Many women experience feelings of loss, regret, guilt, depression, anxiety, and can have trouble bonding with their partner or other children as a result."
"It's a form of PTSD," according to a state-funded center in Alexandria. A third center tells pregnant women that abortion can cause brief psychotic disorders and self-harm.
It's likely antiabortion activists do not realize they are propagating falsehoods about mood and abortion. The antiabortion movement, like so much of our society, exists in an information bubble of its own making. Activists are exposed to ideology-driven papers, produced by interested parties, using weak methodology, to arrive at erroneous conclusions. It's a problem in no way unique to antiabortion studies.
Writing in the journal Contraception in 2008, a team from Johns Hopkins ranked the evidence on the question of whether abortion can lead to trauma, finding that "highest quality studies had findings that were mostly neutral," while "studies with the most flawed methodology" reported negative outcomes for mental health following abortion. A separate, 2009 analysis in the Harvard Review of Psychiatry reported a similar conclusion.
Still, a certainty that abortion must lead to anguish in at least some people remains at the highest echelons of debate. Writing the majority opinion for a ruling in 2007, then- U.S. Supreme Court Justice Anthony Kennedy unburdened himself of his adherence to the position.
"While we find no reliable data to measure the phenomenon," he wrote, "it seems unexceptional to conclude that some women come to regret their choice to abort … . Severe depression and loss of self esteem can follow."
Even leading health care organizations defer to this highly potent zombie idea. Though it does not endorse "post-abortion syndrome," the website of Mayo Clinic frames abortion as fraught with peril. "Having a medical abortion is a major decision with emotional and psychological consequences," reads copy at the top of a Mayo webpage. It warns of "a mix of emotions, including relief, loss, sadness or guilt," feelings that could warrant counseling.
It's all very well-meaning language that surely reflects our deference to the antiabortion movement in America, a bare-knuckled political project which has been permitted to operate in the modern health care space under the special handling granted to those claiming a moral high ground. What it doesn't reflect is the good news from well-designed studies on mental health and abortion.
Careful investigations of outcomes following abortion can be found in the five-year Turnaway Study from the University of California, San Francisco. Its authors compared women who had received a wanted abortion to women who had wanted an abortion, but who were turned away for waiting too long. The project has found no emergent risk of psychological distress for having a wanted abortion.
To the contrary, the researchers found the most common emotion endorsed at five years following an abortion is relief, and that perceived stigma predicted the rare individuals — 1% — who suffered a delayed onset of regret. This might suggest women have made their peace with terminating an unwanted pregnancy, and that their only source of regret is due to their emotional manipulation by others.
Today we are asked to assume that women who seek abortion necessarily sense having crossed an innate moral line, a transgression of natural law capable of causing the sort of grief, trauma or remorse comparable to the experience of war or violence. As Tulane historian Karissa Haugeberg has put it, "people assume that there's always been a vibrant religious or moral opposition to abortion," when in fact "that's actually relatively recent. It's not something rooted in ancient history."
For those rare women facing regret caused by our stigma, we would do well to replace our offer of counseling with history. Though it routinely goes unnoted, abortion was widely practiced and abortifacients publicly advertised in colonial America. In fact, until the mid-1800s, abortion was permitted within the United States for all but the enslaved.
That is to say, the first ban on abortion in the United States was designed to facilitate the exploitation of enslaved women, and the tearing away of their children for sale. Yet somehow we are supposed to assume our innate revulsion must be directed at abortion, as opposed to those who would attempt to ban it.
Should lawmakers vote to cease the funding of bad advice about the harms of abortion, perhaps we can begin to accept that it's our opposition to abortion, not the age-old practice itself, that causes women harm.
Paul John Scott is a writer who lives in Rochester.