Impact of Abortion on Mental Health among College Women

Induced abortion is a medical procedure common in the United States. U.S. Census Bureau, 2012, reports that about 1,211,500 induced abortions were conduction in 2008. In 2014, the figure had reduced 926,190, and 862,320 in 2017. About 18% of pregnancies in 2017, miscarriages excluded, ended up in abortion (Jones & Jerman, 2017). The rate of abortion among women aged 15 to 44 was 13.5 abortions per 1000 women in 2017, an 8% decline from 14.6/1,000 in 2014, the lowest figure the U.S. has ever witnessed since 1973 (Nash, 2019). Globally, a study shows that abortion rates are high, without about 56 million induced abortions occurring every year between 2010 and 2014, at the rate of 35/1,000 married women and 21/1,000 for unmarried ones (Zareba et al. 2020). However, the discussion on whether abortion has adverse effects on women’s psychological health and wellbeing has been a subject of far-reaching research since 1973, when abortion became legalized in the U.S. through the Supreme Court in Roe 7 v. Wad. In this study, the researcher explores the impact of induced abortion on college women’s mental health, examining the mental impacts of induced pregnancy termination and psychological implications in the relationships with a partner.

1.2. Research Rationale Justification

The issue of whether an induced abortion presents adverse impacts to women’s psychological health and wellbeing remains to be completely determined. Even though some researchers argue that several patients suffer mental health complications due to induced abortion, with about 10 to 20% experiencing severe depression (Mutiso, Murage & Mukaindo, 2018), others maintain that abortion has negligible impact on the psychological impact on women. The few problems that emerge represent the continuation of previous symptoms (Sullins, 2016). Because of such discrepancies in research, this study considers it essential to clarify whether abortion significantly impacts women’s mental health and wellbeing.

Review of Literatures

Several literature reviews on the psychological impacts of induced abortion on women have been conducted over the years. However, this study is restricted to those conducted within at least 10 years and below.

Zareba et al. conducted a narrative review of the psychological effects of induced abortion on women and their couple relationships and sexually. The researchers noted that the experience of pregnancy termination could cause the development of depression, post-traumatic stress disorders, post-abortion distress (PAD) and post-abortion syndrome (PAS), and challenges in interpersonal relationships. PAD involves experiencing severe post-abortion stress, often within the first three months following the abortion, and persevering for over one year. PAD is characterized by several experiences, including a sense of guilt or loss, psychological pain, a feeling that life is worthless, and occasional sleep disorders. PAD also impacts sexual experiences, which is occasioned by the fear of conceiving again (Zareba et al. 2020).

On the one hand, PAS is a chronic disorder developing after some months after the abortion and resurfaces occasionally. PAS is characterized by reliving the trauma, including nightmares, insomnia, retrospections. It is also occasioned by defense mechanisms including repression, rationalization, denial, avoidance of situations and places that remind one of the events, chronic anxiety, and an outburst of anger, avoidance, and concentration problems. Other symptoms of PAS include depression, suicidal thoughts, low self-esteem, loss of sexual interests, and addictions (Zareba et al. 2020).

Reardon conducted a comprehensive literature review on abortion and psychological health controversy. The researcher noted that abortion is consistently linked to psychological problems than in post-birth. Though Reardon cited the pre-existing psychological problems as the primary risk of psychological illness post-abortion, and a very significant factor that is challenging post-abortion mental illness is linked to it (Reardon 2018). After extensively adjusting for confounding, sociodemographic, and other pregnancy outcomes, Sullins noted that abortion was consistently linked to increased psychological disorders and substance use during adolescence and early adulthood. The underlying assumption for substance abuse is that abortion is linked to adverse psychological outcomes, including depression among women, and drugs provide an easily accessible tool to alleviate the stress (Sullins 2016).

Van Heyningen et al. examined the primary factors influencing psychological problems post-abortion. They noted that the reason for undertaking abortion, the medical procedure, personal, economic, cultural, and religious, pregnancy terms shaping the woman’s attitude and perception about abortion are the main factors to post-abortion mental health problems. Mainly, factors associated with most adverse effects include previous psychiatric disorders, unwanted and unplanned pregnancy, lack of social support, pressure from people in the surrounding, and personality prone to adverse reactions toward stress (low sense of control, pessimism, and low self-esteem). Similar factors are also linked to psychological disorders for women who opt to continue with an unwanted pregnancy. Women who have aborted for the first time are more likely to develop an anxiety disorder than those who have given birth to their first child. The most common cause for anxiety post-abortion is the previous psychological health problems (van Heyningen et al., 2017). Anxiety disorders and violence experienced pre-pregnancy significantly influence anxiety disorders post-abortion.

Hajek carried out an empirical study on the correlation between abortion and woman’s couple relationship satisfaction. Women who experience abortion also tend to report escalated abuse by their partners and are predisposed to have unstable couple relationships due to psychological reasons, including emotional instability and egocentrism. According to Hajek, abortion leads to a dyadic stressor, stress for both partners. The stress of the other partner, a woman or a man post-abortion, often spills over, destabilizing and even dissociating the relationship, leading to additional psychological stress on the woman (Hajek 2021). The study is supported by Zareba et al. study, which observed that abortion increases the likelihood of argument concerning children by 116% and 196% in women and men, respectively, and family conflicts by 80% alongside sexual dysfunction in women by between 122% and 182%. Such events predispose women to psychological problems, including depression, anxiety, suicidal thoughts, and other mental illnesses. However, women do not seek early psychological support since they are often unaware of potential mental disorders that follow later post-abortion (Zareba et al., 2020). A sense of sadness often appears later, with the first symptom appearing within three to four months and even one year after the procedure (Hajek 2021).

Study Hypotheses 

H1: Induced pregnancy termination has adverse impacts on college women’s psychological health.

H2: Induced abortion adversely impacts college women’s couple relationship and sexuality with their partners, hence presenting psychological health problems.

Research Methods

Study Subjects/Participants

The research will recruit female volunteer students from undergraduate healthcare and introductory psychology from the health sciences. A sample size of 100 students will be included in the study. The age range of students will be between 18 and 50 years. The participants’ racial composition and educational levels will be noted. Inclusion criteria will comprise women who have had an abortion at least once. 

Data Collection Procedure

A web-based survey questionnaire designed for this research will be administered through the University database systems for the Department Of Health Sciences and Psychology Department. The questionnaire will assess the demographic features, including the age of abortion and religious affiliation, history of fatal delivery or abortion, and specific questions about the effect of abortion on present psychological health status. The researcher will adopt Symptom Checklist-90-Revised (SCL-90-R) to assess perceived mental distress or psychological health status. SCL-90-R refers to self-reported instruments comprising of primary symptoms (Pirimoglu et al. 2021).

Data Analysis

The researcher will adopt a Multivariate Analysis of Variance (MANOVA) to analyze the data. The pregnancy products: delivery of fetuses or abortions and determining whether the result, abortion, or fetal delivery led to present psychological health as defined by the responses will be used as independent variables. The mental symptoms of distress will assessed by the SCL-90-R will be the dependent variable. ANOVA will be used for secondary analysis. Frequency analysis will be adopted to determine a series of features and patterns of inclusive sample concerning the experiences of abortion to provide data concerning the woman receiving the abortions.

Ethical Consideration Before commencing the study, the researcher will seek ethical approval from the institutional review board. The participants will be engaged based on voluntary participation and the basis of informed consent. The researcher will provide adequate information concerning the study so that the participants are well informed. Data collected will only be used for research purposes, and the anonymity and privacy of the respondents will be kept confidential.