As we approach the 40th anniversary of Roe and Doe on January 22, 2013, where are we? Ever since those beginnings our Supreme Court has based much of its jurisprudence on its understanding of the health consequences of abortion or birth on women, including their mental health.[1]
In Doe v. Bolton, the Supreme Court created the “health exception” to the Roe v. Wade trimester framework. Under the health exception, a woman could obtain an abortion at any time, up to the moment of birth, if giving life to the child would adversely affect the woman’s health. The Court stated: “We agree … that the medical judgment may be exercised in the light of all factors –physical, emotional, psychological, familial, and the woman’s age — relevant to the wellbeing of the patient. All these factors may relate to health.”
In 1993, however, the Supreme Court fundamentally changed its analysis in Planned Parenthood v. Casey.[2] Casey reduced a woman’s “right” from that of a fundamental right, which requires “strict scrutiny” of any legislative attempt to ban or restrict it, to merely a right that could not be “unduly burdened.” The Court allowed a mandatory 24 hour waiting period and said that truthful, non-misleading information could be required to be given to women to obtain informed consent, even if it led to an increase in the actual number of live births. One major reason for this change was the psychological damage that could occur through abortion. The Casey Court stated:
“It cannot be questioned that psychological well-being is a facet of health. Nor can it be doubted that most women considering an abortion would deem the impact on the fetus relevant, if not dispositive, to the decision. In attempting to ensure that a woman apprehend the full consequences of her decision, the State furthers the legitimate purpose of reducing the risk that a woman may elect an abortion, only to discover later, with devastating psychological consequences, that her decision was not fully informed. If the information the State requires to be made available to the woman is truthful and not misleading, the requirement may be permissible.”
In 2007, in Gonzales v. Carhart[3], the Supreme Court’s most recent abortion decision, the Court upheld Congress’ ban of one particularly gruesome method of partial birth abortion, in which three quarters of the baby are brought outside the mother’s womb while a suction device is inserted into the child’s brain to collapse the skull. Significantly, the Court also focused on the psychological damage to women. The Court stated:
“While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained.” See Brief for Sandra Cano et al. as Amici Curiae in No. 05-380, pp. 22-24. “Severe depression and loss of esteem can follow.” See ibid. “The State has an interest in ensuring so grave a choice is well informed.” (Emphasis added).
The immediate consequence of the Supreme Court’s decision in Carhart was to set off a flurry of activity by pro-abortion academics, scientists and medical associations purporting to show that that there were no more adverse consequences for abortion than there are for birth. One of the major articles refuting this contention is a peer reviewed journal by Professor Priscilla Coleman in the British Journal of Psychiatry.[4]
Coleman’s study is based on an analysis of 22 separate studies which, in total, examine the pregnancy experiences of 877,000 women, with 163,831 women having an abortion.
Coleman’s study says:
“Overall, the results revealed that women who had undergone an abortion experienced an 81 percent increased risk of mental health problems, and nearly 10 percent of the incidence of mental health problems were shown to be directly attributable to abortion.”
Abortion was also linked with a 34 percent chance of anxiety disorders, and 37 percent higher possibility of depression, a more than double risk of alcohol abuse (110 percent), a three times greater risk of marijuana use (220 percent), and 155 percent greater risk of trying to commit suicide.
When compared to unintended pregnancy delivered, women had a 55% increased risk of experiencing any mental health problem.
The major organization reports claiming that the Supreme Court was wrong are the six person American Psychological Association report and a report of a study group of the Royal College of Obstetricians and Gynaecologists in England. (2011)
Since 2007, following Carhart, three more major court victories have approved a legislative approach that reduces the number of abortions by giving women truthful, relevant and non-misleading information about the true nature and consequences of abortion, including its adverse psychological consequences.
The first major court victory following the Supreme Court’s decision in Carhart, was Rounds v. Planned Parenthood.[5] Rounds upheld the South Dakota requirement that abortionists tell women that abortion was “the taking of a life of a separate, living, unique human being.” This information was important for women to know or they could suffer severe psychological consequences.
The next major court victory was the 5th Circuit decision in Lakey v. Medical Abortion Providers.[6] In Lakey, the 5th Circuit upheld a Texas statute requiring abortionists show the woman the actual sonogram, and to describe the parts of the child. This sonogram would prevent abortionists lying to the women by telling them the child in the womb was simply a “mass of tissue.” Planned Parenthood in San Antonio indicated this law resulted in an immediate twenty percent drop in abortions the first week.
The final and most recent Court of Appeals decision is Planned Parenthood Minnesota v. Rounds. Here 8th Circuit upheld a South Dakota statute telling a woman who has an abortion she will have an increased risk of suicidal ideation and suicide. The Court held there was sufficient, credible scientific evidence to prove that this information was true, relevant and not misleading to women making a decision about abortion. Most would agree that an increased risk of suicide would be relevant to such a decision. As you can see, the psychological effects of abortion on women is currently one of the most important and controversial topics in our courts. AACC members as professionals need to explore if abortion is a factor in patients’ history and be trained to recognize, identify and link the symptoms to the cause. In doing so you will be able to help us stand up for the truth that abortion does hurt women. Attached is a statement of 100 Scientists, Medical and Mental Health Professionals supporting the Supreme Court’s decision that abortion does have severe consequences for some women. If you would like to sign this document, please email us permission to add your name to the list at info@txjf.org.
[1] Roe v. Wade 410 U.S. 113 (1973) and Doe v. Bolton 410 U.S. 179 (1973).
[2] 505 U.S. 833 (1992)
[3] 127 S. Ct. 1610 (2007)
[4] The British Journal of Psychiatry (2011) 199, 180–186. doi: 10.1192/bjp.bp.110.077230.
[5] 467 F.3d 716 (2006)
[6] 667 F.3d 570, 574 (5th Cir.2012)