Abortion and Mental Health
Evaluating the Evidence
Brenda Major University of California, Santa Barbara
Mark Appelbaum University of California, San Diego
Linda Beckman Alliant International University, Los Angeles
Mary Ann Dutton Georgetown University Medical Center
Nancy Felipe Russo Arizona State University
Carolyn West University of Washington, Tacoma

Abortion as a Traumatic Experience
One perspective argues that abortion is a uniquely traumatic experience because it involves a human death experience, specifically, the intentional destruction of one’s unborn child and the witnessing of a violent death, as well as a violation of parental instinct and responsibility, the severing of maternal attachments to the unborn child, and unacknowledged grief (e.g., Coleman, Reardon, Strahan, &
Cougle, 2005; MacNair, 2005; Speckhard & Rue, 1992).
The view of abortion as inherently traumatic is illustrated by the statement that “once a young woman is pregnant. . . . it is a choice between having a baby or having a traumatic experience” (Reardon, 2007, p. 3, italics in original). The belief that women who terminate a pregnancy typically will feel grief, guilt, remorse, loss, and depression also is evident in early studies of the psychological implications of abortion, many of which were influenced by psychoanalytic theory and based on clinical case studies of patients presenting to psychiatrists for psychological problems after an abortion (see Adler et al., 1990).
Rue and Speckhard (1992; Speckhard & Rue, 1992) posited that the traumatic experience of abortion can lead to serious mental health problems, for which they coined the term postabortion syndrome (PAS). They conceptualized
PAS as a specific form of posttraumatic stress disorder
(PTSD) comparable to the symptoms experienced by Vietnam veterans, including symptoms of trauma, such as flashbacks and denial, and symptoms such as depression, grief, anger, shame, survivor guilt, and substance abuse.
Speckhard (1985, 1987) developed the rationale for PAS in her doctoral dissertation, in which she interviewed 30 women specifically recruited because they deemed a prior abortion experience (occurring from 1 to 25 years previously) to have been “highly stressful.” Forty-six percent of the women in her sample had second-trimester abortions, and 4% had third-trimester abortions; some had abortions when it was illegal. As noted above, this self-selected sample is not typical of U.S. women who obtain abortions.
PAS is not recognized as a diagnosis in the Diagnostic and
Statistical Manual of Mental Disorders (DSM) of the
American Psychiatric Association (2002).