Study explores abortion's mental aftermath.

Assessments of abortion's psychological risks to women invariably generate debate. Some case reports have described women's traumatic reactions to their abortions. Yet several studies find that rates of depression and other mental ailments in women receiving abortions remain stable for several months, at least after a first-trimester procedure.

A new investigation largely supports the view of abortion as psychologically benign for most women. Still, nearly one in five women report sadness, dissatisfaction, and regret about their abortions 2 years later, report psychologist Brenda Major of the University of California, Santa Barbara and her coworkers.

In their study, which appears in the August ARCHIVES OF GENERAL PSYCHIATRY, many of the women citing negative reactions to their abortions had suffered major depression at some time in their lives. A history of depression, therefore, may raise the likelihood of subsequent sadness and regret in any woman with an unintended pregnancy, whether or not she gets an abortion.

The researchers approached 1,177 randomly chosen women arriving at any of three abortion providers in Buffalo, N.Y., in 1993. A total of 442 of these women obtained a first-trimester abortion and completed psychological assessments 1 hour before the abortion and 1 hour, 1 month, and 2 years afterward.

The women completing the study were largely unwed teenagers and young adults. The sample contained a large number of whites and blacks but few Hispanics. Half the women had not sought any prior abortions, and most of the rest had obtained one or two abortions in the past.

The women's mental health showed no overall tendency to decline in the wake of an abortion, Major's group says. Around one-fifth of the women experienced substantial depression within the 2-year follow-up, a rate comparable to that already reported for all U.S. women ages 15 to 35. Posttraumatic stress disorder, which is often observed in victims of rape and sexual abuse, appeared in 1 percent of the women after 2 years, a much lower rate than that for young women in the general population.

Most women expressed satisfaction with their decision to have an abortion and had no regrets about it. However, the minority citing dissatisfaction and regret increased over time, reaching 16 percent and 19 percent, respectively, at 2 years. Further studies should track women for 5 to 10 years after their abortions, the researchers say.

The definitive study of abortion's mental aftermath is ethically impermissible, remarks psychologist Nancy E. Adler of the University of California, San Francisco, in the same journal. It would at minimum randomly assign women either to continue their unwanted pregnancies or terminate them.

Although research can't exclude the possibility that first4rimester abortion leads to mental harm, the new findings boost confidence that it doesn't stoke psychological problems in "the vast majority of women," Adler argues.