Flawed Study Claiming Women Don't Regret Abortions Doesn't Settle Debate

"This Study Should End The Debate About Whether Women Regret Having Abortions," reads the headline from ThinkProgress. The study, published in the journal PLoS One, claims that 95 percent of women having abortions do not have regrets afterward.

From the study:

Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding.

Far from settling the debate, however, the study has a number of flaws that belie the conclusions drawn by the authors. Among the flaws:

1) This study's findings and conclusions are overreaching due to self-selection and high drop out rates. To quote from the study: "Overall, 37.5 percent of eligible women consented to participate, and 85 percent of those completed baseline interviews (n = 956). Among the Near-Limit and First-Trimester Abortion groups, 92 percent completed six-month interviews, and 69 percent were retained at three years; 93 percent completed at least one follow-up interview." This means 62.5 percent of women refused to participate in the study.

2) With 62.5 percent of eligible women refusing to participate in the study, it is improper for the authors to suggest that their findings reflect the general experiences of most women. There are numerous risk factors which have been identified as predicting which women will have the most severe post-abortion reactions. One of these risk factors, for example, is ambivalence about having an abortion or carrying to term. Another is the expectation that one will have more negative feelings about the abortion. In a similar post-abortion interview study by Soderberg, the author reported that in interviews with those declining to participate "the reason for non-participation seemed to be a sense of guilt and remorse that they did not wish to discuss. An answer often given was: 'Do do not want to talk about it. I just want to forget.'"

3) It is very likely that the self-selected 37.5 percent of women agreeing to participate were more highly confident of their decision to abort prior to their abortions and anticipated fewer negative outcomes. This concern about selection bias is highlighted by the study's own finding that "women feeling more relief and happiness at baseline were less likely to be lost [to follow-up]." Clearly, due to the large numbers of women choosing not to be questioned about their experience, and the large drop out rate of those who did agree, this sample is not representative of the national population of women having abortions.

4) Despite the initial selection bias, 15 percent of those agreeing to be interviewed subsequently opted out of the baseline interview and another 31 percent opted out within the three year followup period. This indicates that even among women who expected little or no negative reactions, the stress of participating in follow up interviews lead to a change of mind. The authors also make much of the claim that 93 percent of the participants "completed at least one follow up interview" which the media outlets incorrectly reported as meaning, "Only 7 percent of the participants dropped out of the study during follow-up."

5) The bias of the research team is made clear in press releases and a infographic purporting to summarize the study. In these "summaries" the research group conceals the details regarding the high non-participation rate and boldly claims "95 percent of women who had abortions felt it was the right decision, both immediately and over 3 years" -- omitting the fact that 62.5 percent refused to answer the question at the time of their abortion and of those interviewed at the time 31 percent were out of the study by the third year. Notably, the problem of high non-participation and drop out rates is not mentioned in the abstract, press release, or other summarizing materials published by the authors. To the contrary, they consistently imply that their results apply to the entire population of women having abortions.

Notably, the claim of declining regret and declining negative reactions is at odds with Brenda Major's two year longitudinal study, which also had high drop out rates, that found that there was a trend of decline in relief and increase in negative emotions over the two year period among those who did not drop out of her study. (See Major B, et al. Psychological responses of women after first-trimester abortion. Archives of General Psychiatry. 2000: 57(8), 777-84.)

Another oddity, the authors report that in the final group analyzed, average age 25, 62 percent were raising children. This would appear to be a very high rate that is not typical of national averages for women seeking abortion. Also, the sample included 413 women who had an abortion near the end of the second trimester compared to only 254 women having an abortion in the first trimester.

Additionally, the authors do not report on any assessment of whether women experiencing negative emotions sought any post-abortion psychological or spiritual counseling. In other words, it is unclear if the women reporting a decline in negative emotions experienced this decline because of intervention (counseling) or reconciliation (spiritual effort) or whether the decline is "natural" as the authors suggest.

Yet another problem is that the questionnaire used by the authors focused on just five emotional reactions which the women attributed to their abortions: relief, happiness, regret, guilt, anger. (Why "sadness" was omitted is unclear.) The "decision rightness" measure was based on a single question of whether or not the "abortion was right for them."

But there is clear evidence from other studies that many women experience symptoms of post-traumatic stress disorder which includes symptoms of denial and avoidance behavior. In a study by Rue, for example, among women reporting intrusive memories and dreams related to their abortion, only half attributed these thoughts to their abortions.  In other words, half were in such denial that while on one hand they could report certain intrusive thoughts, half denied that these thoughts had anything to to do with their abortions.

Therefore, women reporting less "anger" relative to their abortion may in fact have more feelings of anger in their lives but may not be attributing this anger to their abortions, but rather to other problems, though perhaps in counseling, they might discover their increased feelings of anger were projected on other issues but are related to unresolved hurt over the past abortion.

Theresa Bonpartis, who herself underwent an abortion and now offers support for others  suffering after abortion through Lumina post-abortion ministry, commented on the study:

I often wonder where they get the women for these "studies." Certainly not from places where women who are seeking help go. This one in particular was done at the Bixby Center for Global Reproductive Health at UC San Francisco’s School of Medicine. Biased? Please!

The study only looked at three years after a woman's abortion.  Most women do not even begin to deal with an abortion until around seven years after.

Lumina receives about 200 new women every year who come to us because they are suffering from a past abortion and have many regrets. The prochoice side itself says that 10 percent of women who have abortions suffer, which in a country where over 56 million abortions have occurred, brings the figure to millions of women.

Other studies prove differently. One only has to visit the Elliot Institute web site, or Priscilla Coleman's research, or many others, too many to list, to find that out.  Time magazine's article "Hardly Any Women Regret Having an Abortion..." which was just published and written by "staff" makes a bold statement, while only looking at this one study.

To be honest, this makes me angry. Mostly because it perpetuates the feeling of being crazy if your abortion does bother you, like there is something wrong with you if it does. So, if you see this article and are suffering, please reach out for help, You are not alone; there are millions of us out there and many great resources for healing. Hope and healing are possible.

Learn More:
They're Still Trying to Disprove Post-Abortion Trauma Syndrome
Flawed, Biased Turnaway Study Now Claims 95 Percent of Women Happy After Abortion
Hardly Any Women Regret Having an Abortion -- Only Millions of Us!

Takeaways from the UCSF Abortion "Turnaway" Study (Series from NRL News Today):
Part I: Set up for a Spin
Part II: Finding What They Looked For
Part III: Spinning the Consequences of Abortion
Part IV: Research Team with an Agenda
Part V: How Bias Can Tilt Results

Get Help:
Help After Abortion
Help During Pregnancy
Center Against Forced Abortions (legal help for those being pressured, coerced or forced to abort)

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