Letter to the Editor

Coleman, Coyle, Shuping, and Rue make false statements and draw erroneous conclusions in analyses of abortion and mental health using the National Comorbidity Survey

Most research in mental health and abortion has examined factors associated with post-abortion psychological health. However, research that follows women from before to after their abortion consistently finds that depressive, anxiety, and stress symptoms are highest just before an abortion compared to any time afterwards.

This finding suggests that studies investigating psychosocial factors related to pre-abortion mental health are warranted.

The current study uses data from 353 women seeking abortions at three community reproductive health clinics to examine predictors of pre-abortion psychological health. Drawing from three perspectives in the abortion and mental health literature, common risks, stress and coping, and sociocultural context, we conducted multivariable analyses to examine the contribution of important factors on depressive, anxiety, and stress symptoms just before an abortion, including sociodemographics, abortion characteristics, childhood adversities, recent adversities with an intimate partner, relationship context, future pregnancy desires, and perceived abortion stigma.

Childhood and partner adversities, including reproductive coercion, were associated with negative mental health symptoms, as was perceived abortion stigma. Before perceived abortion stigma was entered into the model, 18.6%, 20.7%, and 16.8% of the variance in depressive, anxiety, and stress symptoms respectively, was explained. Perceived abortion stigma explained an additional 13.2%, 9.7%, and 10.7% of the variance in depressive, anxiety, and stress symptoms pre-abortion.

This study, one of the first to focus on pre-abortion mental health as an outcome, suggests that addressing stigma among women seeking abortions may significantly lower their psychological distress.

This paper examines the content of Post Abortion Syndrome (PAS) claims, the social actors involved and how this social diagnosis bypassed professional dissent and diffused into public policy in the United States. Previous works on the spread of PAS focus on almost exclusively on anti-abortion think tanks and policymakers. Missing from these analyses, however, is an emphasis on the grassroots-level actions undertaken by evangelical crisis pregnancy center (CPC) activists in introducing and circulating PAS claims. The CPC movement introduced PAS claims and provided the fodder for anti-abortion think tanks to construct evidence of pro-life claims. Despite dissent from health professionals and academic researchers, CPC PAS claims successfully diffused into federal and state abortion policy. I draw upon Brown et al.’s social diagnosis framework and Armstrong's five-stage model of diagnosis development to frame this account.