How does having an abortion — or being denied one — impact mental health? Experts explain.

A distressed woman presses her hand to her bowed forehead.
Lack of access to a wanted abortion can negatively affect mental health, say experts. (Getty Images)

Anti-abortion-rights activists have argued for years that abortions are detrimental to a person's mental health. But, despite this argument appearing on social media and in politics again and again, research has shown that's not the case — and may, in fact, be the opposite.

Most recently, a study published in the Archives of Women's Mental Health analyzed data from 7,162 women who had an unplanned pregnancy within the past year. The study's researchers found that "psychological distress was the lowest for wanted birth and increased for abortion, adoption and unwanted birth." However, it found that "abortion was associated with lower distress scores than both adoption and unwanted birth. Compared to the wanted birth, adoption and unwanted birth showed significantly higher levels of distress."

Meaning, the best-case scenario in an unintended pregnancy was for someone to give birth to a baby that they wanted. Beyond that, people who didn't want to become pregnant and either kept their baby or gave the baby up for adoption had much more distress than those who underwent an abortion.

Research has also shown that many women do not feel regret five years after having an abortion — but many who are anti-abortion argue that they do. One 2020 study examined the feelings and emotions of 667 women who had an abortion and found "no evidence of emerging negative emotions or abortion decision regret" after five years. The researchers noted that both positive and negative emotions about abortion dropped over the first two years after a woman had an abortion and plateaued after that. "Decision rightness remained high and steady," they added.

According to the Guttmacher Institute, "there is still no conclusive evidence directly linking abortion to subsequent mental health problems."

However, not having access to a wanted abortion can impact mental health. The University of California, San Francisco's Turnaway Study, which is a longitudinal study that examines the effects of unwanted pregnancy on women’s lives, has similarly found that being denied an abortion can harm a woman's mental health and financial well-being. The study found that women who are denied an abortion and have to carry an unwanted pregnancy to term are four times more likely to live below the federal poverty level. Women who are forced to carry an unwanted pregnancy are also more likely to suffer from anxiety and loss of self-esteem after being denied an abortion, the study found.

On June 24, 2022, the Supreme Court overturned Roe v. Wade, the landmark ruling that guaranteed the right to abortion in America. Currently, 58% of American women ages 13 to 44 live in a state that is hostile or extremely hostile to abortion rights, according to the Guttmacher Institute, putting many women at risk of being denied a wanted abortion.

"People seek abortion for many reasons ranging from concerns about their ability to support a child and their other dependents financially and emotionally, suggesting that abortion is often a decision driven by women's concerns for current and future children, family, as well as existing commitments and responsibilities," Antonia Biggs, associate professor and social psychologist at UCSF's Advancing New Standards in Reproductive Health, tells Yahoo Life. "We find that when people are able to obtain a wanted abortion, they describe feeling predominantly positive emotions, most commonly relief, and over 95% described the abortion as the right decision shortly after their abortion and up to five years later."

Biggs also points out that "people who had a wanted abortion are at no greater risk of experiencing adverse mental health outcomes when compared to people denied an abortion."

Restricted access to abortion is not good for mental health, Dr. Cassy Friedrich, family medicine physician and psychiatrist in California and fellow with Physicians for Reproductive Health, tells Yahoo Life. "Lacking agency over one's pregnancy options causes unnecessary distress for pregnant people and people who are able to become pregnant," she says. "The research shows that people who have had abortions experience less distress than people who have unwanted births, and I see patients all the time that directly reflect the research findings."

According to a 2022 statement by Frank C. Worrell, then president of the American Psychological Association, "Rigorous, long-term psychological research demonstrates clearly that people who are denied abortions are more likely to experience higher levels of anxiety, lower life satisfaction and lower self-esteem compared with those who are able to obtain abortions. In addition, there is no research to indicate that abortion is a cause for subsequent mental health diagnoses.”

The distress of being denied access to abortion, however, is about more than being forced to carry an unwanted pregnancy to term, Biggs notes. "Our research from the burden study found that facing multiple obstacles accessing abortion care resulted in being forced to disclose the abortion decision to people who were not supportive," she says. "We found that experiencing obstacles accessing abortion care and being forced to tell people about the abortion decision that they would have preferred not to tell was associated with more symptoms of depression, anxiety and stress."

But Friedrich points out that there is more than mental health at stake. "Pregnancy is medically risky, and people should be able to make their own decisions about whether or not to take that risk," she says. Biggs agrees. "Findings from the Turnaway Study suggest that when compared to being able to get a wanted abortion, people denied an abortion were much more likely to experience economic insecurity that lasted for years and extended to their children and to bond poorly with the baby," Biggs says. "Forced childbirth also led to more adverse physical health and birth outcomes."

Doctors stress the importance of people understanding the facts around abortion's impact on mental health. "I want people to understand that having an abortion does not have a negative impact on one's mental health," Friedrich says. "Lack of access to abortion and abortion stigma do have profound negative impacts on the mental health of pregnant people and people who are able to become pregnant."

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