Why False Claims about a Nonexistent "Post Abortion Syndrome" Influence Access to Abortion in America
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Opponents of abortion often claim that a nonexistent disorder they call “post abortion syndrome” afflicts women who have had abortions. There is no medical or scientific support for the existence of the syndrome, yet those who claim it exists have influenced the Supreme Court and state lawmakers to restrict access to abortion. How did this happen?
What is Post Abortion Syndrome – and How Do We Know It is Fake?
The inventors of post abortion syndrome borrowed extensively from evidence-based literatures about a different, well-established, and serious illness called “post-traumatic stress disorder.” By analogy to that illness, they suggested that women who have had abortions might experience problems such as depression, suicidal thoughts, excessive use of drugs or alcohol, low self- esteem, regret, grief, anxiety, flashbacks, or even denial about a negative event that triggered their problems. Those trying to establish post abortion syndrome also claim that an affected woman could experience specific additional symptoms, such as avoidance of any person or event associated with the abortion, inability to establish or maintain relationships with men, development of eating disorders, or avoidance of sexual intimacy and pregnancy. Further, they said, such women could be obsessed with becoming pregnant again in an attempt to have a “replacement” or “atonement” baby or experience difficulties bonding with future children; and they might suffer “anniversary syndrome” involving intensified symptoms coinciding with the date of the abortion or the projected due date for the fetus that was aborted.
Despite this laundry list of specifics, post abortion syndrome does not really exist, as a growing body of medical and scientific research demonstrates. In the mid-1980s, the Reagan Administration ordered a review of the literature on the psychological effects of abortion. C. Everett Koop, then the openly anti-abortion Surgeon General of the United States, conducted the review and concluded that the available research on the subject was inconclusive due to poor methodology and a reliance on anecdotal evidence. Research continued and by now a host of academic researchers as well as the American Psychological Association, American Psychiatric Association, American Medical Association, American College of Obstetricians and Gynecologists and the American Public Health Association refute the existence of the syndrome.
Why False Claims Spread
Post-abortion counseling programs originated in crisis pregnancy centers in the early 1970s, long before the idea of a specific post abortion syndrome gained currency, and even before it was named. Nevertheless, since the 1970s these centers have created the conditions for false claims and a false industry to flourish – building an audience for anti-abortion think tanks and researchers who churn out methodologically questionable studies arguing the syndrome exists.
Although post abortion syndrome is supposed to be a psychological condition, those who discuss it often point to medical risks of abortion such as infertility, infection, and blood clots. Accepted scientific evidence about such proven, albeit rare, medical risks is linked to pseudo- psychological language about the supposed syndrome, to give it a veneer of medical credibility. Anti-abortion advocates thus attempt to connect reputable medical evidence to unproven claims. What is more, anti-abortion researchers attempting to legitimize this syndrome have made their diagnostic criteria impossibly broad, much vaguer than those used to diagnose genuine post- traumatic stress disorders. Finally, when women who have had abortions deny they have symptoms, the proponents declare that these women are simply in denial, too mentally unstable to recognize the effects of their abortions!
How Have Anti-Abortion Falsehoods Affected Policy?
False claims about a fake syndrome cannot simply be ignored, because they have actually affected public policy. An extreme example happened in South Dakota, where in 2005 a task force issued a report making sweeping claims about the disastrous mental health effects of abortion. In response, the state legislature proposed to ban all abortions except to prevent the death of a pregnant woman. The ban – plus a similar attempted constitutional amendment – failed only because it was rejected by voters in a referendum.
South Dakota is not the only state to pass or consider drastic steps based on claims about a nonexistent post abortion syndrome. In 2006, affidavits purportedly about this illness were entered into the legislative records of Alabama, Louisiana, Mississippi, and Ohio, all of which passed abortion restrictions that year. Currently, 20 states require abortion providers to give clients information on psychological after-effects of abortion and eight of these states include only negative effects. Many states distribute inaccurate information to women about this supposed syndrome. At the federal level, Congress debated abortion legislation based on such false claims in 2001 and 2009 and held hearings on claims about the syndrome in 2004 and 2007.
The courts have also been influenced by false claims about post abortion syndrome. In 2012, the 8th Circuit Court of Appeals upheld a South Dakota law that requires physicians to falsely tell women that abortions put them at risk for suicide and suicidal thoughts. In 1992, The Supreme Court upheld Pennsylvania abortion restrictions that require a waiting period for women seeking abortions as well as a physician’s description of supposed psychological harms. Most striking of all was the Supreme Court’s 2007 decision in Gonzales v. Carhart upholding a federal ban on intact dilation and extraction abortion procedures. Writing for the 5-4 majority, Justice Anthony Kennedy admitted there was no credible evidence supporting post abortion syndrome, yet nevertheless said that “while we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained...Severe depression and loss of esteem can follow.” Justice Kennedy thus invoked unsubstantiated claims to justify the Court’s first-ever prohibition of a procedure deemed necessary by physicians in specific cases.
According to the Guttmacher Institute, roughly one million abortions are performed in the United States each year. If claims about a fake syndrome continue to spread, women will continue to see their health and rights compromised by official actions based on inaccurate information.