Abortion is not a contentious issue in America these days - campaign platforms primarily center on differences in taxation and the scope of government but, for the most part, abortion for the left and the 2nd Amendment for the right are really only invoked to whip the fringes into a frenzy.

In California, where I live, it may seem a little different, both Senator Barbara Boxer and Rep. Nancy Pelosi campaign heavily on a platform that if they are not reelected women will be dying in back alley abortions (which tells you California has a lot of people on the fringes who believe one Republican member of Congress in San Francisco could overrule the Supreme Court) but nationwide it is only an issue when it involves federal money.  The Supreme Court made abortions legal nationwide nearly 40 years ago and gun ownership is in its 224th year so those still come up on occasion, but they are not really something the public is voting on in a national election.

Abortion is back in the news these days because the Health Care Reform Act (so-called "ObamaCare" by opponents) was positioned as not changing abortion funding - right now, abortion is legal but taxpayers don't have to pay for it. However, there is a loophole in that  people who get federal subsidies can buy insurance that covers abortions. While the majority of Americans aren't fomenting over abortion these days, 70% still don't want to pay for it.  A bill was passed in the House to try and limit the language to not pay for abortions but it is certain to die in the Senate and Pres. Obama would veto it anyway.

Yet science may create a new wrinkle in the debate.   A meta-analysis in the British Journal of Psychiatry last month examined the psychological impact of abortion and stated that the peer-reviewed research found abortion increases the likelihood of a variety of mental health issues, like depression, anxiety and even suicide.  And Democrats care far more about science than Republicans, they always say, and never filter science through politics, so they are likely to be cheering for more evidence-based research when it comes to abortions.  Or not. 

This analysis is in contrast to American Psychological Association reviews in 2008 stating abortion's mental health impact is slight.   Priscilla K. Coleman, Professor of Human Development and Family Studies at Bowling Green University, says her new analysis is more rigorous,  covering 22 peer-reviewed studies with data on 877,181 participants, 163,381 of whom had abortions in the years 1995 to 2009. 

Coleman also controlled for demographic groups and prior history of mental health problems and found that women who had undergone an abortion had an 81 percent increased risk of mental health problems. Almost 10 percent of the incidence of mental health problems was attributable to abortion. The strongest correlation was to substance abuse and suicide - 110 percent more likely to abuse alcohol, 220 percent more likely to abuse marijuana and 155 percent more likely to commit suicide.  Comparison groups were no abortion, unintended pregnancy delivered and pregnancy delivered.  If that 10 percent number holds up, that is a big difference in risk.  Only 10 percent of smokers get lung cancer and we have seen how cigarettes are vilified.

Of course, the flaw in all these sorts of mental health studies is that women more likely to have abortions might have been prone to being alcoholics or depressed anyway, even if it was not previously diagnosed.  Circumstances related to the pregnancy itself can also be a factor in depression, though it isn't like women aren't aware of birth control by now, or are more commonly forced into sex, like women in third world countries (though those extreme examples are often highlighted by proponents of abortion as being some huge number of instances) yet none of those questions were asked about studies saying there was no mental health impact of abortions so it's safe to eliminate that qualification here also.

Those non-questions were not asked by advocates of political positions but scientifically would they make the difference if they were?  Hard to say.  The public determines policy, not science, and mainstream media trumpet "evidence-based medicine" when it endorses causes they are sympathetic to, like abortion, yet had little to say on this one.  CBS and The Telegraph gave it some coverage.  If an aspect of health care reform is going to cause an increase in mental health issues for primarily poor women, and both sides claim to care about poor women, you think it would at least be a discussion.

The Royal College of Obstetricians and Gynaecologists issued a press release saying they weren't buying it because they weren't sure she controlled for prior mental health health histories, as expected, but this was in a peer-reviewed journal and "no it isn't" arguments without a factual basis to dispute the results aren't very convincing, it is just an anti-science stance to protect a pet cause.   The Royal College did not dispute the APA studies saying abortions caused no mental health problems.

Mental health issues can be persistent and it seems strange that more psychologists don't at least want to examine anything that might be a cause of a mental health problem - but perhaps that is still the nature of abortion.  It may still be an undercurrent of politics even if it is not a hot-button issue. If it polarizes one side, it might also polarize the other, perhaps including blinders when it comes to data they would rather not consider.

Citation: Priscilla K. Coleman , Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009 BJP September 2011 199:180-186; doi:10.1192/bjp.bp.110.077230