On 13th September 2013, the Haut Conseil à l’égalité entre les hommes et les femmes (HCEfh) (Council for equality between men and women) delivered a report to the Minister N.Vallaud-Belkacem, calling for the creation of institutional tools (Website “in favour to the right of abortion”1, national campaign of information on the “right to abortion”…). These elements show a political willingness to set up abortion as a right and to trivialize it. And yet we hear more and more talking about the consequences of this act on women. This way, on July 2013 C.V.Bellieni2 published a summary of studies3 which prove, in view of the international scientific literature, that the abortion has mental consequences on women’s health. Interview with C.V.Bellieni.
G: Your publication reveals that you have assessed the risk of correlation between abortion and subsequent mental disorders, in order to give complete information to women who hesitate to abort. What did you learn?
CVB: It is a task which has analysed carefully all the studies published on this risk of correlation, between 1995 and 2011, or 36. We excluded six for methodology problems. Among the 19 which compare abortion and birth (the others compare abortion with miscarriages or the birth of undesired child), 13 show worst consequences with abortion (depression, anxiety disorders, drug addiction, or loss of self-esteem), 5 show similar consequences and only one would show better consequences after abortion.
After having analysed all these publications, we can conclude that abortion can be considered as a more significant mental risk factor for women than the birth of a child. It is difficult to think, from data of literature, that it is more favourable for mental health to abort than to give birth or to mourn a miscarriage. Further researches will be interesting in this field to prove the mental consequences of abortion which stand out in view of scientific literature.
G: You underline that losing a child before the birth is a traumatic experience, whether for miscarriage or abortion. Yet there is a difference between deciding to kill his/her child and to experience his/her undesired lose. May you enlighten us?
CVB: From these data, one has to mourn for both cases, but some studies show it is more difficult in case of abortion. Above all, the long-term consequences seem to interest abortion, while miscarriage would have serious but transient consequences. The data seem to underline that in both cases women experience them as a loss. But for abortion, it seems culturally and sociably to be prohibited for women to mourn a death. In the case of a miscarriage the prohibition is on a “family way” because woman’s relatives tend to minimize it. The analogy between both pains is interesting: a mental pain, so serious and so similar, is it due to the consciousness of losing a child, or a “project”? The researchers have also underlined the differences between the birth of a non-planned child and abortion, to verify if the latter was a “favourable option” for the mother, but data seem to deny it.
G: Reminding abortion is a public health issue. But yet the French society, for instance, does not take it into consideration. How do you explain such a denial which harms women? To you what should be proposed?
CVB: It does not only deal with abortion, it also the pregnancy which is still a taboo; we can only talk about it when we know that it will not be any problem; the possibility to think about risks is simply prohibited: the son must be perfect, the postpartum depression or the mourn after foetal loss is ignored, like after abortion. The prematurity is trivialised. An ecology of reproduction, an ecology of pregnancy, on the contrary, would consider this, and would compensate the psychological consequences of abortion.
Our conclusions are not isolated: another study carried out by a group from New Zealand4 show the same results as ours; and a recent study of the University of Florida (2013), on students’ abortions, show the high risk of post-traumatic stress; and yet, the psychological consequences of abortion compared to births are ignored by mass media.
This silence is amazing and the responsibility of pregnancy policies is high. We have to choose between accompanying each pregnancy or to let people decide alone; accompaniment means to avoid the paternalism, but also to propose a way. Even in countries where abortion is authorized, we have to plan economic aids, alternatives (neonatal adoption), a prenatal pattern which does not only give a diagnosis, but also therapeutic and social possibilities and knowledge and finally to help for the pain of “missed” mother5.
1. Available online on Saturday 28th September 2013;
2. Carlo V. Bellieni is neonatologist and medical doctor. he is one of the heads of the neonatal intensive care unit of the University of Sienna, Italy. He is also secretary of the bioethics commission of the Italian pediatrics society;
3. ” Avortement et conséquences sur la santé mentale : regard sur la littérature “ co-authored with Giuseppe Buonocorre, Doctor of Medicine and Philosophy and published in July 2013 in the Japanese journal Psychiatry and clinical Neurosciences ;
4. (Aust N Z J Psychiatry, September 2013);
5. Women who could not be mother due to abortion: Editors note;