We humans are complex critters. Our behavior is hard to predict. I've been married to my wife for almost 34 years, we know each other as well as any two people can, and I still can't predict her behavior more than half the time. So, studies involving human behavior, human activities, and especially human mental illnesses tend to be very tentative indeed.
Because of this, there are times when we are examining surveys, studies, and so on, when we should remember the old saying, "correlation does not equal causation." But there's another precaution when looking into these matters, and that is knowing the direction of cause and effect. That can make a huge difference; is the direction "A causes B," or "B causes A?"
Case in point: A Canadian study showed that women who had induced abortions were more likely to require mental health treatment. So, which is cause, and which is effect?
A recent study of women in Quebec, Canada, published in the Journal of Psychiatric Research revealed that those who chose induced abortion were more than twice as likely to be hospitalized for a mental health problem than women who gave birth.
Researchers found that, per 10,000 person-years, 104 women who had an abortion were hospitalized for mental health problems such as psychiatric disorders, substance abuse, and suicide attempts, versus 42 women who did not have abortions. A person-year (think man-hour) represents the number of people studied over the course of a year. As a whole, the study followed more than 1.2 million pregnancies for up to 17 years after either an abortion or birth.
Now, it would be easy to point at this as "A causes B," where A is the act of having an abortion, and B is the mental health issue. And the linked article words it to imply just that:
The data indicated that women who chose a repeat abortion were more likely to encounter a mental health problem requiring hospitalization than those who had their first abortion. A woman’s risk of hospitalization was highest in the first five years after her abortion, and, unsurprisingly, was higher if she had already had mental health problems, which the study took into account.
This is not the first study to confirm that abortion compromises women’s mental health. For instance, a 2023 study using Medicaid data showed that women who have a first-pregnancy abortion face a significantly higher risk of needing mental health treatment, particularly inpatient treatment, after the abortion than women who give birth.
There may be an element of that to it; regret over something like this, I would imagine, would be considerable.
But there may be another side of it, too. Women who already have mental health issues may be more likely not only to have an abortion, but to engage in the kinds of behavior that put them in the position to have an abortion.
This misjudgment of cause and effect could explain a great many issues. Another example may be the issue of traditional vs. non-traditional life patterns; there are a number of studies over many years that show that people who follow the traditional pattern of school-job-marriage-children do better, emotionally, physically, and financially in life than those who do not. But I'm inclined to think that is because the kind of people who follow that pattern are already more disciplined, more inclined to think about the future, more likely to put off immediate gratification in return for future rewards, and not that just following that pattern automatically leads to those future rewards.
The same may apply here. Healthy women, mentally, are less likely to, well, sleep around.
The study described concludes:
While these findings are not evidence of a causal link between abortion and long-term mental health sequelae, they support the possibility that abortion may be a marker of an increased lifetime risk of mental disorders. Screening for mental disorders at the time of abortion may be an opportunity to identify women who could benefit from psychological and social support, particularly women with preexisting mental health disorders, under age 25 years, and with previous live births or abortions.
So, even this study has not established that A causes B. Like science should be, the language is tentative.
And, in this case, I'm inclined to believe that there are elements of both possible outcomes involved. Women with mental health issues are more likely to engage in risky behavior - or to be coerced into risky behavior. Undergoing an abortion after engaging in that risky behavior may well cause further mental health issues later.
Human behavior is very complex and can be very interesting. This particular issue around a controversial subject might be a question that can never be completely answered, but it does give mental health professionals some markers to watch for, especially in younger women and girls who have not yet been in a position to engage in those risky sexual behaviors.
