Book review

“Abortion and Mental Health”

By Dr Pravin Thevathasan MRCPsych

Life Publications
Life House, 1 Mill St.,
Leamington Spa. Warwicks. CV31 1ES

£1.95

When the Abortion Act was passed in 1967, the Royal College of Psychiatrists did not oppose it and put out a statement to the effect that there was no evidence abortion harmed women. Then came the Rawlinson Report of 1994 and two years  ago the College were saying that … “some studies identify a range of mental disorders following abortion”. Fergusson and colleagues, in their 30 year longitudinal study published in 2006, showed that women who had had an abortion were 30% more likely to suffer mental health problems and, moreover, this was not dependent on prior mental ill health.

The dispute was also fuelled by Dr Paul Dragg`s Paper in 1991 in the American Journal of Psychiatry of a meta analysis of 250 papers. But in this admirable and courageous publication Dr Thevathasan  points out that many of the studies that Dragg was relying on were carried out too soon with many less than a year after the abortion and some were based on small numbers or had many women dropping out.

Dr Thevathasan not only points out that many of the adverse mental health outcomes  come many years after the abortion. They also manifest many of the features associated with Post Traumatic Stress Disorder and he uses the term Post Abortion Trauma or PAT which includes a number of features such as uncontrolled weeping, sadness, recurrent nightmares, flashbacks and sleep disorder grief and guilt. Many women turn to drugs or alcohol for relief and depression and suicide may take place. Nor is the author unwilling to enter the spiritual realm mentioning  the woman’s desire to find peace and reconciliation with her lost child.

He challenges ordinary clinical psychiatry by saying that healing can only come after the murder of the unborn is honestly faced. He rightly points out that this is a “taboo” subject and there are no social rituals of atonement to help women damaged by abortion. He asserts that post abortion counselling needs to be done by “pro-life”, and “pro-women” counsellors.

Sometimes PAT is experienced after the birth of a wanted child or in the presence of other people’s babies. Surprisingly often women go on to have an “atonement baby”. Abortion can also be destructive of relationships and interestingly, he mentions that PAT can also affect men. 

It is his willingness to share with us, not only the mental health symptoms which amount to serious mental disorder that, according to one source, affect 10% of women who have had an abortion, but graphically illustrates their anguish by mentioning their own descriptions of  their feelings. He dedicates this publication to those  women who have shared their abortion experiences with him. There may be  little prospect that this problem will be addressed at the level needed, but this publication comes closer that most to explaining the need. 

Dr A P Cole
FRCP FRCPCH

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