Intended for healthcare professionals

Rapid response to:


Abortion does not increase mental health problems in women, shows review

BMJ 2011; 343 doi: (Published 09 December 2011) Cite this as: BMJ 2011;343:d8045

Rapid Response:

Re: Abortion does not increase mental health problems in women, shows review

Knietowicz’s article highlights the heterogeinity in the studies on abortion. Mental health effects can go both ways; when the decision to have abortion is based on a sound argument of weighing for and against with realistic expectations of the effect on the person’s life,which matches the outcome, an abortion can be perceived as at least empowering and eventually as a relief. People with mental health problems are not always more at risk of further mental health problems following an abortion. An abortion can be experienced as traumatic when based on the wrong reasons such as pressure or as a pseudo solution for a different or more serious problem and when the outcome has a real or perceived adverse effect, i.e. when the person cannot have children at a later stage. Also, it is a form of a loss. Professionals at the front line of abortions and mental health professionals have to consider four emotional responses by those undergoing the abortion, relief or no reaction, a normal grief reaction, abnormal grief reaction or an acute and delayed posttraumatic stress reaction. Severe self-harm and suicidal gestures can occur; in such cases it can be helpful to raise awareness in the person about the reasons behind these reactions. Mental health workers have to be mindful that the emotional pain around an abortion can be a screen trauma, overshadowing other traumatic events or unresolved issues in people with or without mental problems. Sometimes it can be worthwhile to explore whether losses such as an abortion are aetiological or sustaining factors to mental health problems. All these factors will determine whether mental health input is required and direct the level and focus of treatment.

BMJ 2011;343:d8045

Competing interests: No competing interests

17 December 2011
Ruth L. Brand Flu
Developmental child psychiatrist
The Town House Derby, 123-125 Green Lane Derby