*This post first appeared on Care2Causes in Women’s Rights*
Mental illness and disease are not much different than physical illness or disease. This approach fits squarely in the medical model: there are doctors and hospitals and diagnoses. There are also risk-factors, treatments and morbidity rates.
If you have a problem, most likely, it has a name, whether it’s cancer or diabetes, depression or schizophrenia. “Health” in this model is the absence of illness or disorder, but it is not a measure of the strength, vitality or fitness of your body, mind and spirit.
The medical model is the one most often used when conducting research about abortion and mental health, including the latest study out of Denmark, just published in the New England Journal of Medicine. This significant project confirms (in great detail and with an impressive pool of data) what many researchers have said before: there is no science that shows an abortion causes mental illness.
While I hope this science is a relief to every woman who worried that, after an abortion, she may wake up one day with a life-threatening illness like bulimia, alcoholism, or obsessive compulsive disorder, it is inadequate for understanding the scope and depth of a woman’s emotional experience when it comes to abortion.
That’s why it is so important to understand the difference between the medical model that’s focused on reducing disease and the well-being model focused on health promotion; what these differences mean for scientific research; and, eventually, what they mean for the development, adoption and promotion of strategies that can effectively enhance the emotional health of women who have had abortions.
Have no doubt: the Danish study answers important scientific questions about cause and effect when it comes to mental health and abortion. Yet, as long as women have abortions, we are going to have feelings about it. Whether our feelings about our abortions are complicated, ambiguous or clear, having them is a natural, normal part of being human. But, our personal feelings have little to do with the medical diagnosis that is a part of mental health research. As the Danish study points out:
“most studies have failed to distinguish between mental health diagnosis such as depression and psychosis and feelings of sadness, loss, or regret, which, although unpleasant, do not necessarily signify a mental disorder.”
Scientific researchers interested in understanding and promoting the emotional health of women who have had abortions would do well to look outside the medical model and towards the growing body of research in Positive Psychology, including the comprehensive volume published by Oxford University Press called The Science of Wellbeing.
The context surrounding a woman’s personal experience with abortion in the United States is quite different than the context within Denmark. For example, most women who have an abortion in the U.S. are already parents, whereas the study suggests otherwise for Danish women.
Also, in Denmark, all health care, including abortions and mental health services are free, which is not the case here. These social and cultural circumstances are significant factors in how a woman feels about her abortion and in her ability to cope afterward. Her family may be a source of pain, or one of strength; her faith, a blessing or a constraint. These are the issues that the science of wellbeing can address, taking us toward a more complete picture of what a woman has and needs to be emotionally well after an abortion.
In 2009, I provided written and oral testimony before the National Institutes of Health(NIH), Office of Women’s Health Research, along with Danielle Thomas and Elsa Valmidiano of Exhale, about the need for more research to promote wellbeing after an abortion. I testified:
“Today, more than ever, there is a great need for sound, thorough research into women’s emotional well-being after an abortion: The abortion procedure is so common, the families and communities impacted are so diverse, the debate around abortion is so loud, and the overwhelming stigma – which, according to NIH’s own definition, ‘threatens psychological and physical well-being, and helps to perpetuate health inequalities within societies’ – is so harmful that it is time for the National Institutes of Health to proactively address the emotional needs of women who have abortions, by using its support and resources to undertake and share sound, thorough research into women’s real experiences.”
Scientific research on emotional health gives us, as women who have abortions, the tools and information we need to promote our own well-being. It can be used to help us better understand the behaviors and practices that build our resilience, strengthen our confidence, and improve our emotional literacy. It can also help providers, caregivers, family and friends to be important sources of emotional support as we build proactive networks of respect and understanding.
It’s good to know that abortion doesn’t cause mental illness. It would be even better to know what’s needed to promote emotional health after abortion.