Psychiatrists Can Help Patients Make Autonomous Decisions on Abortion

Abortion is an excellent, if unfortunate, example of the contrast between decisions and policies based on empirical findings and decisions and policies in the real world, according to Nada Stotland, M.D., an expert in women’s reproductive health and a former APA president, who spoke at APA’s 2015 annual meeting today. Literally thousands of anti-abortion bills are introduced in state legislatures each year, she said, and many pass and are signed into law by governors. Laws that harm women are cloaked in mantles of “protecting women” rationales.

Laws limiting abortion are rationalized on specious, patently false medical claims: that abortion causes breast cancer, depression, suicide, and substance abuse, she continued. Laws in some states require that abortion providers have hospital privileges; that abortion clinics meet the same standards required for hospitals performing major surgeries; that women, who may have to travel hundreds of miles to clinics open only on certain days, wait 24 hours or more and then make a second trip. Laws impinge on medical practice in unparalleled ways: requiring that women undergo and view unnecessary ultrasounds or be given specific medical misinformation. All of these limitations weigh most heavily on minority, poor, and young women.

Abortion highlights the stark contrast between abstract beliefs and real-life behaviors, said Stotland. Women who demonstrate at abortion clinics undergo abortions when they, like other patients seeking clinic care, find their pregnancies unsustainable under their current circumstances. Abortion policy also reveals logical non-sequiturs; the very pregnant adolescent whose parents are legally empowered to prevent the abortion she seeks will, in a few short months, become a parent with full responsibility for a newborn baby.

Scientific studies using credible methodology reveal that abortion often occurs because of stressful psychosocial conditions, including domestic violence, but that abortion itself does not cause psychiatric illness, Stotland said.

“As physicians and mental health professionals, we need to help our patients considering abortion and integrating abortion experiences through the fog of misinformation so that they can make autonomous decisions based on their own beliefs and circumstances, and we need to insist that our policymakers respect scientific evidence, common sense, the doctor-patient relationship, and the rights and well-being of women,” she concluded.