UK's Royal College of Psychiatrists claims abortion could lead to mental illness

Great Debates
41

I think there should be minimal levels of counselling for any major procedure; side effects, where known, should be discussed with the patient.

It just so happens that a side effect of abortion, as well as giving birth, can be depression. Expectant mothers are told that they may suffer post-partum depression. Why not say the same thing to women who have abortions if there is a documented link between the procedure in question and long-term depression?

Is that statement untrue or misleading?

The story is not a medical site; the Times is a UK Newspaper with a conservative tilt. The story quotes both that story of a depressive woman killing herself as well as bits from the RCP statement (without quoting it in full) as well as quoting a Journal of Child Psychology study. I am not so naive as to believe that a newspaper would not run a sensationalist story, but I think you’ll find that I never defended the newspaper but the RCP itself as well as the concept that more information to women undergoing a serious medical procedure is not a bad thing.

Are you a medical practitioner in the United Kingdom? Do you know for a fact the procedures that are followed in the UK before a woman can procure an abortion from her GP?

All the RCP is asking for is additional information in a damn pamphlet. They’re not talking about showing women pictures of aborted fetuses or scaring the crap out of them with horror stories of people killing themselves in the depth of depression.

And I can’t understand why this is a bad thing. Surely forewarned is forearmed, and proper treatment can be better indicated for women who suffer depression after getting an abortion if it is known that depression can be one of the side-effects.

42

Telling women the side effects is terrorizing them? Telling women one possible side effect is deceiving them?

So you’re willing to suppress scientific research and put womens’ life in danger to ensure women have the right to choose? That’s the same kind of logic as burning down the village to save it from Communism.

43

Telling them “If you get an abortion, you’ll go mad !” Is terrorising them. And that’s what such “counseling” would amount to.

I said nothing of the sort. I was answering your question about why abortion is special. One of the effects of the “counselling” you want will be to put them in danger, by pushing them towards childbirth, and away from abortion. Because ALL the “counselling” will be is a one sided terror lecture about how abortion drives you insane, without a mention of the dangers of birth.

44

Now you’re just making shit up. NO ONE is saying that. The RCP has studied the issue and has seen a correlation between abortion and depression. They have an ethical duty to warn their patients about it. Rather than spout your standard ludicrously over-the-top statements designed to inflame emotions, why not just consider for a single moment that the world outside of your basement is not the Machiavellian hellhole you seem to think it is.

Bullshit. You said exactly that - there can be no counselling because the risk is that women will be encouraged to give birth rather than abort. Counselling women does not mean you hand them over to a crack team of Evangelicals for prayer in relays. It does not mean scare tactics or some sort of nightmare of repression for women like you claim - that is just your paranoid fantasy of repression and fear.

Counselling here means you sit down, have a discussion of the risks of the procedure, make sure the woman is conscious of the risks, and move on. 24% of UK doctors will not perform an abortion; that means 66% will. Are you so hopelessly blinded by rage and ignorance that you cannot see this simple math? The world is not the US. Things don’t work the way you claim over here.

45

Yes, I believe I and others have pointed that out. Where does it say the women are NOT counseled? That they do not receive information regarding side effects?

Yes, it is misleading. I think that anyone without medical background could very easily misinterpret that headline.

Although I am not a medical practitioner in the UK, I have no doubt my counterparts there follow the standard procedure of counseling. And this site seems to back that up (in fact it’s #1 on their list):

No, they aren’t. They’re asking that women be forced to go through a “cooling off period,” and receive a pre-surgical counseling session about their mental health. Big difference.

Absolutely. Once again…can you tell me where in the article or study it says these women are NOT receiving information about possible side effects? Because I didn’t find that anywhere.

46

Forgot to address this.

There isn’t one. According to the RCP’s findings (linked in the article, but not mentioned by the news article):

47

Maureen - I don’t have access to the study and won’t defend the Times article. I will say that a cooling off period, as long as the choice is still ultimately decided by the woman in question in conjunction with her doctor, is not something I am worried about. The counselling isn’t going to be the horrific experience Der Trihs seems to think it will be, I’m fairly sure, and women’s access to abortion will remain as it is. The RCP isn’t asking for major changes to the law.

The Times article was a bit sensational and it doesn’t surprise me they didn’t quote the whole RCP / Journal of Child Psychology study. It’s a news story in a newspaper - as far as some of the rags in the UK go that’s pretty mild sensationalism. But I will also say that although I am a strong proponent of a women’s right to choose, I don’t think it should be ‘abortion on demand’ and don’t think a cooling off period or additional warnings about long-term effects is a bad thing.

48

Maureen - Your cite doesn’t mention psychological effects unless I am missing it. I think that is what the RCP is concerned about.

ETA - never mind, just found it. Perhaps the RCP is concerned because it is not enough information.

49

No, it’s not. Lying about the risks of abortion is a standard tactic. So, for that matter, are “cooling off” periods, which are nothing more than attempts to force poor women to give birth, since quite often they simply can’t travel twice or more in a short period large distances.

50

A bit further down, under the heading “Information for Women”:

I grant you, it’s the last one on the list, but it is there.
Ah, sorry. Did not notice your edit.

51

Standard for whom? Medical professionals, who have already agreed to provide abortions to patients, are going to lie to their patients about the risks of the procedure? Your ignorance of life and culture outside the US is showing. The UK does not work like the US; poor people are not denied access to medical care here as the NHS provides equally to everyone. Poor people do not have to travel across state lines to secure abortions - we don’t have states, and regions do not make their own medical policy so one region cannot block access to abortions. If a woman is not happy with her doctor, she goes to another down the street. She doesn’t have to travel hundreds of miles to secure an abortion. It’s flat-out not true.

52

Yes - found that area. I don’t think, in spite of the somewhat inflammatory article, that the RCP will be advocating anything wildly unreasonable or would be sharpening an agenda. When thinking of “Royal Colleges” think equivalent of the AMA - not very likely to have a partisan or religious agenda.

53

Nor is it a vast right-wing conspiracy to force women to not have abortions.

Bah, the fact there’s research indicating there may be a problem means that it should be investigated, not that we should “burn the witch!”

The position maintaining that it’s all a scare tactic inherently assumes that there’s no side effect whatsoever, despite the lack of serious long-term scientific investigations into the mental health of post-abortion women. There’s a little, and it’s ambiguous, meaning more work is needed.

Shouldn’t women be informed of potential risks to themselves from an elective procedure? Not doing so seems more “dark ages” to me.

54

That is the case in the USA, as I understand it. Not so much in the UK, where there is no strong pro-life movement.

The medical establishment here (UK) appears quite concerned about the mental effects of procedures. For example, I have recently had an HIV test as part of a emigration medical check. The doctor was required to give me pre-test counselling in case the very fact of the impending test caused me anxiety! The statement by the RCP is quite in keeping with this sort of thing.

It is unfortunate of course that statements of this kind can be used as ammunition by pro-lifers around the world, and I can understand your hostility to them. Pro-choice advocates are in a difficult position. Abortion is a medical procedure, and it is simply false to state that is risk-free or always consequence free. However, the pro-life groups will use any risks and possible consequences as weapons. It’s just something we’re going to have to live with.

55

There is a pro-live movement in the UK, but it is NOTHING LIKE the one in the US. That’s what people in the US don’t seem to get and why this thread has been a bit frustrating for me - the RCP is not some pro-life organization with a partisan or religious ax to grind. It’s a bunch of Doctors who want additional warnings attached to a medical procedure.

Exactly my point. This is not some conspiracy to suppress women’s right to choose; this is purely the RCP making sure to cover all bases. And a ‘cooling off’ period’ does not mean ‘come back in 2 months’ it means come back tomorrow or the next day. And don’t forget, you US people panicked about this - the UK has the morning-after pill and you don’t even need a prescription - you just go to the pharmacist. We have abortion up to the 24th week of pregnancy, and it’s been legal for years and years. And if you don’t like all that, the Eurostar is under a hundred pounds to France or Belgium. Stress here is a big deal that is constantly worried about. A friend of mine has been off work for over 8 months on stress leave; as an American she finds it all a bit funny and is milking the shit out of it, but it is a big deal that physicians are very concerned about in the UK for all kinds of things.

There’s the rub, and I can understand (a bit) the passion on the pro-choice side as this information will get used by pro-lifers as ammunition against abortion. But that’s not what the RCP is using it for, and even MPs here aren’t using the information for that, which is what I’ve been saying all along.

56

Have people read the actual declaration by the college? It doesnt actually say they’re at risk if they have an abortion - it says the research hasnt been resolved regarding mental health risks for abortion - only regarding birth, which definitely has a risk mental health wise.

All they’re really doing is recommending further research so that a firm conclusion can be drawn on whether abortion actually is a risk for mental health, as they think the current research is inconclusive. It doesnt call for compulsory counselling either (its an MP calling for that), all it does is recommend a possible updating of pamphlets and education and training of health professionals.

What the article clearly shows in my view how a statement can so quickly be turned into something else, by other groups.

Otara

57

I posted a beautiful long, well thought out post last night, and the damn hamsters ate it. So, I’m going to give you the cut-down, post St Paddy’s day hangover, edited for TV version.

Here is the 1967 Abortion Act, which covers abortion in the UK (except Northern Ireland).

Abortions require the signatures of two doctors, and can be preformed for free in NHS hospitals or for a fee in specialist clinics. The two doctors usually don’t just sign a form, but have a discussion with the woman about her options and about whether this is something she really wishes to do. The NHS service often has a waiting list and delays, so many women choose to pay for speed and convenience. Very few people have their own OB/GYN, most will be referred to abortion services by their own GP, or will self refer to a private clinic. There is plenty of information and support available on emotional effects of abortion. If you look at the post-abortion information produced by BPAS and Marie Stopes (warnings, pdf file) you will see that emotional health is in no way neglected currently.

Post abortion follow-up will either be through the abortion provider, or via their own GP, whichever the woman chooses. Counselling, anti-depressants, in-patient psychiatric treatment and various psychological therapies are available free of charge on the NHS and can be accessed via their GP. Private abortion providers such as BPAS and Marie Stopes provide non-judgemental post-abortion counselling, usually first session is free, subsequent sessions for a fee.

Here is some info on postnatal depression. The most interesting statistic is that "the incidence of depression in the first month after childbirth is three times the average monthly incidence in non-childbearing women." The incidence of postnatal depression is 12-13%, of baby blues is 40-50% and of a puerpueral psychosis is 0.002%. Having the baby doesn’t make everything rosy, and well known risk factors for depression include 3 or more children under 10 in the house, and being the main carer for a child resulting from an unplanned pregnancy.

Northern Ireland is in a rather unique position in that abortion law is so fuzzy that nobody really knows where they stand. Currently abortions are not offered for “social reasons”. Abortions are however available in Northern Irish NHS hospitals on the decision of a consultant obstetrician for situations where the life or health of the mother are in significant danger, for rape and incest and for foetal abnormality. Everyone else has to travel to the UK.

Having worked as a doctor in Northern Ireland in obs and gynae I can say for definite that our patients were counselled exhaustively on their options and offered a lot of support. Granted, these patients were most often dealing with the trauma of terminating a wanted pregnancy because of a severe foetal abnormality, but they were given contact details for every counselling service and support group you can imagine.
Nitpick: Can we stop calling the Royal College of Psychiatrists the RCP, please?
That’s the Royal College of Physicians, which looks after all the medical doctors, i.e. anyone who is not a surgeon, psychiatrist, GP, paediatrician, family planning doctor, obstetrician, gynaecologist, radiologist, anaesthetist, opthalmologist, pathologist, public health doctor or occupational health physician. They all have their own professional bodies. The abbreviation you want is RCPsych.

58

Thanks irishgirl- it’s nice to hear from an expert. And hope the hangover isn’t too terrible.

Can I ask, however - do you think the RCPsych is asking for something excessive or out of line in this case for analysing and discussing the possible link between long-term depression and abortion? Ignoring the Times article, is the suggestion really all that controversial?

59

Yes, I did, and it’s quite different from the article, which is much more inflammatory than the study.

Agreed, and it’s too bad the study couldn’t have been presented in a more objective, less salacious fashion.

And seconded to the thanks to irishgirl for the info.

60

The statement by the RCPsych is, IMO extremely even-handed, sensible and objective.

All it basically says is that women need support, whatever choice they make. It also says that we should try and get more information on whether induced abortion actually causes more mental health problems than continuing an unwanted pregnancy, so that we can give accurate advice to women because of the current paucity of accurate information and the conflicting evidence available at present .

It is a change from the RCPsych position on psychiatric indications for termination of pregnancy in 1994, in which the College basically stated that abortion was almost always less harmful than continuation of an unwanted pregnancy.

The 1994 statement was much more pro-abortion, in my view, while the new statement is more even-handed. The 1994 statement was a rebuttal to the suggestion that no pregnancy should ever be terminated for psychiatric indications and the new statement was in response to the government requesting that the College update its 1994 statement, so that does explain some of that bias.

I think The Times was irresponsible in the way that they spun this story, as the College’s position is nowhere near where the article claims it to be. In addition, the RCPsych can only make recommendations, it cannot prevent doctors (who, as OB/GYN or GPs are not members of this particular College anyway) from acting as they see fit.