Link of "Informed Consent" on Abortion with Mental Health Disorders Fails Court Test

(WOMENSENEWS)--The appeal of South Dakota's 2005 "informed consent" law on abortion gave pro-choice advocates a sliver of victory earlier this month.

A doctor is still required to tell a woman that an abortion "ends a human life" 24 hours ahead of the procedure, to give her time to reconsider. The court upheld that essential part of the script citing a previous ruling on First Amendment freedom of speech grounds.

But the Eighth Circuit Court of Appeals in St. Louis said a section requiring doctors to describe "all known medical risks" of abortion -- including an increased risk "of suicide ideation and suicide"-- must be removed. That frees doctors to use professional judgment when informing patients of the potential risks.

"We are very happy to have the Eighth Circuit confirm what reliable medical professionals have been saying for years," said Mimi Liu, who represented the case as the staff attorney of the Planned Parenthood national office, in Washington, D.C. "It has been a long road."

She said the quashing of the suicide advisory could affect other states considering advisories on a linkage between abortion and psychological distress. "No other state has tried to pass a similar provision since this law was passed in 2005, I suppose in part because of waiting to see what happened here," said Liu.

Planned Parenthood brought the suit against South Dakota Gov. Mike Rounds, Attorney General Marty Jackley, representatives from "pro-life" medical groups and two crisis pregnancy centers, run by Christian organizations in the United States and around the world, that encourage women to avoid abortions and carry through with all pregnancies.

The issue, however, has not been completely put to rest in South Dakota.

A re-hearing petition is now making the rounds with Priscilla Coleman, professor of human development and family studies at Bowling Green University in Bowling Green, Ohio, who is on board to provide expert testimony.

Study Finds Risks

In a recent analysis of 22 studies conducted between 1995 and 2009, published by The British Journal of Psychiatry, Coleman found "a moderate to highly increased risk" of mental health problems after abortion, including suicidal behavior.

"I'm hoping that the research will get attention from professional organizations and that evidence-based counseling will make its way into the abortion services available," said Coleman.

The court is expected to make a decision in October on hearing the appeal, which is being brought by Alpha Center and Black Hills, two crisis pregnancy centers. Also, the state may be petitioning for further review, says Planned Parenthood. Petitions are due today.

Meanwhile, much of the script was either upheld or modified.

"We are very pleased that more of the informed consent law was found constitutional," said Valerie Johnson, board member of South Dakota Right to Life. "South Dakotans know that when a woman is given more information about her developing unborn child, she is more likely to choose life for that child."

South Dakota was the first, and only, state to include the risk of suicide in an abortion-specific informed consent law.

But, some states have found other ways to suggest a mental health risk.

"It gets murky when you get into what states have included in their written abortion counseling materials," said Elizabeth Nash, a public policy associate at Guttmacher Institute, the New York-based provider of reproductive health research. "In some states abortion counseling includes a section in the written materials that says something along the lines of 'abortion can be difficult emotionally, some women feel relief while others have negative feelings. If those feelings continue a woman should seek the help of a mental health professional.'"

34 States Require Counseling

Today, three of the 34 states that require counseling before an abortion mandate a warning of negative emotional responses. They are Michigan, Nebraska and West Virginia, says a report from the Guttmacher Institute, though only West Virginia mentions the risk of "suicidal thought or acts."

Three other states--Kansas, Texas and Utah--include mental health risks in their state-funded material, and both Texas and Utah include suicide and thoughts of suicide as a risk.

"We've seen the idea that mental health disorders are a risk of having an abortion over and over again in state legislation," said Nash. "Many times the debates are put to an end when legislators see that the research is not bearing out."

The possibility of a link between abortion and mental health disorders entered high-profile politics in 1987, when President Ronald Reagan asked then Surgeon General, C. Everett Koop--an outspoken opponent to abortion--to prepare a report on the psychological effects of the procedure. After reviewing 250 articles from the Atlanta-based Centers for Disease Control and Prevention, Koop in 1989 declared an insufficiency of scientific evidence to make a comprehensive conclusion and would not publish the findings.

Seeking a more clear-cut statement, the American Psychological Association in 1990 commissioned a report by the journal Science, which concluded that women who have voluntary abortions do experience severe distress, but the majority of that occurs before, not after, an abortion.

"The weight of the evidence from scientific studies indicates that legal abortion of an unwanted pregnancy in the first trimester does not pose a psychological hazard for most women," the study said.

No Evidence

In 2008 a task force commissioned by the American Psychological Association again found no credible evidence "that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems."

Proponents of the South Dakota bill--the state and crisis pregnancy centers--relied heavily on studies by anti-choice researchers Coleman and David Reardon, said Jennifer Aulwes, media relations director of Planned Parenthood Minnesota, North Dakota and South Dakota, based in Minneapolis, in an e-mail.

"Their research has been discredited by leading professionals and organizations in the field," said Aulwes.

The connection between abortion and suicide crept into public education during the era of abstinence-only sexual education under President George W. Bush.

One curriculum, "Me, My World, My Future," taught teens: "Following abortion, according to some studies, women are more prone to suicide," according to the 2004 Waxman Report, commissioned by then California Rep. Henry Waxman.

"What's happened is that the anti-abortion movement has found people to put out methodologically flawed studies that allege that there is a problem with mental health after having an abortion," said Jessica Arons, director of the Women's Health and Rights Program at the Center for American Progress, a progressive think tank based in Washington, D.C.

Pregnancy crisis centers, where women are often encouraged or required to seek counseling before an abortion, may also warn women about the negative mental-health consequences. Because the centers aren't medical facilities, the information is often not regulated.

The article was first published by Women's eNews