Science vs. myths about later abortion

Since the legalization of abortion by the US Supreme Court’s 1973 Roe v. Wade decision, restrictions on abortion have largely been based on ideas about fetal development and the purported negative mental health effects of abortion that are not supported by scientific evidence. Significant research has been conducted in the past decade to shed light on the nature of the misinformation that informs restrictive abortion legislation. The questionable evidence for these restrictions has been centered on three key areas: the impact of abortion on women’s mental health, inaccurate beliefs about whether a fetus can feel pain, and the time at which a fetus could survive outside of a woman’s body. Inaccurate information asserting that abortion is reversible or that it causes cancer has also been used as the basis for legislation and anti-abortion media campaigns.

Does abortion impact mental health?

Contemporary research has found no link between having an abortion and experiencing subsequent mental health problems [1][2]. The theory that abortion causes depression or a “post-abortion syndrome” has been debunked, and the research used to support these claims has been found to be methodologically flawed [3] [4] [5]. The strongest predictor of post-abortion mental health is pre-pregnancy mental health, yet the flawed studies used to support a link between abortion and poor mental health did not control for this factor [4]. Additionally, few studies have distinguished between later abortions obtained for fetal anomalies and later abortions obtained for other reasons [1]. This is important because abortions obtained for fetal anomalies often occur during wanted pregnancies, while later abortions obtained for other reasons usually do not. Thus, the emotional experiences of these two situations are likely very different.

The Turnaway Study compared over 800 individuals who received a wanted abortion to those who were denied a wanted abortion because their pregnancy exceeded the gestational age limit of the abortion clinic. In the short-term, those who were denied a wanted abortion were more likely to experience negative emotions than those who received a wanted abortion [6]. At one week, 95% of people who obtained an abortion felt that having the abortion was the right decision [6], and at three years, over 99% felt that having the abortion had been the right decision for them [7]. At five years, the researchers found no differences between individuals who received and those who were denied wanted abortions with respect to depression, anxiety, self-esteem, life satisfaction, post-traumatic stress disorder, or post-traumatic stress symptoms [8] [9] [10] [11] [12]. Further, no increase in the use of alcohol or drugs was found following abortion [13] [14]. However, those who were denied abortions did experience other negative consequences related to mental health, including remaining in relationships marked by intimate partner violence [15]. These data support the already existing body of evidence concluding that abortion does not harm mental health. In fact, for those obtaining a desired abortion, the emotion experienced by the majority was relief [16].

View our fact sheet on later abortion and mental health here.

Is there such a thing as “fetal pain”?

There is no agreement among medical providers that a fetus can experience pain any earlier than the time period between the very end of the second trimester and the start of the third [1] [2]. Research into the ability of a fetus to feel pain has demonstrated that the neural pathways that make pain processing possible do not fully develop until the third trimester [3]. Thus it is necessary to make an important distinction between the way a self-aware adult may experience pain and the reactions a fetus may have to stimulus before the full development of those neural pathways [1][4]. Despite a lack of conclusive evidence, 17 states prevent women at 22 weeks LMP or later in their pregnancy from having an abortion because of the inaccurate idea that a fetus could experience pain at that point [5]. Thirteen US states also require that women be given information about fetal pain during pre-abortion counseling despite this lack of evidence [6]. In a review of the scientific evidence since 2007, the Royal College of Obstetrics and Gynaecologists confirmed in 2010 that there is no methodologically sound research to support the experience of fetal pain any earlier than 24 weeks [7]. The American College of Obstetrics and Gynecology has also supported this finding [8].

View our fact sheet about the myth of fetal pain here.

What is viability?

Despite the predication of the Roe v. Wade decision on the point at which a fetus can survive outside of a woman’s body, called viability, neither the medical community nor the legal community have defined or agreed upon when viability begins. When over 1,000 US obstetricians and gynecologists were surveyed with regard to their intervention and delivery practices, the overwhelming majority indicated 24 weeks LMP as the point at which they considered a fetus to be viable [1]. Studies of infant survival and impairment rates support this range [2] [3] [4]. In studies of preterm infant survival and outcome rates, the risk of neurodevelopmental impairment is greater the earlier an infant is delivered in a pregnancy, with 45% of those infants born between 22-23 weeks having neurodevelopmental impairment, and all infants born between 22 and 25 weeks having a high risk of moderate to severe neurodevelopmental impairment [2] [3]. A study of infant survival rates across 11 US hospitals revealed that only 3.4% of infants born at 22 weeks survived without severe impairment and only 5.1% survived overall at that week of pregnancy [4].

View our fact sheet about the issue of viability here.

Does abortion cause cancer?

The idea that abortion, through the interruption of hormones and cell development in early pregnancy, could increase a woman’s risk of breast cancer has repeatedly been used by those opposed to abortion to attempt to further restrict access to it[1]. The research that initially found this link has been revealed to be methodologically flawed [1]. Although this topic continues to be the subject of ongoing research, the most rigorous and sound scientific evidence shows no link between abortion and cancer [2] [3] [4]. Major medical and professional associations, such as the National Cancer Institute, the American Cancer Society, and the American College of Obstetricians and Gynecologists, attest that a link between abortion and breast cancer is unsupported by scientifically sound research [5] [6] [7].

View the Tools for Advocates section for reasources that debunk the myth of a link between abortion and cancer.

Can medication abortion be “reversed”?

With the signing of state law SB 1318 by Arizona Governor Ducey in March 2015, doctors in Arizona were mandated to inform women during pre-abortion counseling that abortion is reversible [1]. Although the law has since been put on hold pending a federal court decision, it is the first law to endorse the scientifically unsupported idea of medication abortion reversibility. This concept is based on a series of case studies of seven women whose doctors attempted to reverse a medication abortion by administering progesterone after the women had taken only the first of two medications required for a complete medication abortion [2]. Because the sample size of the study is so small, including one subject that was lost to follow-up, and because there is no control group, it is impossible to discern what effect, if any, the progesterone had on the pregnancies of these women. There is no additional published literature supporting medication abortion reversal, and researchers as well as the American College of Obstetricians and Gynecologists have confirmed that there is no current evidence to support the claim that abortion is reversible or to support the experimental administration of progesterone that the study suggests using for an abortion reversal [3]. A 2013 study of women who chose to continue their pregnancy after taking only the first dose of mifepristone for a medication abortion, and who did not receive progesterone for a "reversal" found that the rate of ongoing pregnancy was approximately 80% [4]. This is not substantially different from the ongoing pregnancy rate after administration of progesterone as reported in the 2012 case study series of women who received progesterone to attempt to reverse a medication abortion [2]. Other research has estimated that the ongoing pregnancy rate for women who take only one of the two doses of medications required for a successful abortion ranges from 30-50% [3]. There is currently no sound evidence that suggests medication abortion can be reversed.

For more factual evidence about later abortion see the Related Research in our archives.