Originally published September 2023; updated and expanded September 2025
What does the research show?
Meta-analyses and other large studies indicate that abortion can adversely impact mental health. A 2024 systematic review and meta-analysis by Bodunde et al. examining mental health after different adverse pregnancy outcomes, for example, found that abortion was associated with depression and anxiety. Although the authors noted that there were not enough studies on other mental health outcomes to conduct meta-analyses, they also cited studies showing an association between abortion and negative outcomes such as PTSD and substance use disorders. A 2011 meta-analysis by Coleman similarly found that women who had abortions had a 59% greater risk of mental health problems compared to women who had not had abortions; when compared with women who had live births, they had a 138% increased risk.
A 2025 study by Auger et al. of nearly 27,000 abortions and more than 1.2 million births in Canada found that for five or more years following the pregnancy outcome, women who had abortions were more likely to be hospitalized for mental health reasons compared to women who had live births or stillbirths. Even after controlling for prior mental health and other risk factors, women who had abortions had an 81% greater risk of a psychiatric hospitalization, 157% greater risk of hospitalization for a substance use disorder, and 116% greater risk of hospitalization for a suicide attempt.
Studies published by CLI scholars have produced similar results. A peer-reviewed analysis of state Medicaid data showed that, compared to women who gave birth, women who had an abortion in their first pregnancy were 3.4 times more likely to experience an increase in outpatient mental health visits and 5.7 times more likely to experience an increase in inpatient admissions. Another study by CLI authors comparing the cohort with first-pregnancy abortions with women who had a natural pregnancy loss in their first pregnancy found that the natural loss cohort did not have a significant increase in mental health visit rates, while rates for women who had abortions doubled and tripled.
The impact of abortion on mental health remains controversial
In contrast to these studies, some reviews of the research have concluded that there is no association between abortion and poor mental health. In 2008, the American Psychological Association (APA) conducted a review of the literature, noting that while research was inadequate to make a conclusive determination, women who had a “single, legal, first-trimester abortion for nontherapeutic reasons” had mental health problems at around the same rate as other women. However, the APA did note that “[n]onetheless, it is clear that some women do experience sadness, grief, and feelings of loss following termination of a pregnancy, and some experience clinically significant disorders, including depression and anxiety.” In the United Kingdom, the Academy of Royal Medical Colleges summarized their findings by observing that studies that did not control for whether a pregnancy was unwanted indicated increased risks of some types of mental health problems after abortion compared to live birth, while studies that did control for pregnancy wantedness offered “insufficient evidence.” A systematic review published in 2008 concluded that studies finding an association between abortion and poor mental health were poor quality, while studies finding no association were of better quality.
A major reason for these conflicting findings is the fact that mental health is complicated, and the contribution of abortion to women’s mental health is challenging to study. Women who have abortions often have other risk factors for mental illness, including higher rates of mental health problems pre-abortion. To investigate the association between abortion and subsequent mental health problems, researchers must control for women’s pre-pregnancy mental health status; some scholars argue that higher rates of mental health problems experienced by women who have abortions can be entirely explained by prior mental health challenges. However, studies from the United States, New Zealand, Australia, and Norway with data both before and after an abortion have found that women who had abortions were more likely to have mental health problems, even after controlling for prior mental health and other risk factors.
Another issue contributing to the controversy is the selection of comparison groups. Women who have abortions might be compared to women with no abortions, women who have only live births, all other pregnancies, women who have never been pregnant, women denied an abortion, and more. Some researchers argue that the only appropriate comparison group is unintended or unwanted pregnancy carried to term. One study found an association between abortion and depression, but when other researchers analyzed the same dataset but included only unwanted pregnancies, the second study found no increased risk of depression after abortion. However, other scholars point out that not all abortions are performed on unintended or unwanted pregnancies. For example, in one analysis published in 2019, the most striking results were for abortions of wanted pregnancies, with a 69% greater risk of mental health problems compared to women who have birth. The 2011 Coleman meta-analysis highlighted the high rate of unintended pregnancy in the United States and noted that studies comparing abortion to all live births by their nature include large percentages of unintended pregnancies carried to term; the meta-analysis found that women who had abortions had a 55% increased risk of mental health problems compared to women who gave birth to their unintended pregnancies. Furthermore, “wantedness” or “intendedness” is not a simple binary, and women’s feelings and intentions regarding their pregnancies can change over time.
Additionally, some researchers have experienced pressure to censor their results. When pro-choice scholar David Fergusson studied the mental health ramifications of abortion, he expected to find no association and was surprised to discover that women who had abortions had a higher risk of mental health problems. The New Zealand Abortion Advisory Committee discouraged him from publishing his results, but Dr. Fergusson stated it would be “scientifically irresponsible” not to publish his findings.
Specific outcomes
Multiple studies have found associations between abortion and specific mental health outcomes:
Substance use
- The Bodunde meta-analysis cited a 2014 study by Steinberg et al. finding that even after adjusting for prior mental health disorders, women who had abortions had a 130% greater likelihood of experiencing substance use disorders.
- The Coleman meta-analysis found that women who had abortions had a 110% greater likelihood of alcohol use/misuse and a 230% greater likelihood of marijuana use.
- The 2025 study by Auger et al. found that women who had abortions were more than 150% more likely to be hospitalized for substance use than were women who gave birth.
Depression and anxiety
- The Bodunde meta-analysis found that abortion was associated with a 49% greater likelihood of depression and a 43% greater likelihood of anxiety.
- The Coleman meta-analysis found a 37% greater likelihood of depression and a 34% greater likelihood of anxiety.
Suicide
- Studies from the United States, Italy, and multiple studies from Finland have found that women who have abortions have suicide rates approximately two to six times that of women who give birth.
- A study by CLI scholar David Reardon surveyed nearly 2,000 American women and found that women who had abortions were twice as likely to report having attempted suicide. They were also significantly more likely to attribute their suicidal feelings and actions to their pregnancy outcomes.
- The 2025 study by Auger et al. found that women who had abortions had approximately twice the risk of being hospitalized for a suicide attempt compared to women who gave birth.
Does abortion help mental health?
Much of the debate focuses on abortion’s capacity to harm mental health, but abortion access is often justified based on the assumption that abortion can improve mental health. In 2013, Fergusson reanalyzed the studies included in Coleman’s 2011 meta-analysis and the Academy of Royal Medical Colleges review to answer a slightly different question: does abortion offer mental health benefits? He found that contrary to improving mental health, abortion was associated with small increases in women’s risk of anxiety, substance abuse, and suicidal behavior. Ultimately, Fergusson concluded that “there was no evidence to suggest that rates of mental health problems were lower in women having abortions than in comparison groups of women having unwanted pregnancies. This conclusion held for all studies, all authors and all outcomes considered, irrespective of variations in study quality.” Still, he noted that one study comparing women who had abortions to women who were refused abortion found that women denied abortion had worse outcomes and proposed that as an avenue for further research.
When Fergusson published his study in 2013, the “Turnaway Study” was already underway to investigate the consequences of receiving or being denied an abortion. Researchers compared women who had abortions with those who were “turned away” for being past the gestational limit of the abortion center. The Turnaway study has been criticized for its biased, unrepresentative sample and high drop-out rate, but the findings are often interpreted as showing that while abortion does not harm women’s mental health, being denied an abortion can. However, the study itself does not demonstrate lingering mental health harm from not receiving an abortion. In a study of mental health outcomes five years after getting an abortion or being turned away, the Turnaway group initially experienced higher depression and anxiety at week one. But mental health outcomes quickly evened out, and by five years out, the Turnaway group had similar outcomes to women who had first-trimester or late-term abortions. Furthermore, the study does not enable a clean assessment of the risks associated with abortion versus live birth because approximately 40% of the original Turnaway group had a prior abortion. Perhaps most striking, the Turnaway study found that by five years, 96% of women “turned away” were glad they had kept their pregnancies.
Unwanted abortions and mental health problems
A growing body of research indicates that women who have unwanted abortions may be particularly at risk for subsequent mental health problems. A 2023 study by Reardon et al. found that only 33% of women described their past abortions as “wanted,” compared to 43% who described their abortions as accepted but inconsistent with their values and preferences, 14% who said their abortions were unwanted, and 10% who felt coerced. Only women who had wanted abortions described positive emotions and mental health. Unwanted abortions that were inconsistent with or contrary to women’s values and preferences were associated with negative emotions and poor mental health. Another 2023 study by Reardon et al. found that feeling pressured to have an abortion was correlated with negative emotions, life disruption, and a decline in mental health.
Putting the research into context
Empirical research regarding mental health outcomes related to abortion, whether positive or negative, is an important part of the discussion of abortion, abortion-related policy, and informed consent. However, the relative significance of any such results must be properly contextualized by several points that go beyond empirical data. First, it must be noted that the intrinsic moral quality of abortion is independent of how women who obtain abortions might or might not feel after having undergone an abortion. People might experience positive subjective feelings after having engaged in an action that objectively makes them worse off, morally speaking. Conversely, people might experience negative subjective feelings after having engaged in an action that objectively makes them better off, morally speaking. Second, women’s feelings and emotions about abortion may change over time as they are shaped by life experiences that may give them a new perspective on their pregnancy outcomes (whether on their abortion or their decision to carry to term what may have initially been an unwanted pregnancy). Finally, for those who do end up suffering from mental health problems subsequent to an abortion, these problems need not have the last word: healing and hope are available through support groups, counseling, and spiritual communities ready to embrace and help women suffering in this way.
