Study: Abortion in First Pregnancy Linked to Much Higher Use of Mental Health Services

For Immediate Release: July 10, 2023
Contact: [email protected]

Difference Not Explained by Prior Mental Health History

Washington, D.C. – Women whose first pregnancy ends in abortion have much larger increases in mental health treatment compared to those who had a live birth, according to a recent peer-reviewed study of Medicaid claims data from a team of Charlotte Lozier Institute experts. Moreover, these women were less likely to have a prior history of mental health service utilization, suggesting that the abortion contributes to the difference.

The interdisciplinary research team analyzed claims data for more than 4,800 Medicaid-enrolled women over a 17-year period, in seven states where state taxpayer funds were used to pay for abortions and where all claims for the whole period were submitted. By doing so, the team avoided the limitations of surveys that rely on self-reporting, such as low participation, loss to follow-up, and recall bias. The study, published in International Journal of Women’s Health, is the first to take a comprehensive view of mental health services on an outpatient versus an inpatient basis following abortion.

Compared to women whose first pregnancy was a birth, higher rates of use were observed for women whose first pregnancy was an abortion in three mental health service categories:

• Outpatient visits – 3.4x more likely to increase.
• Inpatient hospital admissions – 5.7x more likely to increase.
• Days of hospital stay – 19.6x more likely to increase.

Lead author James Studnicki, Sc.D., a veteran public health scientist and CLI’s vice president and director of data analytics, noted studies from Finland, Italy, China, Germany, Korea and the United States have all linked abortion with an increased risk of adverse mental health outcomes including anxiety, depression and suicide.  “Some researchers insist that any limits on abortion to protect mothers and children create ‘mental health harms,’” said Studnicki. “Our study using years of claims data adds to an extensive body of international, peer-reviewed science showing the opposite – abortion itself has a significant negative impact on several measures of mental health.”

Tessa Longbons, Lozier’s senior research associate and a co-author of the study, added:

“The evidence is clear that abortion of a first pregnancy is associated with substantial mental health harms to women. Women have a right to know this and to understand the extent of these harms before they make such a life-changing decision.”

“A Cohort Study of Mental Health Services Utilization Following a First Pregnancy Abortion or Birth” was authored by Dr. James Studnicki, Tessa Longbons, Dr. John Fisher, Dr. David Reardon, Dr. Ingrid Skop, Dr. Christina Cirucci, Christopher Craver, Dr. Maka Tsulukidze, and Dr. Zbigniew Ras.

Lozier Institute researchers were the first to utilize 17 years of anonymized Medicaid claims data to identify each woman’s first pregnancy outcome – birth, abortion, or natural loss – and then trace the outcomes of every subsequent pregnancy. An earlier study in the series found that women whose first pregnancy ended in abortion had more pregnancies, more miscarriages, more than four times as many abortions, and only half as many live births as women whose first pregnancy ended in a live birth.

The Institute’s Unwanted Abortion Studies have found that the majority of women with a history of abortion report high levels of pressure to abort, describing their abortions as unwanted, coerced or inconsistent with their own values and preferences, which in turn is strongly associated with a self-described decline in mental health. More of the Institute’s studies are accessible via the peer-reviewed section of our website at LozierInstitute.org.

Charlotte Lozier Institute was launched in 2011 as the education and research arm of Susan B. Anthony Pro-Life America. CLI is a hub for research and public policy analysis on some of the most pressing issues facing the United States and nations around the world. The Institute is named for a feminist physician known for her commitment to the sanctity of human life and equal career and educational opportunities for women.

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