﻿ Post Abortion Syndrome (PAS): Terminology, summary, symptoms, frequency

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Post-Abortion Syndrome:

Terminology, summary,
symptoms, & statements

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"Post-abortion syndrome" (PAS) is perhaps the most common name for serious, long lasting, negative mental health problems after an abortion. The term was first used in 1981 by Vincent Rue, a psychologist and trauma specialist in testimony before a committee of Congress. 10

Synonyms include: "post-abortion trauma," "post-abortion depression," "abortion trauma syndrome," and "post-abortion psychosis. "post-traumatic abortion syndrome," "Post-abortion stress syndrome," "PAS," and "PASS".

The Feminists for LIfe website states: "Given the relatively low risk of death, the debate about abortion has shifted to focus on the perceived mental health impacts of abortion..." 1

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Of the approximately 1.2 million abortions performed in the U.S. annually, the risk of death is about 1 in 160,000. This is lower than the risk of dying during childbirth, or having an appendectomy or tonsillectomy.

As in so many other aspects of elective abortion, the pro-life and pro-choice sides are poles apart in their beliefs about the after-effects of the procedure.

bullet Many pro-life groups conclude that a large percentage of women who have undergone an abortion experience serious depression, and massive feelings of guilt that last for years. This has been called "Post-traumatic abortion syndrome," "Post abortion syndrome," "Post-abortion stress syndrome," "PAS," and "PASS".

bullet Many pro-choice advocates agree that PAS exists, but believe that it is rare.

bullet A major longitudinal study by the American Psychological Associated was unable to detect any evidence of PAS.

bullet A review of 216 peer-reviewed articles on the subject of abortion and mental health found that: "... most well controlled studies continue to demonstrate that there is no convincing evidence that induced abortion of an unwanted pregnancy is a per se significant risk factor for psychiatric illness." 2

bullet A representative of the APA has testified before a committee of the U.S. House of Representatives that PAS does exist, but is less common than postpartum depression after a birth.

bullet A commentary in the Journal of the American Medical Association (JAMA) points to PAS as a rare post-abortion phenomenon.

PAS seems to happen primarily to women who, at the time that they had an abortion, experienced one or more of the following experiences: They


Believed that the fetus was not a human person, and changed their beliefs later.

bullet Believed that the fetus was a human person, but proceeded with the abortion anyway.

bullet Felt heavily pressured, either by family, boyfriend, husband, friends, or circumstances, into having an abortion that the didn't want.

bullet Did not received adequate counseling and information before the abortion.

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Symptoms of PAS:

One writer, 3 a pro-life PAS counselor, lists about 2 dozen indicators of PAS. These were taken from a PAS checklist developed by Anne Speckhard and Vincent Rue. Some symptoms that she included are:

bullet Appearance since the abortion of at least three symptoms related to "persistent avoidance of the stimuli associated with the abortion trauma or numbing of general responsiveness" out of a list of 8 possibilities.
bullet Appearance since the abortion of at least two symptoms from a list of 10 specific behaviors.

OCRT Note: We have serious reservations about the usefulness of checklists used in therapy and counseling. Four volunteers in our group compared our life experience over the past decade with the indicators in this checklist, and concluded that all of us are suffering from PAS. It is very likely that the checklist gave 4 false positives. One of us is a male, and none of the three female staff persons have ever had an abortion.

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Statements by various mental health associations about the incidence of PAS:

bullet 1979 to 1987: The American Psychological Association conducted an 8 year study involving almost 5,300 women, starting in 1979. The women were interviewed each year until 1987. The researchers found that the best predictor of of the women's well-being during the study was their well-being at the start of the study. Whether they had had an abortion or not during the interval covered by the study did not seem to affect their mental health. Neither did their income level, job status, educational attainment, marital status, etc. In other words, they were unable to detect the existence of PAS from this size of sample.

bullet 1989: Former Surgeon General C. Everett Koop, a famous opponent of abortion access, was asked by President Reagan to study the health effects of induced abortions. He responded in a 1989-JAN-8 letter that he could not form a conclusion from the available data. A year later, Dr. Koop told representatives of some pro-life groups that the risk of significant emotional problems after an abortion was "miniscule".

bullet 1989: A panel of the American Psychological Association unanimously concluded that legal abortion "does not create psychological hazards for most women undergoing the procedure." They found that about 21% of US adult women had experienced an abortion. If severe emotional reactions were common, then they would have expected to notice an epidemic of women seeking treatment. No evidence of such a flood of patients was observed. The Associated Press reported that:

"... for a vast majority of those who have voluntary abortions, 'severe negative reactions are infrequent in the immediate and short-term aftermath,' the study said. The greatest distress, it found, 'is likely to be before the abortion. Severe negative reactions after abortions are rare and can best be understood in the framework of coping with a normal life stress,' the study said." 4

bullet 1992: A review of an article in the Journal of Social Issues states that PAS:

"... results in partial to total cognitive restructuring and behavioral reorganization. Secondary symptoms of PAS include depression, substance abuse, sleep disorders and suicidal thoughts."

The authors of the article concluded that: "at present, it is impossible to estimate with any degree of accuracy the incidence of Post Abortion Syndrome." They urge that more research be done. 5

bullet 1995: Dr. Paul Sachdef, professor of social work at Memorial University in Newfoundland, Canada, conducted 70 in-depth interviews of women who had elective abortions during the previous 6 to 12 months. 6 They are typical of women who have sought abortions: aged 18 to 25, single, white females. All had terminated their first pregnancy during the first trimester. This is when about 90% of all abortions in North America are done. All gave mental health as their reason for seeking an abortion. He concluded: 7

bullet Two-thirds of the woman had only used contraceptives rarely or not at all.

bullet Three-fourths of the woman thought they would not become pregnant.

bullet Almost 80% "felt relief and satisfaction" soon after the abortion.

bullet Long term guilt or depression were rare.

bullet Elective abortion is less traumatic than giving a child up for adoption.

bullet Women do not lightly decide to have an elective abortion.

June Scandiffino (Toronto ON Right to Life) disagreed with his findings. She wonders about the 10% of women who declined to be interviewed. She maintains that the "Post-traumatic abortion syndrome" may not emerge until perhaps seven years after the elective abortion.

bullet 1997: The American Psychological Association further analyzed the data from the 1979-1987 study and issued a press release on 1997-JAN-31. 8They concluded:

"Data from [a] long-term study demonstrate that even highly religious women are not at significantly greater risk of psychological distress because they had an abortion."

This time they included an analysis of the woman's religious beliefs and practices - specifically:

bullet whether they were affiliated with a religious group, or were not religious.
bullet if religious, whether they attended church often or rarely.

They found that:

bullet "...having had an abortion (or more than one) had no relation with self-esteem"
bullet the "...type of religion to which women who had an abortion belonged also did not make a difference in their post-abortion well-being..."

Thus, even religious women did not appear to suffer from PAS at a detectable level. They further analyzed the data for the Roman Catholic women in the study. They found that "highly religious Catholic women were slightly more likely to exhibit post abortion psychological distress than other women..." But they suspected that this is probably explained by the presence of a lower level of well-being at the start of the study, rather than any after-effect of the abortion.

bullet 2008: The Task Force on Mental Health and Abortion of the The American Psychological Association (APA) studied all of the empirical studies on PAS published in English in peer-reviewed journals since 1989 "...that compared the mental health of women who had an induced abortion to comparison groups of women, or that examined factors that predict mental health among women who have had an elective abortion in the United States. The task force found "... no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems for adult women." They issued their draft report on AUG-14.

Brenda Major, PhD, chair of the task force, said: "The best scientific evidence published indicates that among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion or deliver that pregnancy. The evidence regarding the relative mental health risks associated with multiple abortions is more uncertain."

The task force's report noted that "... other co-occurring risk factors, including poverty, prior exposure to violence, a history of emotional problems, a history of drug or alcohol use, and prior unwanted births predispose women to experience both unwanted pregnancies and mental health problems after a pregnancy, irrespective of how the pregnancy is resolved. Failures to control for these co-occurring risk factors, the task force noted, may lead to reports of associations between abortion history and mental health problems that are misleading." They called for better designed future research into PAS. 9

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References used:


  1.  Serena, "New study debunks 'Abortion Trauma Syndrome,' Feminists for choice, 2009-AUG-24, at: http://feministsforchoice.com/
  2. Gail.E. Robinson, et al., "Is there an 'Abortion Trauma Syndrome'? Critiquing the evidence," Harvard Review of psychiatry, Volume 17, Issue 4, 2009-AUG, Pages 268 to 290. An abstract is available at: http://www.informaworld.com/
  4. "Study Finds Little Lasting Distress From Abortion," Associated Press, 1990-APR-06, at: http://query.nytimes.com/
  5. Anne Speckhard and Vincent Rue, "Post-Abortion Syndrome a Growing Health Problem," Journal of Social Issues, 1992-FALL. Available at: http://www.forerunner.com/
  6. Charlotte Parsons, "Guilt over abortion is rare...," The Globe and Mail, 1995-SEP-14
  7. Dr. Paul Sachdev, "Sex, Abortion and Unmarried Women" Unknown publisher, 1995
  8. "The American Psychological Association on post-abortion syndrome," APA press release reprinted at: http://www.catholic.net/
  9. "APA Task Force Finds Single Abortion Not a Threat to Women's Mental Health," American Psychological Association, 2008-AUG-12, at: http://www.apa.org/
  10. "Post Abortion Syndrome," Wikipedia, as at: 2010-AUG-12, at: http://en.wikipedia.org/

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Copyright © 1998 to 2010 by Ontario Consultants on Religious Tolerance
Latest update: 2010-OCT-10
Author: B.A. Robinson

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