The health sequelae of abortion are surrounded by enormous controversy, as indicated by the recent article by David Reardon and associates1 and Brenda Major's related commentary.2 My colleagues and I have also obtained evidence that women's well-being is adversely affected by abortion. We found that Canadian women who had had an abortion were significantly more likely to experience diminished well-being in the postmenopausal years than those who had not.3
However, both research studies (that of Reardon and associates1 and our own3) must be interpreted with caution. Many will rush to conclude that it is the abortion procedure itself that is associated with psychological harm resulting in mental illness or diminished well- being. These studies appear to provide evidence that women who have abortions are significantly less likely to experience health and wellness in the short- and long-term compared with women who have not undergone this procedure. Yet from the data in these studies, it is impossible to determine whether it is the procedure, the life circumstances or demographic profiles of women seeking abortion, or concomitant medical factors more commonly found in women seeking termination of pregnancy that predispose the women to poorer health outcomes. Surely those on both sides of the debate would agree that more research is needed to explore these questions.
Because the abortion debate is highly charged and clouded with ideological, political, religious and economic influences, it is sometimes difficult to objectively determine what is factual and credible scientific information and what represents sexual and philosophical ideology. The medical and academic communities are becoming aware that “researcher neutrality” may well be an oxymoron. CMAJ is to be commended for allowing both sides to present their evidence. With such open debate, it is less likely that the truth will be stretched for theological or philosophical reasons or that factual evidence will be dismissed or negated for ideological and political reasons.
Stephen Genuis Physician Edmonton, Alta.
References
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