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Abortion and mental health: guidelines for proper scientific conduct ignored

Published online by Cambridge University Press:  02 January 2018

Gail Erlick Robinson
Departments of Psychiatry and Obstetrics & Gynaecology, University of Toronto, Ontario, Canada. Email:
Nada L. Stotland
Rush Medical College, Chicago, Illinois, USA
Carol C. Nadelson
Harvard Medical School, Boston, Massachusetts, USA
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Copyright © Royal College of Psychiatrists, 2012 

Coleman presents her conclusions as ‘an unbiased, quantitative analysis of the best available evidence’ concerning the adverse mental health consequences of abortion. Reference Coleman1 Huge numbers of papers by respectable researchers that have not found negative mental health consequences are ignored without comment. Not surprisingly, over 50% of the ‘acceptable’ studies she uses as her ‘evidence’ are those done by her and her colleagues Cougle and Reardon. The work of this group has been soundly critiqued not just by us Reference Robinson, Stotland, Russo, Lang and Occhiogrosso2,Reference Major, Appelbaum, Beckman, Dutton, Russo and West3 but by many others as being logically inconsistent and substantially inflated by faulty methodologies. As noted by the Royal Society of Obstetricians and Gynaecologists, 4 the authors consistently fail to differentiate between an association and a causal relationship and repeatedly fail to control for pre-existing mental health problems. We note that Coleman did not include in her articles the publication by Munk-Olsen et al in the January 2011 New England Journal of Medicine, Reference Munk-Olsen, Laursen, Pedersen, Lidegaard and Mortensen5 which concluded that

‘the rates of a first-time psychiatric contact before and after a first-trimester induced abortion are similar. This finding does not support the hypothesis that there is an overall increased risk of mental disorders after first-trimester induced abortion’.

Indeed, the draft position statement of the Royal College of Psychiatrists concludes that when researchers control for wantedness of the pregnancy and pre-existing mental health problems, there is no increase in mental health disorders following an abortion. That same document, currently being finalised, is very critical of the methodology of the studies by Coleman and her colleagues. The ‘unbiased nature’ of most of the studies Coleman has used in her analysis and the Declaration of interest stated as being ‘none’ must be taken with a large grain of salt. Reardon, the leader of this group, has clearly expressed his rhetorical strategy as ‘we can convince many of those who do not see abortion to be a “serious moral evil” that they should support anti-abortion policies that protect women and reduce abortion rates’. Reference Reardon6 He has stated that ‘I do argue that because abortion is evil, we can expect, and can even know, that it will harm those who participate in it. Nothing good comes from evil’. Reference Reardon7 These authors have a clear agenda and publish a steady stream of papers, based on faulty methodology, designed to prove their point. If we and other researchers know this, how is it that reviewers for esteemed journals such as yours consistently fail to recognise these deficiencies and biases?


1 Coleman, PK. Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009. Br J Psychiatry 2011; 199: 180–6.CrossRefGoogle ScholarPubMed
2 Robinson, GE, Stotland, NL, Russo, NF, Lang, JA, Occhiogrosso, M. Is there an ‘abortion trauma syndrome'? Critiquing the evidence. Harv Rev Psychiatry 2009; 17: 268–90.CrossRefGoogle ScholarPubMed
3 Major, B, Appelbaum, M, Beckman, L, Dutton, MA, Russo, NF, West, C. Report of the APA Task Force on Mental Health and Abortion. American Psychological Association, 2008.CrossRefGoogle Scholar
4 Royal College of Obstetricians and Gynecologists. RCOG statement on BJPsych paper on mental health risks and abortion. RCOG, 1 September. 2011.Google Scholar
5 Munk-Olsen, T, Laursen, TM, Pedersen, CB, Lidegaard, Ø, Mortensen, PB. Induced first-trimester abortion and risk of mental disorder. N Engl J Med 2011; 364: 332–9.CrossRefGoogle ScholarPubMed
6 Reardon, DC. A defense of the neglected rhetorical strategy (NRS). Ethics Med 2002; 18: 2332.Google ScholarPubMed
7 Reardon, DC. A defense of the neglected rhetorical strategy (NRS). In Proceedings of the University Faculty for Life Conferences, Life and Learning XII – 2002: 7796. University Faculty for Life, 2003 ( Scholar
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