The Physical and Psychological Impacts of Abortion on Women

Abstract

Although abortion remains a highly divisive topic in the sociopolitical spheres, the public has little knowledge concerning the associated risks to women’s health. This study seeks to improve understanding and knowledge by studying the physical and psychological effects of abortion.

This study applies a qualitative approach, including a review of the existing primary and secondary sources on the nature of abortion and the effects it may have on a female organism, interviews with healthcare professionals dealing with abortion cases and women who have experienced abortion. The study analyses abortion as a medical procedure and discusses the changes it triggers in a female organism at the cellular, genetic, and chemical levels, the negative impact of the procedure on women’s physical and mental health, and the problems it may cause in the future. Also, the study provides statistical data on abortions in the United States and an economic analysis of the issue. Based on these findings, suggests a number of solutions that can prevent detrimental outcomes and risk factors. Since abortion is vital in many cases and involves saving the mother’s life, it is crucial to ensure it remains legal. However, restricting access to those necessary cases can protect the public unaware of these consequences.

The Physical and Psychological Impacts of Abortion on Women

According to World Health Organization (2021), annually, around 73 million abortions take place in the world. For centuries, women have been fighting for their right to take full control of their bodies and decide whether they want to become mothers. The factors making women have abortions differ dramatically. Some of them take such a step for medical reasons, some – for economic ones, while some women realize they are not psychologically ready to become mothers. Whatever pushes a woman to have an abortion, it is always a stressful and difficult decision. More than that, though nowadays it is considered a common health intervention and is on the list of essential health care services in many countries, abortion is still a subject of numerous disputes both in the public and the medical community. Pregnancy is a complex phenomenon that triggers many processes in the woman’s body, and, by having it terminated, a female organism needs time to recover. Besides, abortion is associated with many economic, legal, and medical problems. While some people focus on its moral aspect and discuss the rights of women to have control over their bodies and the right of a fetus to live, scholars mostly focus on the impact of abortion women, namely her mental and physical health. The problem is that, while deciding to have an abortion, many women are unaware of the risks they are likely to face both before and after the procedure and the problems to which the latter may lead them in the future. There are several types of abortions available to women, but all of them may have a range of negative impacts on women’s mental and physical well-being they may face both while preparing for the procedure and after it. Within the current debate about the legality of abortions and the reproductive rights of women in the United States, restricting abortions and increasing women’s awareness of the adverse effect of this widespread medical procedure is essential because it may not only lower the number of abortions but also help women to prepare for the procedure and, in such a way, mitigate the negative impact mentioned above.

Relevance of the Problem of Abortions

Many women nowadays participate in the battle for their reproductive right to make abortions because they want to be in full control of their own bodies. At the same time, many women who decide to make an abortion do not know the potential risks to their mental and physical health that can seriously impact their future lives. As Zareba et al. (2020) state, abortion may cause post-traumatic stress disorder, depression, and relationship issues, depending on the reason, medical method, pregnancy term, and other variables. These aspects have made the relevance of the topic of abortion risks and the control of the reproductive rights of females even higher lately. Abortions in the United States should not be fully banned but they should be restricted and effectively controlled because this procedure is risky for women’s organisms and mental health. The intended goal of the further study is to provide a deeper clarification of the physical and psychological risks of abortions for female patients, even if the procedures are performed by skillful and competent doctors, and the proposition of effective changes to the legal system on the basis of the data from published scientific resources and qualitative interviews with gynecologists, female activists, women with abortion experiences, and politicians. The attempt to determine these aspects of the topic and educate female patients looks important in the context of the recent debate about the legality of abortions and the reproductive rights of women.

Abortion as a Medical Procedure

Medical abortion is a routine medical procedure, but its safety depends on the conditions in which it is performed and the term at which the pregnancy is terminated. It is safe if performed by a medical professional following the protocol recommended by World Health Organization and using the methods appropriate to the pregnancy duration term (“Abortion,” 2021). Annually, 61 percent of unwanted pregnancies and 29 percent of all pregnancies are terminated with abortions (“Abortion,” 2021). About half of all abortions occur in low-income regions, and 97 percent of them are medically unsafe (“Abortion,” 2021). However, this problem can be avoided by promoting abortion treatment that is accessible, safe, cheap, respectful, and timely, which is critical for public health and human rights protection. In 2020, the World Health Organization (WHO) presented a list of priority healthcare services, and comprehensive abortion services were on it. Since abortion is a widespread medical procedure, it can be performed by various doctors, which makes the procedure available to more women. Currently, there are two main types of abortions recommended by the WHO: those performed using medication or those performed through a surgical procedure (“Abortion,” 2021). A medical abortion is one that a woman can perform herself, or at least partially, at home within the first 12 weeks of pregnancy. To do it, the woman should take a special pill given to her by a healthcare specialist and follow all the provided instructions. Medical abortions are considered relatively safer and have fewer negative effects on women’s health. Another type of abortion is surgical abortion which should be performed by a professional in-clinic. Regardless of the type of abortion women choose, they need access to comprehensive, reliable information, high-quality abortion management, and post-abortion care.

Cellular and Genetic Effects of Abortions

Pregnancy is a complex process that triggers a chain of hormonal and physiological changes in a woman’s organism. Numerous genes regulate cell division and proliferation. The process through which a cell duplicates itself is called the cell cycle (Peterson et al., 2013). Fetal cells migrate to the mother during gestation, and, over time, they can merge with the mother’s cells. Even as the child grows older, his or her cells continue to exist within the mother’s body. A miscarriage or an abortion can also result in microchimerism. Because of it, approximately 50 percent of pregnancies do not succeed. Fetal cellular microchimerism measures taken before and after a miscarriage or the end of pregnancy reveal significant fetal cell transfer (Peterson et al., 2013). Fetuses whose pregnancies were terminated via surgery had a higher prevalence of microchimerism than those whose pregnancies were terminated with medication. Fetal microchimerism has the potential to significantly affect women’s health due to the high incidence of miscarriage and the prevalence of fetal genetic abnormalities that occur during these events (Peterson et al., 2013). There was a case when male DNA was discovered in a lady who had never given birth, revealing a peculiar biological reality. Scientists realized she had an abortion after questioning her about the presence of Y chromosomes in her brain (“What Happens After an Abortion,” 2018). The DNA from the aborted kid was detected in the mother, leading researchers to conclude that he was a boy. In such a way, it does not matter if a kid is born alive or not; the cells will be retained by the mother anyway (“What Happens After an Abortion,” 2018).

Chemical or Biological Issues Associated with Abortions

After the placenta separates from the uterine lining, the pregnancy is over. The hormones of a pregnant woman are disrupted when the placenta separates after delivery. However, returning to the pre-pregnancy state could be a lengthy process. Therefore, pregnancy tests can be positive even after a woman has had an abortion. Breast and nipple discomfort is also a standard early indicator of pregnancy after fertilization. Progesterone and estrogen levels shift in the first three months of pregnancy, preparing the body for breastfeeding. The breasts, the genitalia, and possibly a few other body parts are all affected by the fluctuation in hormone levels that occurs during menstruation (“What Happens After an Abortion,” 2018). It may take a few weeks for the woman’s body to recover after an abortion. Besides, the hormonal shifts occurring in the woman’s body after the procedure may cause her to have postpartum depression, extreme exhaustion, guilt, anger, and numbness (“What Happens After an Abortion,” 2018). Postpartum hormones are also essential for getting new moms to latch on and nurse their newborns (“What Happens After an Abortion,” 2018). Breastfeeding begins immediately once a pregnancy ends, regardless of the reason. If the pregnancy continues through the abortion attempt, the mother is more likely to be able to breastfeed. Colostrum is the initial milk produced by a mother during pregnancy. This, in addition to the woman’s weight gain, enlarges her breasts during pregnancy. A woman whose pregnancy is terminated may keep producing colostrum regardless of the fact she does not have a baby.

Negative Impact of Abortions on Women’s Physical Health

Abortions, especially unsafe ones, are also associated with many risks to women’s physical health. In particular, in developing countries, abortions are a major cause of maternal death and morbidity. The main danger is an infection that may develop if standard pre-op procedures, such as hand washing, using surgical gloves, thorough sanitizing, and using sterile tools, are not taken (Sajadi-Ernazarova & Martinez, 2019). The same thing can happen if the patient already has an existing infection, such as cervicitis or endometritis. The uterus can become swollen with blood if the sperm and eggs are not eliminated. As a result, the uterus swells and contracts too much, triggering bleeding. In addition, it may lead to an infection or possibly sepsis (Sajadi-Ernazarova & Martinez, 2019). Injuries such as wounds in the vaginal or cervical area or harm to the uterus, intestines, or bladder may also occur during surgical medically unsafe operations. Gerds et al. (2016) state that “the most common side effects/health problems reported by women following an abortion … were: pain (4% and 3%), cramps (3% and 3%), abnormal bleeding (2% and 2%), and nausea/vomiting (1% and 3%)” (p. 57). In case the abortion attempt fails and a woman keeps carrying her pregnancy, “abnormal bleeding, anemia, blood transfusion, life-threatening eclampsia, extended postoperative wound healing, fractured pelvis, hypokalemia, infection, postpartum hemorrhage, and retained placenta” are also common (Gerds et al., 2016, p. 57). Besides, abortions that are followed by complications increase the risk of miscarriages and infertility in the future.

Negative Impact of Abortions on Women’s Mental Health

There are many dangers linked to abortion that might compromise the mental health of the person having one. First, an unplanned pregnancy may cause emotional and mental strain in the time leading up to the decision to have an abortion (Kotta et al., 2018). Further, the reasons for having an abortion can psychologically affect women’s health. After both therapeutically induced and elective abortions, the mother may feel shame or guilt or harbor beliefs that her neglect or actions are to blame for the decision to have an abortion. Besides, abortion operations are typically accompanied by feelings of loss, sorrow, and despair (Reardon, 2018). Some women also experience anxiety and depression following abortion procedures. Even if a woman approaches the issue from a pro-choice perspective, post-abortion counselors claim that she may still endure maladjustments (Reardon, 2018). Unsolved issues following an abortion can result in mental health crises. While all women may experience distress after abortion, some women have a higher risk of experiencing negative outcomes. Pregnancy losses, isolation, disagreements over choices, strong moral convictions, and insufficient counseling before the abortion are all variables that might increase the likelihood of undesirable results (Reardon, 2018). Therefore, the identification of risk factors related to negative outcomes is necessary to provide more counseling before and after abortion to at-risk women.

There are several factors influencing the abortion decision that also impact the outcome of the procedure on women’s well-being. In particular, elective abortion is associated with fewer adverse consequences on women’s psychological state than therapeutically induced abortions (Kotta et al., 2018). Further, the stage of pregnancy at which the latter is terminated also affects the outcomes of abortion. Late abortions relate to higher risks of psychological distress than early abortions (Kotta et al., 2018). Besides, social, institutional, and legal reactions to abortion contribute to the creation of an environment that stigmatizes abortions. An abortion stigma relates to the belief that abortion is socially unacceptable or morally wrong. Among women seeking an abortion, this stigma can manifest through shame, fear, negative attitudes toward abortion, and feelings of guilt (Keefe-Oates et al., 2019). It, in its turn, hinders women’s access to safe abortions, restricts conversations and access to information about abortion, and propagates confusion about the legal aspect of the procedure. At the same time, women who have access to counseling services may talk about their worries and overcome any abortion-related shame they may feel (Keefe-Oates et al., 2019). Contrary to a popular belief, women are regularly coerced by family members, partners, or employers into having abortions (Reardon, 2018). It is challenging to conduct randomized controlled studies on this problem due to the unethical nature of such investigation. Forcing women to get abortions would be necessary to obtain data for this kind of research. At the same time, voluntary participation in abortion studies solely relies on self-selection, which does not represent the entirety of the population of women undergoing abortions. Consequently, the results of studies investigating the effects of forced and voluntary abortions are subjective. Factors like the prior mental health problems of the women, limited access to social support, and internalized abortion stigma can increase women’s risk factors for experiencing adverse outcomes after abortion.  Adequate counseling before and after abortion is necessary to address these issues and support access to safe abortion among women.

Mathematical/Analytical Perspective of Inquiry

It is challenging to conduct high-quality studies on the frequency of induced abortions because of the social and political sensitivity of the topic (“The Economic Cost of Abortion,” n.d.). The research on the health effects of unsafe abortions is also limited for the same reasons. Therefore, there are significant holes in the data about abortion rates and associated mortality (“The Economic Cost of Abortion,” n.d.). There is a severe issue with underreporting that makes it challenging to study the problem. For example, many women who have had abortions lie if asked about it in a survey (“The Economic Cost of Abortion,” n.d.). It is also unclear whether or not abortion data from these surveys are accurate for all women since underreporting varies for different types of women (“The Economic Cost of Abortion,” n.d.). The abortion rates based on personal interviews with women are, therefore, likely to be erroneous and underreported.

The Economic Issues Involved

Research from the “Women’s Policy Research” has estimated that, since 2021, state and municipal governments are likely to spend $105 billion annually to compensate for the effects of abortion restrictions. These prohibitions discourage women from working and earning money, increase absenteeism and job turnover, and reduce overall economic participation (“Abortion Rights Are Economic Rights,” n.d.). Adverse economic outcomes also include increased vulnerability to poverty, decreased opportunities for full-time employment, increased instances of late payments, and chronic financial distress. Millions of women stand to lose everything if Roe v. Wade is reversed (“Abortion Rights Are Economic Rights,” n.d.). In particular, women living in the states with “targeted regulation of abortion providers” (TRAP) legislation are less likely to advance to higher-paying positions because of this (“Abortion Rights Are Economic Rights, n.d.).

Besides, restricting abortion rights at the state level would hurt the economy and make life more difficult for women and their families (“State Abortion Bans Will Harm Women and Families’ Economic Security Across the US,” n.d.). The Supreme Court, in the case “Dobbs v. Jackson Women’s Health Organization,” reversed “Roe v. Wade” that, over the preceding fifty years had protected the right to abortion, on June 24, 2022 (“State Abortion Bans Will Harm Women and Families’ Economic Security Across the US,” n.d.). “Roe v. Wade” also ensured the availability of a lifesaving medical procedure for women. Further, it facilitated women’s participation in the labor force and academic success, making it easier for them to provide for themselves, their families, and their communities (“State Abortion Bans Will Harm Women and Families’ Economic Security across the US,” n.d.).

Meanwhile, political forces advocating abortion banning claim that this procedure is economically harmful to the state and women. According to The Republican Joint Economic Committee, in 2019, abortion cost the state $6.9 trillion (32% of GDP) (“Abortion Rights Are Economic Rights,” n.d.). The Committee members also estimate that abortion costs society 425 times more than mothers’ earnings throughout pregnancy (“Abortion Rights Are Economic Rights,” n.d.). Mothers lose $26,000 during the first six years of their children’s lives. All abortions in 2019 might save women $16.2 billion in lost wages over the next six years. The JEC estimates that soon abortion will cost $6.9 trillion, excluding societal expenditures, outweighing its financial benefits. Besides, abortion is considered to slow down economic growth, innovation, and workforce participation (“Abortion Rights Are Economic Rights,” n.d.). However, the following approach considers abortion exclusively as an economic problem and disregards all other factors forcing women to terminate their pregnancies.

The Solution to the Problem of Abortions

Abortion is a potentially dangerous procedure to a woman’s health, but its banning can have even more negative consequences. According to WHO, in countries where abortions are severely restricted or forbidden, the number of abortions remains the same, but most of them are medically unsafe, which even increases all the risks (“Abortion,” 2021). The criminalization of abortions does not solve such problems as the lack of access to high-quality healthcare, stigmatization, and lack of support for women willing to have abortions, but only intensifies them. Instead, the main priority of the state should be to increase the awareness of women of the possible negative consequences of abortions for their mental and physical health. Women should not only be able to have access to reliable evidence-based information on abortion, its effects and risks, and contraceptive methods, but also to get professional support and care before, during, and after the procedure. 

Conclusion

All things considered, abortion, though being a widespread medical procedure, is rather dangerous for women’s mental and physical health, and informing women about these risks is the main tool for protecting them. As a matter of fact, a woman may experience the negative impact of abortion on her well-being when she makes a decision to terminate her pregnancy and prepares for the procedure. In particular, at this stage, she can experience severe stress, a sense of hesitancy, fear, anxiety, and even develop a depressive disorder. Intensified by social pressure, stigmatization, and the lack of support from her dear people, these problems may also negatively impact the woman’s physical health, leading to the development of numerous illnesses. More than that, when unsolved, all the psychological problems mentioned above may lead women to a mental health crisis after the abortion. The medical procedure can be very stressful for the woman itself and is frequently followed by a sense of guilt, which makes her very vulnerable and impacts all spheres of her life. Besides, the post-abortion period is associated with a great number of risks for women’s physical health. Depending on the term at which the pregnancy is terminated, the conditions in which it is carried out, and the qualification of the healthcare worker, women may experience such problems as hemorrhages, sepsis, pregnancy losses, and infertility. All these factors may considerably deteriorate women’s life quality. Therefore, it is essential for the state not only to provide women with access to high-quality healthcare but also to raise awareness about all the risks associated with abortions and the outcome they may have on women’s lives. Even in case a woman has solid reasons to terminate her pregnancy, this knowledge will allow her to prepare herself for the procedure psychologically and physically and choose the safest method of abortion.

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