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Reyah Balthazar of Toronto, Canada was five months pregnant when she had to make the difficult decision to have an abortion due to pregnancy complications that would have put her life and the life of her baby at risk.

“It was the hardest decision I ever had to make,” says Balthazar. “It has been a year now and I am still grieving the loss of my baby. I had always been pro-life, and to have to go through that procedure was traumatizing. I am still trying to come to terms with the experience.”

In Canada, abortion is legal at all stages of pregnancy. In the United States, abortion is an extremely controversial topic. Though it is legal, each state can decide at what point in a pregnancy it is illegal for a woman to have an abortion and some states like Iowa have made it illegal for a woman to have an abortion after six weeks, a time when many women do not know they are pregnant.

Adding to the controversy is the nomination of conservative federal Judge Brett Kavanaugh to the Supreme Court by President Trump whom many fear will have a negative effect on women’s abortion rights. A new NPR/PBS NewsHour/Marist poll has found that 75 per cent of Americans don’t want to see the controversial 1973 Roe v. Wade ruling by the Supreme Court overturned which made abortion legal across the country.

As the debate over abortion continues, a topic often left out of the discussion but equally as important is the mental health of women like Balthazar and others who have had an abortion.

“When I had my 12-week prenatal screening, I was given the unfortunate news after by my doctor that no parent or mother would ever want to hear,” says Balthazar. “I was notified that my pregnancy would be high risk and there were complications with the pregnancy and the baby. It was a genetic problem and the chances of the baby surviving would be low. My health and life would also be at risk.”

The evidence over whether abortions cause mental health problems in women has been mixed and controversial as pro-life and pro-choice advocates use any study to their advantage despite limitations of the study and in some cases, weak evidence.

According to a New Zealand study by David M. Fergusson, L. John Horwood and Joseph M. Boden published in the British Journal of Psychiatry, evidence over a 30-year period shows that there is a small increase in risk of women developing a mental disorder after having had an abortion. 

In New Zealand, abortion is legal only when the woman or fetus is at risk of developing physical or mental health complications. Researchers combed through the data of 534 women from the Christchurch Health and Development Study and found that women who had an abortion were 1.54 times more likely to experience mental health problems such as major depression, anxiety disorder, suicidal ideation, alcohol dependence, and illicit drug dependence than women who had not had an abortion. Researchers also found that women who had an abortion had a 30 per cent higher rate of mental health problems than the rate of mental health disorders in other women. Anxiety and substance use disorders were among the most common mental health disorders experienced by women who had an abortion.

In a Norwegian five-year follow-up study published in BMC Medicine, researchers found that women who had an abortion had significantly higher anxiety ten days, six months, two years and five years following their abortion and were more likely to experience feelings of avoidance, guilt and shame than women who had experienced a miscarriage. Abortion in Norway became legal within the first three months of pregnancy in 1978. Researchers found their results in line with other studies that showed 50 per cent of American women who had abortions experienced avoidance symptoms, and 25 per cent of American women found it difficult to be near babies. Researchers conclude that women should be provided with information on potential mental health outcomes related to having an abortion and follow-up talks by health care providers should be given to women who have had an abortion. 

Balthazar suffered an anxiety attack during the abortion and mental health problems in the days and months that ensued. She felt grateful to have been offered counselling from the hospital following the procedure.

“At first I did not want to attend because I could not face my depression. I did not want to talk to a stranger about my emotions. I was ashamed that I had to go through that procedure,” recalls Balthazar. “However, with the help of counselling, I have overcome all the sadness I was feeling inside and have now learned to accept what happened. Through counselling, I am now able to heal and go through my grief in a safe space. All parents deserve this right.”