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Nathalia De Luna

Dr. Lindberg

ENGL 1302

4 April 2024

Abortion Stigma and Its Effects on Mental Health

Abortion has historically been a topic of contention, mainly because it can provoke strong

arguments from moral and political perspectives. However, because these discussions are so

debatable, the psychological effects of abortion are hardly discussed. For many women, the

decision to have an abortion can be incredibly complex and emotionally challenging. However,

contrary to popular belief, the development of post-abortion psychological issues is primarily

caused by the stigma associated with abortion rather than the procedure itself. By exploring

factors such as fear of being judged, pressures of motherhood, age, and first-time pregnancies

that contribute to this internalized and enacted stigma, it becomes evident how these attitudes

towards abortion profoundly influence women’s psychological well-being over time.

To begin with, it is widely believed that women who undergo abortion are at a heightened

risk of experiencing adverse mental health effects, particularly in the development of anxiety and

depressive symptoms. However, various studies have proven this notion incorrect and have

instead found that the abortion procedure itself is not a cause for long-term mental health

conditions. For example, in a study that compared the progression of anxiety and depression in

women who were denied an abortion and those who were allowed to carry on with the

procedure, it was found that over time, “Women having near-limit abortions initially had similar

levels of depression and lower levels of anxiety than women who were denied abortions and

subsequently carried their pregnancies to term” (Foster et al. 2080). In addition, these results are
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supported by Maureen Curley and Celeste Johnston’s examination of psychological distress after

abortion in students, which found that factors such as the number of abortions performed, their

timing, length of time since the abortion, or their number of subsequent gestational abortions

were not linked to higher emotional distress following the abortion (291). Ultimately, these

findings refute the concept that abortion alone can be a trigger for the development of adverse

mental health issues.

While the termination of pregnancy itself does not inherently cause adverse mental health

effects, the stigma that society places on the topic of abortion significantly influences women’s

mental health when considering or deciding to undergo the procedure. This is demonstrated in

the study conducted by Antonia M. Biggs and scholars, which found a connection between

disclosing abortion-seeking behaviors to others and an increased risk of psychological distress

(16). A potential underlying reason for this correlation is the fear of being judged by others,

which may amplify feelings of isolation and internalized stigma. Therefore, to avoid feeling

rejected by society and to lessen their emotional stress, women often feel pressured to keep their

abortions a secret. As a result, whenever individuals are unable to communicate their experiences

or look to others for acceptance and support, they may suffer from feelings of shame, guilt, and

loneliness (Biggs et al. 3). Overall, a leading cause for a rise in mental health issues when

seeking an abortion is the stigma that surrounds it and the fear of being judged.

Building on the impact of abortion stigma on women’s well-being, the pressures placed

on women regarding motherhood rise as a significant factor in the progression of psychological

distress. For instance, according to research conducted by Edna Astbury-Ward and colleagues,

because women are taught that abortion is a highly looked down upon event, they continue to

perceive it as “personally stigmatizing” long after the abortion, affecting the disclosure process
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(3137). Consequently, due to societal expectations surrounding motherhood, women may believe

that they are failures in choosing not to be mothers. This internalized stigma can lead to negative

self-perception, low self-esteem, and feelings of worthlessness, contributing to psychological

distress such as depression and anxiety. As proven in the statement from the study’s findings,

“Moreover, it has been argued that the stigma associated with abortion discourages women not

only from disclosing their experiences but also from asserting/advocating their rights to

abortion” (Astbury‐Ward et al. 3144). This statement highlights that the pressure to conform to

societal norms in this context is a pivotal cause of psychological distress.

Not only does societal stigma play a role in the development of mental health issues in

abortion, but another crucial factor that may lead to this is age. Namely, Maureen Curley and

Celeste Johnston claim that “Because of young women’s developmental stage, they are

vulnerable to a number of risk factors associated with post-abortion mental health problems”

(280). The stages of adolescence and young adulthood place young women at an unfair

disadvantage of experiencing mental health problems because of the profound changes in

identity, autonomy, and relationships during this period. However, unplanned pregnancies and

the emergence of abortion can interfere with these developmental processes, increasing stress

and causing mental distress. Curley and Johnson further support this idea by stating, “Finally,

significant psychological impairment, including higher grief, depression, and behavioral

problems, has been found in adolescents and young adults after a first-trimester abortion when

compared with the never pregnant and pregnant controls” (280). Essentially, women who

experience abortion at a younger age are more vulnerable to experiencing significant

psychological conditions as time progresses because of the developmental stages that they are at.
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In addition to this, younger women are more susceptible to suffering from negative

mental health issues in response to abortion because they are at a higher risk of experiencing

enacted stigma. According to Curley and Johnson, the reason for this is that they are more likely

to be characterized by factors such as: “single relationship status . . . lack of social support,

concealment of the unwanted pregnancy and abortion” (280). Because these characteristics are

more specific to these age groups, women under this category are at a heightened risk of

experiencing enacted stigma, leaving them vulnerable to judgment, isolation, and intensified

feelings of shame and psychological distress in the aftermath of their abortion decisions. This

vulnerability is further supported by Astbury-Ward and other scholars, who, in their study,

observed that “Younger participants appeared anxious not to “disappoint” their mothers if the

pregnancy was disclosed to them” (3141). Thus, concealing their abortion experiences reflects an

attempt at avoiding social stigma and potential disapproval from loved ones, perpetuating a cycle

of silence and contributing to the mental health challenges young women face post-abortion.

Moreover, a significant majority of abortions in young women involve first-time

pregnancies. Therefore, instances of terminating a first-time pregnancy can contribute to the

development of mental adversities following abortion. According to Curley and Johnston’s study,

the emotional toll that a first-time pregnancy abortion can have on a woman is comparable to that

of a miscarriage. For instance, they state, “Losing a pregnancy can symbolize the actual loss of a

fetus, and since the target pregnancy was the majority of the sample’s first pregnancy, it may

have greater significance” (289). Consequently, young women facing first-time pregnancy

terminations are especially vulnerable to mental adversities following abortion as they navigate

the challenging emotional weight associated with loss and transitioning into adulthood.

Furthermore, their emotional journey becomes even more difficult because of the unfamiliarity
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of being pregnant, which in turn increases stress and emotional despair. All in all, the stigma

surrounding abortion magnifies these mental health effects by adding layers of shame, guilt, and

societal judgment onto an already emotionally challenging experience, further complicating the

psychological well-being of women undergoing the procedure.

Ultimately, the conversation around abortion is frequently tainted by ethical and political

conflicts, pushing aside questions about its psychological impacts. The surgery itself is not a

direct cause of long-term mental health problems, though, as many studies have demonstrated.

Conversely, the development of post-abortion psychological distress appears to be primarily

driven by the stigma attached to abortion. This internalized and enacted stigma increases

emotions of shame, guilt, and loneliness among women seeking abortions. Subsequently, this is

influenced by several factors, including age, first-time pregnancies, maternal ideals, and fear of

being judged. The increased susceptibility of younger women is especially concerning as they

not only face more obstacles related to first-time pregnancies but are also more likely to

encounter internalized stigma.

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Works Cited

Astbury‐Ward, Edna, et al. “Stigma, Abortion, and Disclosure—Findings from a Qualitative

Study.” Journal of Sexual Medicine, vol. 9, no. 12, 2012, pp. 3137–47,

https://doi.org/10.1111/j.1743-6109.2011.02604.x.

Biggs, M. Antonia, et al. “Perceived Abortion Stigma and Psychological Well-Being over Five

Years After Receiving or Being Denied an Abortion.” PloS One, vol. 15, no. 1, 2020,

e0226417–e0226417, https://doi.org/10.1371/journal.pone.0226417.

Curley, Maureen, and Celeste Johnson. “The Characteristics and Severity of Psychological

Distress After Abortion Among University Students.” The Journal of Behavioral Health

Services & Research, vol. 40, no. 3, 2013, pp. 279–93,

https://doi.org/10.1007/s11414-013-9328-0.

Foster, D. G., et al. “A Comparison of Depression and Anxiety Symptom Trajectories

between Women Who Had an Abortion and Women Denied One.” Psychological

Medicine, vol. 45, no. 10, 2015, pp. 2073–82,

https://doi.org/10.1017/S0033291714003213.

Kitty K.C. Chan. "Psychological Aspects of Legal Abortion - a Review." Journal of the

Hong Kong College of Psychiatrists, vol. 4, no. 1, 1994, pp. 36. ProQuest,

https://go.openathens.net/redirector/tamiu.edu?url=https://www.proquest.com/schol

rly-journals/psychological-aspects-legal-abortion-review/docview/2791677197/se-2.