Some women continue to experience emotional distress decades after having an abortion, according to recent research that challenges the assumption that such effects are always short-lived.
A study published in the International Journal of Women’s Health Care examined the experiences of American women aged 41 to 45 and found that nearly 45% of those who had undergone an abortion experienced moderate to severe psychological challenges linked to the procedure, even many years later.
The research analysed responses from 226 women, drawing from a nationally weighted sample, reflecting experiences of two decades after abortion.
The study found that while the majority of participants said they experienced minimal long-term difficulty and remained confident in their decision, a substantial minority described ongoing difficulties.
Nearly half of women experienced moderate to high levels of abortion emotional distress after an abortion. Around a quarter (24.1%) reported high levels of distress. These included persistent feelings of grief, sadness, intrusive thoughts, or emotional disruption affecting work and relationships.
The study estimates that that would translate to approximately 7.5 million women nationwide, with nearly half of that group (3.4 million) experiencing multiple symptoms associated with post-traumatic stress.
Notably, the research found no clear evidence that distress diminishes with time, suggesting that for some women emotional effects may remain unresolved long-term.
The study’s author, sociologist and senior research associate at the Ruth Institute, Rev D. Paul Sullins, concluded that abortion does not consistently function as a long-term solution for emotional distress related to unintended pregnancy. Importantly, the study says that women considering an abortion should be informed at the time that they may experience persistent emotional distress.
Those findings align with a second recent major study in the Journal of Psychosomatic Obstetrics & Gynecology, which examined grief following both abortion and natural pregnancy loss, such as miscarriage or stillbirth.
That study analysed responses from 1,925 women in the same age group, making it one of the largest population-based examinations of pregnancy-loss-related grief to date.
The research found that prolonged or complicated grief is common after pregnancy loss, regardless of whether the loss occurred naturally or through abortion.
Around 39% of women reported that the most intense negative emotions linked to their loss were still present, even two decades later.
Crucially, the second study found that emotional outcomes varied sharply depending on the circumstances surrounding the abortion.
Women whose abortions were described as unwanted, coerced, or inconsistent with their personal values reported significantly higher levels of grief (about 54%) than those who said their abortions were freely chosen (nearly 14%).
In fact, women with unwanted abortions showed grief levels similar to those who experienced miscarriage or stillbirth, while those who felt pressured to abort faced the highest risk of long-term emotional harm.
Across both studies, persistent grief was often accompanied by related symptoms such as intrusive thoughts, flashbacks, and interference with daily functioning.
The findings suggest that emotional responses to abortion and pregnancy loss are highly individual and closely tied to personal beliefs, perceived pressure, and the degree of choice involved.
Researchers from both studies argue that the results highlight the need for more nuanced public discussion, improved pre-abortion screening, and greater attention to long-term emotional support.
They also recommend that healthcare and mental health professionals routinely ask patients about all forms of pregnancy loss, including abortion, to help identify unresolved grief that may otherwise remain hidden.
Rev Sullins stated in his study: “The fact that a quarter of postabortive women experienced serious long-term emotional distress suggests that, as a therapeutic strategy for resolving stress associated with undesired pregnancies, induced abortion was often unsuccessful.
"Clinicians in such settings should develop robust screening procedures to identify patients at high risk of mental health harm or emotional distress, who should be provided appropriate support and/or advised of alternatives to abortion which are less likely to result in harm.
“Research is needed to better understand the risk factors for long- term emotional distress following an abortion and to develop effective therapeutic interventions. Women considering an abortion should be informed of the possibility that they may experience persistent emotional distress.”
