We Cannot Be Silent about the Misleading “Silent No More” Campaign
By Linda J. Beckman, Ph.D.
January 3, 2003

In late November I received an e-mail forwarded from the Elliot Institute News about a new post-abortion awareness campaign called "Silent No More," orchestrated to coincide with the 30th anniversary on January 22nd of the legalization of abortion in the United States. Women who have had abortions that they perceived as harmful would be brought together at state capitols and in Washington, D.C. to speak out about their abortion experiences. While I strongly support women's right to relate their personal experiences, I am deeply concerned by some of the irresponsible statements and distortions of the prevalence of negative mental health effects of abortion made by the campaign organizers.

Georgette Forney, a co-founder of the campaign believes that "very little attention is given to the women who have actually had abortions." Because she regrets having had an abortion she has come to the conclusion that there are millions of women who feel the same way and are suffering in silence about the aftermath of their abortions. It is regrettable that Ms. Forney may have suffered as a result of her abortion. Still she needs to read the reputable research literature on the psychological effects of abortion before she makes incorrect statements about such effects for most women. A relatively large body of research on the psychological effects of abortions strongly supports the conclusion that abortion has positive or neutral rather than negative psychological outcomes for the majority of women (For reviews see Adler et al. 1990, 1992, Russo & Denious, 2000.) Abortion is one of the most common and safest surgical procedures performed in the U.S.; it has been estimated that by age 45, 43 % of all women in the United States will have had an abortion (Henshaw, 1998). Although more than 39 million abortions have occurred in the U.S. since 1973 (Facts in Brief: Induced Abortion, Alan Guttmacher Institute at: http://www.guttmacher.org/pubs/fb_induced_abortion.html), few women report a negative psychological aftermath.

Whereas Ms. Forney speaks as an individual, Dr. David Reardon, another campaign organizer, presents himself as an expert in post-abortion research. He claims that legalization creates a false impression that abortion is a safe procedure that benefits women and that "legal abortion might be causing even more harm to women than illegal abortions had." Such assertions are particularly dangerous precisely because they are cloaked in the guise of scientific expertise. What does the scientific evidence actually tell us? Millions of U.S. women and their providers can attest to the fact that abortion is a safe and generally beneficial procedure. We also know undeniably that abortion is safer and less stressful for women when it is legal, readily available, and can be accessed without harassment from antiabortion picketers.

Reardon also contends that legalization has "made it easier for men to pressure women into unwanted abortions." Yet, I know of no scientific evidence that men are more likely to pressure women into abortions now than in the past when abortion was illegal in the United States.

Finally, the organizers of this questionable campaign ignore much that has been learned in the field of public health since the late 1800s. A public health approach to women's health examines the relative risk and benefits of a procedure, realizing that all medical procedures involve some risk. This notion of risk perhaps is seen most clearly in the use of vaccines to prevent epidemics of diseases such as measles and smallpox. Some people will get sick and some may even die when they are inoculated with a vaccine but at the same time a deadly disease can be prevented for many more, sometimes hundreds of thousands of others. In contrast to many other procedures, legal abortion entails very minimal physical and psychological risk. Over a million women a year have an abortion in the U.S. without any noted negative psychological outcomes.

I do not deny that some women, most usually those with preexisting psychological and emotional problems and/or ambivalence about having an abortion, can be psychologically harmed by the abortion. We need to do all we can to prevent these outcomes by knowing who is most at risk and instituting effective counseling programs for them. The number of women so affected, however, is extremely low compared to the millions of women who have had legal abortions without negative psychological sequelae or have experienced positive psychological outcomes and enhanced life circumstances after an abortion. The distortion of the facts by the organizers of the "Silent no More" campaign is disturbing to say the least. Such misleading information can subvert the informed consent process, influence women to have unwanted births and jeopardize women's mental health. (For a discussion of issues involving informed consent see Russo and Rubin, http://www.prochoiceforum.org.uk/psy_coun11.php).

Allen Guttmacher Institute (2001). Fact sheet: Induced abortion. http://www.guttmacher.org/pubs/fb_induced_abortion.html

Adler, N. E., David, H. P., Major, B., Roth, S., Russo, N. F., & Wyatt, G. (1990). Psychological responses after abortion, Science, 248, 41-44.

Adler, N. E., David, H. P., Major, B., Roth, S., Russo, N., F. & Wyatt, G. (1992). Psychological factors in abortion: A review, American Psychologist, 47, 1194-1204.

Henshaw, S. K. (1998). Unintended pregnancies in the United States. (1998). Family Planning Perspectives, 30, 24-49, 46.

Russo, N.F, & Denious, J. (2000). The socio-political context of abortion and its relationship to women's mental health. In J. Ussher (Ed.). Women's health: Contemporary international perspectives, London: British Psychological Society (pp. 431-439).