There’s no scientific evidence that abortion causes mental health problems.

Let’s get something straight right now: You are allowed to feel however you want about your abortion. You can be relieved, happy, sad, or guilty. You can not know how you feel until much later, or ever. You can regret it. You can feel none of these things, or all of them, at once, or at some point. Your abortion is your own experience, and no one gets to tell you how to feel.

There’s a difference between having complicated and/or sad feelings about your abortion and abortion resulting in mental harm. Post Abortion Syndrome (also known as Post Abortion Stress Syndrome, or PASS) is a claim made by the anti-choice community which asserts that abortion results in irreparable damage to one’s mental health, resulting in depression, suicide, the desire to avoid children and pregnant people, after having an abortion.

Neither the American Psychological Association nor the American Psychiatric Association has granted credence to PASS.

In 2017, Advancing New Standards in Reproductive Health (ANSIRH) released the Turnaway Study, a direct response to a 1988 call by former US Surgeon General C. Everett Koop to a request for a long term study on abortion and mental health. The study concluded that abortion did not adversely affect people’s mental health, either at the time of the procedure or five years later. Being denied an abortion, however, did impact one’s mental health, resulting in low self esteem, dissatisfaction with life in general, and anxiety. In other words, there’s definitely a relationship between being unable to access abortion care and a lower quality of mental health.

Dr. Carly Snyder is a perinatal and reproductive psychiatrist. “Evidence based medicine has consistently shown that the number one emotion women experience after an abortion is relief,” she says. “There is no credible data indicating any increase in mood disorders following voluntary termination.”

You might experience sadness, especially in a situation where you wanted to be pregnant but ultimately decided to have an abortion after finding out about a birth defect or other fetal anomaly, but, stresses Snyder, these feelings aren’t induced by the abortion procedure itself.

A was 20 and studying abroad in Europe when she got pregnant, and knew immediately that she’d be getting an abortion. It was physically painful, she says, and she had anxiety about going to the gynecologist afterwards, but “I don’t even remember feeling especially sad. I always emotionally approached my abortion with a sense of contemplation — even now, I sometimes marvel at the “wow, I could have an 11 year old kid today!” thing, but it never felt traumatic.” What did cause anxiety, she says, was the fear that she wouldn’t be able to actually connect with an abortion provider, and the experiences she had being judged by the doctors she met.

Abortion stigma, a set of ideas perpetuated about abortion being dirty, dangerous, and immoral, among other things, impacts the way we feel about our abortions. It can be hard to separate the messages we’ve received about how we should feel when accessing abortion care (sad, traumatized, guilty) versus how we actually feel. The feeling of relief that many experience post abortion is seen as incompatible with the idea that people with vaginas should always welcome and anticipate pregnancy, regards of circumstances, or whether or not they actually want to become parents.

“A lot of times the sadness around abortion isn’t about the abortion itself, as PASS suggests,” says Steph Herold, a public health researcher who focuses on abortion. “It can be about the context of the abortion, what’s surrounding it, like a terrible ex, or realizing you’re not ready for parenthood. Charlotte Taft, (Former Executive Director of the Abortion Care Network) used to say that pregnancy shines a light on a person’s life and makes you examine everything that’s going on to see if you want to or are able to bring life into the world. And for some, that evaluation leads to sadness even if the abortion is the right decision.”

“I definitely had mental health effects after my abortion,” says J. “It scared me as I thought to myself, this confirms my feeling that I will be prone to postpartum depression. But it had nothing to do with feeling sad about having the abortion. I wasn’t sad about it as in losing the kid. I’m prone to anxiety and depression anyway.”

Here’s the bottom line – mental health is complicated, and there are many things in our lives that dictate how we’re experiencing the world and our own emotional landscapes at any given moment. Abortion is a medical procedure that everyone is entitled to be able to access safely and with dignity. How we feel about our abortion care is allowed to be complicated, but abortion doesn’t equal deleterious effects on our mental health – that’s a tactic used to make us feel ashamed and afraid of seeking health care. In actuality, there is no scientific evidence that abortion hurts our mental health, but plenty of evidence that abortion stigma and inhibiting access to abortion care will.

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