Conversations about abortion should leave room for honest questions about mental health. One frequently cited study using California Medi-Cal records reported a higher rate of suicide deaths among women who had abortions compared with women who delivered. Understanding that finding requires looking at both the numbers and the study’s limitations.
What the Researchers Found
Published in the Southern Medical Journal in 2002, the study linked California Medi-Cal records for 173,279 women who had an abortion or delivery in 1989 with death certificates from 1989 through 1997.
In Table 3’s comparison of women with one known pregnancy, researchers reported:
| Pregnancy outcome | Suicide deaths | Suicide deaths per 100,000 women over eight years |
|---|---|---|
| Abortion | 11 | 62.0 |
| Delivery | 13 | 23.9 |
After adjusting for age, the reported relative risk was 2.54—equivalent to a 154% higher relative risk. The 95% confidence interval was 1.14–5.67, indicating considerable uncertainty around the estimate.
These figures represent approximately 0.062% versus 0.024% over eight years. They are not annual rates, and “2.54 times the risk” does not mean 2.54% of women died by suicide.
Does This Mean Abortion Caused the Deaths?
The study established an association, not causation. Its records lacked information including marital status and complete reproductive histories. The authors themselves acknowledged that abortion history could be a marker for other stress factors.
The American Psychological Association’s review also identified limitations in this research, including uncertainty about the direction of the relationship: women with poorer health could have been more likely to have abortions. A comparison between groups cannot, by itself, separate the effects of abortion from differences that already existed between those groups.
Making Room for Support
A woman should be able to discuss difficult feelings surrounding an abortion without having her experience dismissed or treated as inevitable. Research statistics cannot tell an individual woman how she will feel.
For a support service, the practical message is to take emotional distress seriously, make professional mental health referrals accessible, and offer space for women to describe what they need. Doula support can accompany that care; it does not replace treatment for depression or suicidal thoughts.
Why I Encourage Women to Consider Celibacy
As a doula, the association reported in this study is one reason I encourage women to entertain the idea of celibacy. I am speaking specifically to women who are freely and voluntarily choosing to have sex. This encouragement does not apply to experiences of sexual assault, coercion, or reproductive abuse, for which a woman is never at fault.
This study did not examine celibacy or establish that it prevents suicide. My encouragement is a personal perspective, not a medical conclusion from the research. Each woman deserves accurate information, freedom to make her own decisions, and compassionate support regardless of her choices.
Pregnancy can be a life-altering experience for a woman, affecting her body, relationships, finances, and future. That is why I encourage women who are voluntarily choosing sex to consider how they want to protect against pregnancy until they feel ready and willing to become pregnant. Birth control can substantially reduce the chance of pregnancy, but no contraceptive method is 100% effective, and effectiveness varies by method and how it is used. Celibacy is another option to consider—a way to honor your boundaries, your timing, and the life you want for yourself.
Sources
Deaths Associated With Pregnancy Outcome: A Record Linkage Study of Low Income Women — PubMed
Reardon et al., Southern Medical Journal, August 2002; 95(8):834–841. Records examined: 1989–1997.
American Psychological Association: Report of the Task Force on Mental Health and Abortion
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