The XX Factor

Republican Doctors Are More Likely than Democrats to Say They’d Discourage Abortion Care

“Oh, and by the way, you probably shouldn’t have any more abortions.”

Katarzyna Bialasiewicz/Thinkstock

In nearly half of U.S. states, laws force doctors to give medically inaccurate information to women seeking abortions. Right-wing state legislators have pushed these laws through to discourage women from going through with abortions by giving them an exaggerated picture of fetal development or telling them that abortion increases a woman’s risk of breast cancer and suicide, which it doesn’t.

A new study from Yale University suggests that even doctors who don’t provide abortions and aren’t compelled by law to offer misinformation against it may bring anti-abortion politics into the exam room. Researchers found that Republican doctors were twice as likely as Democratic ones to say they’d discourage a patient who’d had two abortions in five years from having any more abortions and bring up “the mental health aspects of abortion”—even if the patient wasn’t pregnant.

Advertisement
Advertisement
Advertisement
Advertisement

The report, in this month’s issue of Proceedings of the National Academy of the Sciences, analyzes responses from a survey of 301 doctors who were asked to evaluate nine patient scenarios and rate on a scale from one to 10 how likely they’d be to respond in given ways to each patient. Researchers didn’t ask for the physicians’ political views, but matched their names to voter registration records to get their party affiliations. Three of the vignettes in the survey involved politically-charged topics—abortion, guns, and marijuana. These were the only scenarios that elicited significantly different responses from Democratic and Republican doctors in terms of treatment plans and levels of “concern.”

When presented with a hypothetical non-pregnant 28-year-old patient who’d had two abortions in five years with no medical complications, Republican doctors found the patient’s history more “concerning” than Democratic ones and were twice as likely to say they’d proactively discourage the patient from having any more abortions. (In this case, survey respondents who rated this move in the one-to-five range on the scale were “unlikely” to take the action, and those who rated it in the six-to-10 range were “likely” to do it.) Registered Republicans were 35 percent more likely than their Democratic peers to say they’d mention the “mental health aspects of abortion,” too. Co-author Matthew Goldenberg told the Daily Beast that the survey made this phrase as nonspecific as possible to allow physicians to interpret it however they’d like.

Advertisement
Advertisement
Advertisement

In a way, it doesn’t really matter what they took “mental health aspects of abortion” to mean: There’s no scientific evidence to show that abortion has any negative impact on a woman’s mental health. The American Psychological Association has reiterated time and again that there is no connection between a single elective abortion and mental health problems in adult women. Studies on women who’ve had multiple abortions, like the patient in the Yale study scenario, have been “more equivocal,” according to the APA’s 2008 report. But the APA posited that any links between multiple abortions and negative mental health consequences may have more to do with factors that predispose women to both recurring unwanted pregnancies and mental health problems (poverty, a history of abuse, existing mental illness, lack of access to education and health care). Other studies have shown that women who have abortions have a more positive outlook on life and are more likely to have and achieve aspirational life plans than women who are denied the medical procedure.

Advertisement
Advertisement
Advertisement

So, unless these doctors are saying, “hey, just FYI, there’s no science behind any claims of mental-health consequences related to those abortions you had,” raising “mental health aspects of abortion” with a patient means giving her misinformation to scare her out of future abortions. Asking a patient if she needs contraception is perfectly fine; almost every general practitioner who sees female patients does that as a matter of course. Telling a non-pregnant patient that she shouldn’t have any more abortions—essentially shaming her for the two she’s already had—is medically unnecessary, politically motivated, and antithetical to a philosophy of medical care that centers each individual patient’s needs. “Our study suggests that [patients] may need to be aware of their physician’s political worldview, especially if they need medical counsel on politically sensitive issues,” the Yale authors wrote in their report. With all the barriers to reproductive health care women already face, it’s a shame that they might have to dig up their doctor’s voting records to see if they’re getting sound medical advice.

Advertisement