Sir, I read with surprise and interest Melanie McDonagh’s argument (Opinion, Aug 19) that if there remains “at least a risk that having an abortion may cause depression, isn’t there a case for warning women of this?” If women are to be warned about the risks of abortion, however slight and however contentious the research, they should surely be warned of the risks of childbirth, about which there is a fairly broad consensus.

Up to 85 per cent of women experience some affective symptoms postpartum and 10-15 per cent experience clinically significant and persistent symptoms of mood disturbance during the three months postpartum. These episodes are most common among women who have experienced previous episodes of mood disorder but also occur among women with no prior history.

The risks of infanticide and suicide are both increased by postpartum psychiatric disorder. Confidential Enquiries into Maternal Deaths 1997-1999, found that psychiatric disorder and suicide in particular were the leading causes of maternal deaths during the period studied. Suicide accounted for 28 per cent of the maternal deaths.

Most women are already aware that childbirth carries some medical risks. Nonetheless there is a case for informing a woman that the chances of her dying as a result of legal first-trimester abortion are about one in 100,000, while she is about seven times more likely to die in childbirth.

Would Ms McDonagh want to go a step farther, and have doctors remind pregnant women that there is a safer course available to them than carrying the pregnancy to term?

Leah Wallach
Clinical psychologist
Twickenham

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