Sir, Research published in The Journal of Child Psychology and Psychiatry in January has shown that even women without past mental health problems are at risk of psychological ill-effects after abortion. Women who had had abortions had twice the level of mental health problems and three times the risk of major depressive illness as those who had given birth or never been pregnant.

This research has prompted the American Psychological Association to withdraw an official statement denying a link between abortion and psychological harm.

Since women having abortions can no longer be said to have a low risk of suffering from psychiatric conditions such as depression, doctors have a duty to advise about long-term adverse psychological consequences of abortion.

We suggest that the Royal College of Obstetricians and Gynaecologists and the Royal College of Psychiatrists revise their guidance, and that future abortion notifications clearly distinguish between physical and mental health grounds for abortion.

ROBERT BALFOUR
Emeritus Consultant Obstetrician and Gynaecologist, Bridgend

PATRICIA CASEY
Professor of Psychiatry, University College, Dublin

MARJORY FOYLE
Consultant Psychiatrist, London

GREG GARDNER
General Practitioner, West Midlands

LIZ GUINNESS
Consultant Psychiatrist, Surrey

TONY LEWIS
Emeritus Consultant Obstetrician and Gynaecologist, Bridgend

LUKE PARSONS, QC
Barrister, Inner Temple, London

EVELYN SHARPE
Consultant in General Adult Psychiatry

ANDREW SIMS
Past President Royal College of Psychiatrists

PAM SIMS
Consultant Gynaecologist, Hexham

JOAN SMITHIES
Consultant Psychiatrist, Hampshire

TREVOR STAMMERS
General Practitioner, London

GORDON STIRRAT
Emeritus Professor of Obstetrics & Gynaecology, Bristol

ADRIAN TRELOAR
Consultant Psychiatrist, London

HANRI VOGELZANG
General Practitioner, London

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