Phil B.FontanarosaMD, Deputy EditorStephen J.LurieMD, PhD, Fishbein Fellow
In Reply: I concur with Dr Eapen that adoption is an important option. In the 1980s my colleagues and I published a guide to adoption for clinicians.1 Women with unwanted pregnancies routinely receive counseling about adoption; the patient discussed in this Clinical Crossroads article considered and rejected this option.
Eapen makes several incorrect assertions about abortion. The notion of posttraumatic stress disorder after abortion lacks a scientific basis.2,3 Eapen's citation for guilt and depression is more than 2 decades old and from another country. She cites only 1 study (out of 6 published to date) to assert that abortion increases the risk of ectopic pregnancy. When the distorting effects of cigarette smoking and prior sexually transmitted infections are taken into account, well-controlled studies show no measurable increase in the risk of ectopic pregnancy after 1 or more induced abortions.3 Again, Eapen turns to data from another country to cite a high rate of infection, which is inconsistent with extensive experience in the United States.
Grimes DA. Abortion and Unplanned Pregnancy—Reply. JAMA. 2000;283(12):1566-1567. doi:10.1001/jama.283.12.1566-JLT0322-12-1