(LifeSiteNews) — Nearly 40 percent of women who have suffered pregnancy loss, either through abortion or miscarriage, report continuing intense grief even 20 years afterward, according to a recently published study.

The remarkable finding comes from a study of pregnancy loss grief published on Monday, which randomly surveyed American women in their early 40s. The study categorized post-abortive women according to the degree to which they wanted or accepted their abortion.

The highest percentage of women reported that the abortion was accepted but inconsistent with their values (35.5%), followed by women who wanted their abortion (29.8%), women who did not want their abortion (22.0%), and women who were coerced into getting an abortion (12.7%).

The 70.2 percent of women who reported the abortion as inconsistent with their values, unwanted, or coerced had significantly higher risk of prolonged intense grief, known as prolonged grief disorder (PGD) or complicated grief. It is “marked by a failure to transition from acute grief to integrated grief … and may negatively affect physical health, relationships, and daily functioning,” according to the study.

Women who were coerced into abortion had the highest risk of PGD, at 53.8 percent, and women who reported they wanted their abortions had the lowest risk, at 13.9 percent.

A whopping 39 percent of the women with any kind of pregnancy loss reported that “the worst of their negative feelings persist an average of 20 years after their loss,” highlighting the need to educate women on the mental health risks of abortion.

High levels of grief were also associated with disruptive occurrences such as intrusive thoughts, nightmares, flashbacks, and overall “interference with daily life, work, or relationships.”

When this grief follows abortion in particular, it is often exacerbated by guilt and may also be prolonged by an unwillingness to discuss it in counseling or with a confessor, pastor, or spiritual director. As the study notes, “Case studies have shown that many women, even those seeking mental health care, are hesitant to disclose their abortion histories unless they are specifically invited to do so.”

The research supports another study published in September, “Persistent Emotional Distress after Abortion in the United States,” which found that seven million U.S. women suffer severe post-abortion emotional distress.

Both studies refute the often-cited “Turnaway Study” claim, based on a non-representative abortion facility sample, that any post-abortion distress a woman may have is mild and disappears after about two years.

In fact, “women with long-ago abortions were just as likely to be distressed as were women with recent abortions. Like a traumatic event such as sexual abuse, for some women distress did not manifest until later, and for many persisted, even grew, often for decades,” the author of the September study, D. Paul Sullins, told LifeSiteNews via email. “Distressed post-abortive women expressed several of the clinical indicators of post-traumatic stress syndrome (PTSS).”

The studies also challenge the factual basis for “therapeutic abortion” – the claim that abortion typically improves the mental health of women with problem pregnancies – which is the basis for thinking of the practice as a form of “health care” and for its legal justification in many jurisdictions.