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 Psychological Effects 
There is a general perception that women are liberated by abortion.
However, the attempt to “get rid of” a problem, often produces problems of its own.
There is no such thing as a simple uncomplicated abortion,
because abortion is always the disruption of the psycho-biological process of pregnancy
and always involves the loss of a child, albeit unborn.
The trauma involved in being both attached to, and responsible for
the death of one’s foetal child can be emotionally overwhelming.(1)
Dr Julius Fogel, a psychiatrist and obstetrician who has performed
hundreds of abortions himself said: One is dealing with the life force.
It is totally beside the point whether or not you think a life is
there. You cannot deny that something is being created and that this
creation is physically happening… Often the trauma may sink into the
unconscious and never surface in the woman’s lifetime. But it is not as
harmless and casual an event as many insist… A psychological price is
paid. It may be alienation; it may be a pushing away from human warmth,
perhaps a hardening of the maternal instinct. Something happens on the
deeper levels of a woman’s consciousness when she destroys a pregnancy.
(2)
Regardless then of how a woman views the developing baby growing inside
her or experiences her pregnancy, there is a sense there exists a
primitive bond between mother and child, which although not able to be
glimpsed from the outside is a profound attachment that may seem
shadowy and submerged even to her. If this was not the case, having an
abortion would not be more difficult than having a tonsillectomy or
appendicectomy.(3)
There are physiological changes associated with the disruption of an
otherwise normal pregnancy, and sudden hormonal changes can create mood
swings and bodily upsets in the early stages after an abortion, as with
any pregnancy loss. Termination of pregnancy for health reasons or for
foetal abnormality can be complex and mourning may be complicated.
Significant distress may be experienced, particularly for women who
suffer post-operative complications necessitating further treatment
and/or hospital admission, those who experienced a high degree of
ambivalence about the pregnancy, moral conflict over the abortion
decision, or pressure to abort the baby.
In the absence of initial complications, the short term effect of an
abortion is often relief - the operation is over and there is no longer
a need to face the unwanted or difficult pregnancy with all the
accompanying distress and subsequent responsibilities. This may be
“followed by a period psychiatrists identify as emotional “paralysis”,
or post-abortion “numbness.” (4) Psychological defences, such as denial
and repression of feelings, tend to come into action fairly quickly, to
cope with the stress and changes incurred in the decision making
process, living through the actual procedure, the recovery and
adjustment period afterwards, relationship issues and other aspects.
Some women may experience acute and severe reactions. Others appear to
adjust well to the loss incurred in the abortion and it would not
appear to impact greatly. Some have no identifiable symptoms and show
few negative reactions initially, but are at risk of developing
symptoms of at some future stress point (often a new pregnancy,
inability to conceive or complete a pregnancy, or some other major loss
or crisis). Many women are suffering emotionally from a procedure which
was supposed to be emotionally benign.(5)
References:
1. Complicated Mourning: Dynamics of Impacted Post Abortion Grief, Anne Speckhard, PhD, and Dr Vincent Rue, PhD, Pre-and Perinatal Psychology Journal, 1992
2. Aborted Women: Silent No More By Dr David C Reardon, Loyola University Press, 1987, p141
3. Complicated Mourning: Dynamics of Impacted Post Abortion Grief, Anne Speckhard, PhD, and Vincent Rue, PhD, Pre- and Perinatal Psychology Journal, 1992, p2
4. Bereavement in Post-Abortive Women: A Clinical Report, presented at the annual meeting of the Canadian Psychiatric Association, Kent, et.al., Saskatoon, Sept. 1977
5. Giving Sorrow Words, Melinda Tankard Reist, Duffy & Snellgrove, Sydney, 2000
6. Post-traumatic stress disorders in women following abortion: Some considerations and implications for marital/couple therapy, D. Bagarozzi, Internat. Journal of Family and Marriage 1:51-68, 1993; The Long Term Psychosocial Effects of Abortion, C. Barnard, Institute of Pregnancy Loss, Stratham, New Hampshire, 1990. Also refer Hanley et al. 1992.
ABORTION LOSS AND TRAUMA
There is a spectrum of abortion loss and a spectrum of abortion trauma.
Loss
incurred may not be just about the baby loss. There may be a myriad of
losses experienced including: loss of a role and identity, loss of a
dream and life plan, loss of innocence, loss of relationship e.g. with
partner, loss of confidence and trust, loss of self esteem or sense of
self worth. Whatever changes and losses a person may incur through the
abortion experience many people will need to journey through grief at
some point.
Trauma
associated with an abortion may be minor, moderate or severe.
Researchers suggest that women can report abortion-related distress at
some point after their abortion. Only a small percentage of women will
develop an actual Post Traumatic Stress Disorder (PTSD), symptoms of
which may only be triggered later in life. Most women who experience
abortion trauma will encounter feelings of horror or terror at the time
of the abortion, relating to either the actual procedure or how they
were treated by people. Some women may deny having had an
abortion, and others may not recognise or acknowledge any trauma
relating to the event. This denial can be a significant contributing
factor to the development of post traumatic stress.(6)
In 1987, the American Psychiatric Association stated in its then
newly revised manual of diagnostic criteria, the Diagnostic and
Statistical Manual of Mental Disorders III-R (DSM-III-R), that abortion
is a type of ‘psychosocial stressor’ (an event outside the range of
usual human experience) of the type capable of causing ‘post-traumatic
stress disorder’. Interesting that it was removed as a recognised
stressor in subsequent editions of the manual, which may have more to
do with politics than reality. Certainly for a small percentage of our
clients PTSD is part of their experience post abortion. It doesn't
matter what the pattern of symptoms is labeled the important thing is
to be aware of and acknowledge when dealing with post-abortive women
that their symptoms and experiences are real, and provide appropriate
counselling and support to manage what is being presented.
Abortion Related Post Traumatic Stress Disorder (PTSD)
The following pattern of symptoms consistent with PTSD are sometimes experienced in relation to abortion
1. Re-experiencing the trauma
- nightmares, flashbacks, recurrent dreams (of the abortion, the baby or death)
- anniversary reactions (on date of abortion or expected date of delivery)
- distress at exposure to events that resemble some aspects of the
abortion (pelvic examination, sexual intercourse, childbirth, sound of
vacuum cleaner)
2. Avoidance or denial type behaviours
- avoiding thoughts or feelings about the abortion
- avoiding situations or activities that cause thoughts of the
abortion (medical examinations/procedures, exposure to babies or
pregnant women, conversations about pregnancy or abortion....)
- memory blocks or inability to recall aspects of the abortion
- emotional numbing, withdrawal from others
3. Increased arousal
- sleep disturbances e.g. insomnia
- irritability or outbursts of anger
- difficulty concentrating
- hypervigilance e.g. being watchful, on the alert, suspicious
- exaggerated startle response - on edge, jumpy, overreactive
GRIEF AFTER ABORTION
Post Abortion Grief - does it affect you? (A Checklist of questions for you to see if you may be affected by grief from an abortion)
Every mother or father of an aborted child knows the truth - their
children are gone forever and cannot be brought back or replaced. There
will always be a void in their lives - a void made more painful by
memories and regrets, and dreams of what their child might have been.(1)
Grief is a normal, natural, healthy process, of acknowledging and
experiencing our real feelings about and adjusting to living with any
significant loss. Expressing painful and hurtful feelings helps to
release you from them and relieve the pain they induce. Gradually as
you move through the feelings, you become less overwhelmed by them and
they lose some of their power over us. Some of the feelings may never
go away entirely, but the power they have over you and your life will
diminish.
After an abortion, it is not unusual after an initial sense of
relief, you might plunge into an unpleasant, painful place of
distressing feelings and confusing thoughts. Life takes a dip. With
awareness of the loss you may sink down and feel overwhelmed. The dip
can take you down into a mix of feelings e.g. sadness, hurt, anger,
guilt, fear... which may be experienced very intensely, over and over,
and mixed together over time. This ebb and flow of feeling can be
distressing, and many people try to avoid going through it. However,
the only way through is through, if you are to find new features to
give your life meaning and direction.
Even though an abortion decision has seemingly been your ‘choice’
and a voluntary decision, the reality of the loss of the baby through
the termination of the pregnancy, often evokes feelings of sadness and
grief, which may be expressed immediately following the abortion as
distress, or may be suppressed. If you hang on to the feelings they may
begin to consume you - you may internalise the feelings and they become
more and more who you are, or they may manifest as physical symptoms.
Unexpressed feelings, such as anger, may manifest as depression,
affecting sleep patterns, appetite, energy levels, libido, ability to
concentrate, motivation.... or anger may be expressed outwardly, and
sometimes inappropriately, at others.
The perception of loss of a pregnancy is individual, and the
experienced impact of the loss of a baby through abortion varies from
person to person. The significance of that loss may not be uncovered
until the healing process has begun and grief is expressed.
Understanding the process of grief then, is about understanding the
significance of the loss for the self, and what it means. If you
experience the abortion as particularly traumatic, or feel that your
personal boundaries have been violated, or feel abandoned... and if
your grief becomes impacted, the process of recovery may be prolonged
and complicated.
Abortion grief may only surface when another significant change or
trauma occurs in your life. Conversely, other unresolved grief issues
may surface, and need to be dealt with in conjunction with the abortion
grief.
Grief is a process and can take time. Sometimes the grief process
may begin, but is not completed as you become stuck at a particular
point. It can feel particularly difficult to get past the feelings of
guilt and anger if these dominate your heart. Before grieving can be
fully entered into you need to confront your guilt and deal with anger.
You need people who can be there for you, listen to your confusion,
tolerate your feelings, and who will give you ongoing support.
Sometimes it is helpful to talk to someone uninvolved who has special
skills of listening and caring.
I lament the death of my baby
I feel empty inside
Overwhelmed by a sort of haunting sadness....
Why didn’t anyone ever tell me
that grief felt so like fear,
and that I would cry
more than I would laugh..
I never dreamed it could be so painful -
It all feels so unreal, and it’s like
Going through the motions quite disembodied.
Now my baby is gone, my partner is gone,
and I am alone......
WESTBERG'S JOURNEY THROUGH GRIEF
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Shock & denial - These mechanisms help you to absorb your
sense of loss without being totally overwhelmed. There may be a
feeling of numbness and sense of moving like a robot or disembodied
feeling. You may not remember much of events surrounding the abortion
or immediately following.
-
Immediate expression of feelings - Pain & sadness (tears), anger, fear... are not uncommon.
-
Disturbances in physical functions - Bottling things up and holding
the pain in can increase the stress in our bodies e.g.
gastro-intestinal disturbances, problems sleeping, headaches, abdominal
pain....
-
Depression & panic - All is dark and gloomy, life feels like a
nightmare, it may be hard to cope, you may question "Is life worth it?"
-
Guilt - Tormenting yourself about failings, regrets and feelings of
remorse may happen and keep happening until you begin to address what
really happened in the abortion and what is meant for you.
-
Anger, resentment, rage - These feelings and emotions need to be
expressed and may relate to feelings of being let down, betrayed,
abandoned.... You may feel you need to come to forgive before being
able to turn the corner.
-
Idealisation - Holding the past as best and convinced life cannot be
good again. When your energy is locked into what was, could have been
or should have been, there is less energy available to develop the
future positively.
-
Realisation begins to dawn - When you are able to see the weakness
of the past situation and accept the bad with the good you can begin to
hope again.
-
New patterns begin to emerge - Here there is some new thinking and
new routines, finding new reasons to get up and go on with everyday
life.
-
Living with the loss - There has been significant adjustment to the
loss and the loss becomes part of the fabric of life and integrated
into the self. At times feelings of sadness or fear may cause
disruption but life begins to hold new meaning and you are functioning
well.
References:
1. Men and Abortion, Grief and Healing, Brauning, Dr Wayne, Post Abortion Review, Vol 4, No.4, Fall 1996
2. Adapted from Good Grief, a Constructive Approach to the Problem of Loss, Granger E. Westberg
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