|
|
Perceptions And Misperceptions Around Post Abortion Experience
The abortion was supposed to deal with the problem of the unwanted or unplanned pregnancy yet there may be regret, guilt and grief. And everyone is caught up in dealing with it and surviving as best they can.
When working with woman after abortion I am struck and moved by the mix of emotions, perceptions, expectations and confusion that can occur both for the woman herself and those around her.
“The abortion would render me normal and get things back the way they were - but things don’t feel like they did before I became pregnant.”
“People expect me to get over it and get on, and don’t seem to understand or care about what really happened or the pain I am in now.”
Everyone’s scenario is different, however, by the time people come for help they are often at a loss or desperate, because they have not been able to speak about what it was like then and is like now for them afterwards.
Some women will experience feelings of grief, loss or depression immediately after their abortion, but the majority probably feel relief. Often there is so much stress and tension beforehand, around the decision and having the abortion, that the finality of it being over invites release of that stress and tension. It is done, ended, it is time to put it all behind her and go on with her life.
However, for many, the relief is temporary. For the seeds may already be planted for future stress. Unresolved memories and feelings about the decision can impact her in subtle ways in terms of her self esteem, her view of the world and be played out in her life and relationships without her conscious awareness. The abortion can become a source of pressure that may erupt years later in unexpected ways.
Dr Julius Fogel, a psychiatrist and obstetrician who personally performed over 20,000 abortions observed:
“Every woman, whatever her age background or sexuality has a trauma at destroying a pregnancy. A level of humanness is touched. This is a part of her own life. When she destroys a pregnancy, she is destroying herself. There is no way it can be innocuous.... Often the trauma may sink into the unconscious and never surface in the woman’s lifetime.”
Dr Fogel goes on to say that a psychological price is paid. “It may be alienation; it may be 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. I know that as a psychiatrist.”
It can be hard for the post-aborted woman to share her true feelings after her abortion. When those around ask how she is feeling immediately afterwards any expression of relief or being okay is quickly interpreted as meaning that she will be “fine” with it forever, which is not necessarily true.
Subsequent doubts or regrets or grief may be trivialised or ignored. Sharing delayed negative feelings may make others uncomfortable and this may be communicated to her in subtle and not so subtle ways. The message she hears explicitly or implicitly is “Just remember why you did it. It was the best thing” or “Get over it. You have your whole life ahead of you” or “Don’t stir up the past. Focus on the future”.
Such comments shut her down and shut her in upon herself, alone and silenced. These messages effectively reinforce the prevalent social perception that abortion is ‘no big deal’ and the expectation is imposed on the woman after abortion that it shouldn’t be a big deal.
If she expresses distress afterwards, it may be dismissed as a temporary mood that will soon go away. This is what others hope and expect because they too want things back to normal or may simply find it hard to know how to respond.
Many women develop facades and live out a pretence
when inside they are crying or hurting.
This they may see often only later through the healing process. But we need to recognise that the pretence may be a means of survival and a way to keep others happy though it goes to perpetuating the misperception around post-abortion experience and reinforces denial.
Friends and relatives also often pass their perception or expectation to other women considering an abortion with assurances like “ Sally had an abortion. It was no big deal. She’s fine.” How do they know for sure that she is fine? How do they know her fears... her memories... her inner reality?
The reality of what happened and what it meant for her “self” doesn’t go away and as with other unaddressed traumas or issues in people’s lives it seeks expression and resolution. This as we know may occur when another crisis hits or the appropriate situation arises when she is “ready” to share her experience, and where she feels someone empathetic is listening who will take her seriously.
We endeavour to share with people our knowledge and experience working with women after abortion and steps for healing so that more people will be alert to the needs and be able to respond to those in their sphere who may be vulnerable and hurting after an abortion. What are your (mis)perceptions around post-abortion experience? Are you ready and able to respond positively to someone close to you or who comes to you for help in your work place or practice?
- by Carolina Gnad
Inspired by “Forbidden Grief: The Unspoken Pain Of Abortion” by Theresa Burke with David C. Reardon.
NO PLACE TO TURN
One great difficulty faced by women and men who are burdened by the weight of a past abortion is that they are afraid to reveal to others the secret grief they feel over an abortion. They fear the reactions of those who are pro-choice and those who are pro-life.
They are afraid that those who defend abortion will scoff at their need to grieve. After all, if abortion is “no big deal”, if what they aborted was not really their child, why should they grieve? Some abortion defenders would even consider such grief irrational.
On the other hand, they are afraid that if they share their grief with those who condemn abortion, they themselves will be subjected to condemnation. They can just imagine their pro-life friends gaping at them with horrified expressions, saying “How could you ever do such a thing?” They not only fear losing the respect of their pro-life friends, they also fear that such rejection will only intensify their feelings of guilt and loss.
What post-aborted women and men
really want, and need is to be understood.
They need their grief to be
acknowledged and authenticated.
They need the opportunity to
share their grief with people
who will respect their pain,
not turn it into a political statement.
If we want to be a community of healers, then, we must not allow our political or philosophical views of abortion to push away those who are suffering from post-abortion grief. Those who are pro-choice must not deny that there is anything to grieve about when a child is lost through abortion. And those who are pro-life must not treat an expression of post-abortion grief like an opportunity to say “I told you so.”
Both sides of this political debate must simply make room for those who need to grieve. This grief is authentic and meaningful. It must be met with compassion. Not with excuses or condemnations, but simply with compassion and understanding, which are the keys to emotional healing.
(Excerpts from “The Jericho Plan: Breaking Down the Walls Which Prevent Post Abortion Healing” by David C Reardon.)
Men and Abortion
Men’s scenarios are many and varied, but there is no denying that the father is a key figure in the abortion story. His role is often assumed or overlooked, his feelings not acknowledged.
Some men, whose female companion, lover, friend, partner, spouse is having an abortion, may worry “Will she be okay?” Others wonder “How did we get into this mess?” And some think “I never want to be here again, never!” Some have no clue what the effects will be of pressuring a woman to have an abortion and some don’t care. But others do care. Men are in the unenviable position of being damned if they support a woman to have an abortion and damned if they don’t.
Many men, who want to support their partners, either out of duty or genuine concern, are waiting-room fathers, nervous silent and passing time. They may experience feelings of helplessness, fear, powerlessness, loneliness, guilt and sadness.... For some there is confusion - a father is supposed to protect and provide for his family and he has failed; a father is called to love his offspring but he cannot or is forbidden to.
The man may percieve his experience as emotionally insignificant compared to the woman’s ordeal, or he may feel responsible for putting her through this physical and emotional trauma, or he may want to ensure the problem is dealt with so life can return to normal for everyone. The man is supposed to be strong and staunch and focused on the problem and is expected to sort it out and cope. Yet many are traumatised by the abortion experience and have their own grief to work through, which may be unexpected or delayed.
Many men deny themselves permission to feel the emotions they may experience as there is a strong taboo around acknowledging and sharing these deep and personal feelings with others. This is the case, even more so than for women around their abortion experiences.
(Inspired by “Men and Abortion: Lessons, Losses and Love”, Arthur B. Shostak, Praeger, 1984)
Abortion Can Take Heavy Mental Toll
Reprint of Letter to the Editor, Christchurch Press - 5 Jan 2006
The outcomes of the study by Dr David Fergusson (The Christchurch Press January 4) linking abortion and mental health problems is not surprise to those working in the area of post abortion recovery and counselling.
Anecdotal evidence has long supported the claim that there can be significant psychological impacts for women, including symptoms of post-traumatic stress, depression, anger, relationship problems and increased substance abuse.
In medical and counselling spheres, abortion loss is still not widely acknowledged or spoken about. Although abortion has become socially acceptable, abortion grief is still disenfranchised and the attendant stigma and shame often prevents women reaching out for help.
There is definitely a need for further research in New Zealand into short and long-term psychological complications of abortion as post-abortion stress could become a leading mental health problem is not properly addressed.
Most importantly, the need is to hear women’s stories, accept that their post-abortion experiences are real and support their healing.
- Carolina Gnad
Post-abortion Grief and Spiritual Group Intervention
Are there merits to faith-based support for those experiencing post abortion shame and trauma, or does religion and spirituality compound their issues as some would claim?
I recently received a copy of an article from a study, undertaken at the University of South Florida, entitled “Post-abortion Grief: Evaluating the Possible Efficacy of a Spiritual Group Intervention.” (1)
The primary purpose of the study was to determine if a spiritually based grief group intervention decreases shame and other symptoms related to PTSD in women who are experiencing PAG. A second purpose was to identify specific aspects of the intervention that may have been helpful or not helpful for a woman with PAG.
The study used the Impact of Event Scale-Revised (IES-R) which includes the Hyperarousal Subscale, and the Internalized Shame Scale (ISS) pre- and post-intervention. The outcomes indicated that a time-limited, spiritual group intervention resulted in clinically significant improvement in reduction of shame and PTSD (Post Traumatic Stress Disorder) for women experiencing PAG (Post-abortion Grief). 80% reported that their religious belief and spirituality played a strong role in resolving their PAG.
It stated that the actual percentage of women negatively affected by an abortion remains unknown and that some women with symptoms of post-abortion grief would not be amenable to a spiritual intervention. However, for the women in this particular study improvement in well-being was achieved, and many attributed their satisfaction to the use of spirituality in the healing process.
Whether the majority of women do or do not experience significant emotional problems after abortion is perhaps debatable, but there is no doubt that some women do experience significant problems, and maybe more do than we (as individuals, health professionals and a society) care to realise.
Abortion as a death event goes to the core of human experience. It makes sense then that for deep healing to occur spiritual aspects need to be attended to. Post-abortion grief is still largely unrecognised and untreated, and those who experience such grief often find themselves alone or unsupported in mourning the perceived loss of their child.
Unlike most forms of grief, post-abortion grief is elusive; there is no burial, no photos, and no outpouring of sympathy from others to provide comfort and facilitate closure. This lack of recognition may convey to the woman that her PAG is unjustifiable, which over time can perpetuate her silence and delay her mourning.
Faith-based agencies and spiritually based intervention are designed to address PAG and to integrate spirituality into the healing process enabling a more holistic approach. What might some of the other benefits be in providing spiritually based support? Can religion have a therapeutic role?
One unique value of the psychoeducational post-abortion spiritual groups is that members share and validate the perception and experience of loss, provide peer support, offer unconditional acceptance, and accept spirituality and spiritual healing as important. The group members can become a community for the women to openly mourn and process their grief in a safe, supportive environment. The use of rituals such as writing letters to their babies, using visualisations, and reading affirming Bible scripture are indicated to be helpful.
Group facilitators have observed that many of the participants could accept God’s forgiveness and forgiveness from others and extend forgiveness to others, but self-forgiveness is a common obstacle. If not reconciled this can seriously disrupt the process of PAG resolution. For forgiveness to be really effective it has to go beyond an intellectual exercise; it has to be a heartfelt choice made by the individual, and for a person of faith, a heartfelt choice made in relationship with God.
PAG groups typically offer a scheduled format, and some may later form into self-help groups. Similar to other support groups, facilitators are usually trained professionals of volunteers with professional supervision. There is a recognition of the significance of emotional and spiritual pain associated with abortion loss and the need to attend to spiritual concerns of those with post-abortion grief.
The debate and politics surrounding abortion often means little attention is given to the area of risk assessment and treatment for PAG. Some research has shown that women appearing at higher risk for PAG include adolescents, women with second trimester abortions, abortions for medical reasons, and coerced abortions. Women will not speak out about their experiences when faced with a blanket social denial nor will they seek help and understanding that is not forthcoming. Furthermore they will not seek spiritual support and or gain spiritual healing if our secular treatments do not address their post-abortion grief at that very deepest level.
- Carolina Gnad
(1)
Post-abortion Grief: Evaluating the Possible Efficacy fo a Spiritual Group Intervention
, by Susan Dyer Layer, Cleora Roberts, Kelli Wild, Jan Walters, Research on Social Work Practice, Vol. 14 No. 5, September 2004, Sage Publications
|
P.A.T.H.S.
Newsletter Excerpts - 2006
