||The key to moving on from the pain and loss is awareness and understanding|
Newsletter Excerpts 2006
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.
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, and 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
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 post abortion grief. A second purpose was to identify specific aspects of the intervention that may have been helpful or not helpful for a woman with post abortion grief.
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 post abortion grief (Post-abortion Grief). 80% reported that their religious belief and spirituality played a strong role in resolving their post abortion grief.
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 post abortion grief is unjustifiable, which over time can perpetuate her silence and delay her mourning.
Faith-based agencies and spiritually based intervention are designed to address post abortion grief 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 post abortion grief 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.
post abortion grief 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 post abortion grief. Some research has shown that women appearing at higher risk for post abortion grief 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.
- By Carolina Gnad
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