One of the reasons we don't want to talk about the grief of those who have had abortions is that we, as a society, are deeply troubled by the abortion issue. While the majority believe that abortion should be legally available in some circumstances, most are also morally troubled by it. According to one major poll, 77 percent of the public believes abortion is the taking of a human life, with 49 percent equating it with murder. Only 16 percent claim to believe that abortion is only "a surgical procedure for removing human tissue." Even one-third of those who describe themselves as most strongly pro-choice still admit to believing that abortion is the taking of a human life.1
These findings suggest that most Americans put their own moral beliefs about abortion "on hold" for the sake of respecting a "woman's right to choose." This represents a pragmatic choice. As a society, we have chosen to tolerate the deaths of unborn children for the purpose of improving the lives of women.
This moral compromise is disturbed, however, when women speak about their broken hearts after an abortion. They make their listeners uncomfortable and confused. When confronted with a woman's grief over a past abortion, the uneasy pragmatist may have thoughts such as, "But it was your choice. I stood by you. I still want what's best for you. Do you want me to say you did the wrong thing or the right thing? If I say it was wrong, won't I make you feel worse? If it was wrong, was I wrong not to tell you then? If it hasn't made your life better, was I wrong to agree that it was for the best?"
Grief over a past abortion forces us to look not only at the pain of an individual, but at the angst of our society. It is a deeply complex and troubling issue. Most of us don't want to look too deeply. It's easier to change the topic.
I described above some of the emotional obstacles that make it difficult for people to listen to and comfort those who are suffering from postabortion grief. This situation is complicated even further by the politics of abortion.
Pro-choice advocates are often hesitant to recognize the reality of post-abortion grief because they fear this means they have to recognize the death of a baby, which may somehow undermine the political argument for legal abortion. Kayla described how politics stood in the way of her finding help in this way:
I contacted the clinic where I had the abortion. They did not know of any support groups to help me deal with my suicidal feelings. So I called the head of the Abortion Rights Action Group. She told me that my drive to get a postabortion group started was not necessary, and actually went so far as to imply that it might even have a very negative impact on the whole abortion situation in general! She then went on asking me how I would have handled my situation if I had decided to keep my baby and how I would be feeling now. Without any prompting or indication of any spiritual motivation in my inquiry, she also vehemently stated how violently opposed the organization was to any form of "religion" being brought into this kind of support structure.
What I want to know is what right does this tired old woman have to fight for abortion rights for women and then prescribe to them ways in which they may or may not deal with the aftermath of their hard-won victory?
Sadly, abortion proponents and many professional counselors are unwilling to acknowledge the true nature of the grieving person's dilemma, which means their advice to women and men is useless, if not outright damaging. For example, on a website sponsored by a Planned Parenthood affiliate in Illinois, women are encouraged to deal with intrusive thoughts about their abortions by deliberately practicing stuffing techniques:
You can say or yell "stop" whenever you have disturbing thoughts.... If you find yourself fantasizing too often about what the child might have been like, you should substitute another fantasy: a baby crying because you had no time to give it . . . a picture of yourself feeling angry, resentful or stressed by children you weren't ready to have.
Rather than offering comfort to the woman who is feeling the loss of her child, they encourage her to simply reinforce the "rightness" of her decision. In essence, they are telling women that the grief related to abortion can best be assuaged by constantly reminding themselves how horrible life would be if their babies were here with them today.
Would you tell someone grieving at a funeral to try and picture how awful his life would be if his loved one had survived? This advice is counterproductive in that, if it is followed, it will actually inhibit and prolong the grieving process.
When Gretta had severe emotional problems the day after her abortion, she called the clinic, hoping they would offer her help or at least refer her to someone who could.
I was extremely distraught. I almost committed suicide. When my best friend discovered what had happened, we first tried to call the clinic I had been to. A nurse called back; she was the one who had "counseled" me before my abortion. After I told her my state of despair, she proceeded to give me a lecture on using birth control. I threw the phone across the room. I was terribly sad and upset, but not so much I couldn't see her response as inexcusable.
This inability, or unwillingness, of abortion counselors to come to grips with the reality of women's pain and grief after an abortion reminds me of a telephone call from a woman named Noreen, who had heard that I ran groups for abortion recovery.
"Are you pro-choice or pro-life?" she asked in a rather determined manner. I hesitated for a minute, thinking it a bit peculiar that this was the first point of conversation. Noreen persisted. "I need to know if you are pro-choice or pro-life."
"I am a therapist," I replied. "I help women deal with their feelings. After an abortion a woman has many emotions that are difficult to talk about. I help her explore her feelings about her decision and identify how the abortion is affecting her."
There was silence on the other end of the phone.
"Is there something I can help you with?" I asked.
Noreen replied with some hesitation, "Well, we have some women who need some help . . . but we can't send them to you if you are going to make them feel guilty."
Noreen was a counselor at an abortion clinic. She epitomized the conflict of so many women: the fear that recognizing what an abortion took away will actually make the problem worse. She was cautious, as she should have been. Dealing with the reality of post-abortion aftermath is no simple undertaking. There is great fear about fully exploring one's feelings. Noreen was apprehensive about authorizing such an awareness. However, my training as a mental health professional emphasizes support of human emotion and transformation of self-defeating thought processes and behaviors. If a woman is grieving over the death of her baby, the best thing I can do is acknowledge the reality of that experience with her.
Even if an individual wanted the abortion, there can still be a deep and aching wound. I explained this to Noreen. "I can assure you that I am not responsible for how a woman feels after her abortion. If a woman feels guilt, I help her resolve it. If she feels grief, I give her permission to express it."
Noreen persisted. "I still need to know if you are pro-choice or prolife," she stated flatly. I remained silent for a moment, sad that personal ideology could prevent us from having a dialogue and dismayed that Noreen's own doctrine had the power to deny someone the help she requested.
Clearly, she wanted to respond to the frequent complaints of distress she heard and saw. But she was afraid to send women to someone who might acknowledge their loss. She wanted to see them helped only in a way that would reinforce the belief that abortion was the right choice. But the grief process cannot be completed by denying one's loss or by minimizing its significance. For many women, it is clear in their own minds that their abortions were not the destruction of tissue but the destruction of their children. Yet Noreen was afraid to refer them to a counselor who would allow them to embrace this loss under those terms.
I wondered if someone like Noreen could understand the work I did as a therapist. Could she understand the distressing experience of accompanying a woman twice my age as she uncontrollably laments the loss of her child in an illegal abortion? Could she understand the flood of emotions that are released in a post-abortion support group? Could she understand the effort involved in being awakened in the middle of the night to leave my husband and family to help a woman contemplating suicide because of an abortion? No. To Noreen, protecting her ideology was more important than helping women who might regret their choices.
I understand why Noreen and millions like her might withdraw from witnessing such expressions of grief. Helping someone work through such grief can be difficult to stomach. It is horrible. But just as battered or sexually abused women can find the freedom to move on with their lives and stop reenacting the traumas of their past once they acknowledge and begin to deal with their experiences honestly, so it is with women and men who have been emotionally hurt by past abortions. I could not possibly do this work if I did not see the incredible liberation and strength restored in those who engage in the healing process after abortion. It is a most painful labor, but it eventually gives birth to authentic integrity and self-awareness - things often lost in the aftermath of a traumatic abortion.
Again Noreen asked the question, this time impatiently. "Are you pro-choice or pro-life? I need to know."
"Noreen," I answered, "I have seen that abortion hurts women. Not all women, but many women. The individuals I have come to know in my work with post-abortion recovery are women whom I truly love and respect. I have tremendous compassion for women and the dire circumstances which lead them to abort. Women do not come to me if they do not need healing because of their choice. They do not seek my services if they are happy with their decision. My job is to help those who are not happy grieve their loss so that they can move forward. I would not be an effective therapist if I told them what happened to them was good and that they should be willing to do it again if necessary, even if everything inside them is screaming with repulsion and humiliation."
Noreen was silent. I sensed that my remarks hadn't surprised her, and felt that on a deeper level she knew there could be no other answer. Abortion counselors have seen glimmers of the truth. Many women experience intense reactions immediately after their abortions. Some begin to experience extreme reactions even during their abortions. If abortion clinic workers haven't recognized these things as the onset of grief, surely they must notice the blank, dull, emotionless faces of some women, going through the motions, trying so hard not to feel.
Unfortunately, Noreen ended our conversation because she was unable to accept her patients' grief on their own terms. Politics and ideology stood in the way of referring them to a therapist who could not promise to treat them in a way that would advance a "pro-choice" philosophy. She could not accept that I would allow my patients to regret their abortions, or even to believe that they were a terrible choice. Perhaps she honestly believed that the only way women could find healing was by finally learning how to believe that their abortions were "for the best." But the path to healing is not found in hiding one's emotions or in convincing oneself that a mistaken choice was good. Healing should not be held hostage to "pro-choice" sentiments.
The interaction between therapists and women who have experienced abortion is obstructed by unspoken secrets, fears, and political biases. It should be no surprise that because of their own psychological needs, many counselors simply don't want to delve into the subject of abortion. If they do, some prefer to quickly reassure clients that they did the best thing and thereby close off any further expressions of grief. This occurs because many counselors have neglected to identify their own fears and anxieties that might be aroused by such conversations.
Many therapists have been involved in an abortion themselves. Others have encouraged clients to abort or have given their therapeutic "blessing" to the abortion option for clients considering abortion. This is often done out of ignorance of the research that shows that women with prior psychological problems fare poorly after an abortion.2 There is no evidence that abortion ever improves or alleviates psychological problems. The research indicates that it is more likely to make a woman's emotional problems more complicated. While some therapists may simply be ignorant of these undisputed findings, others simply ignore or disbelieve them for their own psychological or political reasons.
Once a counselor has encouraged or approved of an abortion for Patient A, he may become "invested" in defending abortion. If he subsequently allows Patient B to delve into her post-abortion grief and associated pathologies, then the counselor may be forced to question his advice to Patient A. He may be instinctively wary of witnessing an intense post-abortion reaction because it may provoke the his own sense of guilt in having given Patient A bad advice.
Julianne described her experience with her therapist this way:
After my abortion, I could not stop crying. I went to see the therapist who had encouraged me to have the abortion. I cried the whole time there. She sat across from me with a blank look on her face. She said nothing. During this session she was removed and distant - emotionally cold and withdrawn.
As I was leaving her office, she came up to me and said, "I don't usually touch my patients, but you look like you need a hug." She then proceeded to embrace my shoulders and offer a squeeze. I felt like I was being embraced by an evil presence. I shuddered at her touch. How dare she even come near me! A hug! I was sickened at the thought of such a trite expression - after having encouraged me to kill my own child!
Never a word of support for my motherhood! Not an alternative plan, or a resource to help me. She knew I didn't want another abortion. She told me to have a ------ abortion because I would not be able to handle another baby.
Then she offered me a hug!
God, I miss my baby. That's who I wanted to hug . . . my baby who is gone, whom I will never hold or cuddle.
If the therapist has personally had an abortion, a client's confession of grief is quite likely to run into either a wall of denial or another quagmire of unsettled issues. According to another of my clients, Hanna:
I thought I had put my own experiences behind me. I was totally unprepared for the onset of emotions evoked by hearing one of my clients talk about her abortion. There are times when I feel as though I have opened a Pandora's box and my life will never be normal again. Memories I did not know existed have been surfacing at the most inopportune times. My sleeping hours are plagued by graphic nightmares. I vacillate between feeling finally in control and fully out of control. As a professional counselor, I struggle to find a bridge that will allow me to merge my professional expertise with my personal trauma. "Physician, heal thyself!" I do know that the time to reconcile this is now and that it is no accident. I have arrived at this particular fork in the road.
Fortunately, Hanna recognized her own symptoms that screamed for attention and decided to seek help. She was willing to deal with the trauma that she had for many years successfully pushed away but had never truly worked through.
There were many trained professionals in Kasey's life who had the opportunity to help, but they either misunderstood her, cut her off, or ignored her.
I remember my teacher pulling me aside and telling me that she thought I was a little flaky. A week later she told me that she had looked at my charts and medical history, which had been forwarded to the school. She saw that I had had an abortion. I will never forget my feeling at that moment. I was completely horrified and mortified.
At the same time, however, I felt a strange relief that my secret was out. I felt like the woman was showing concern for me, and I was relieved that someone recognized the source of my pain. I broke into tears and told her how awful it had been. I told her everything I had been going through. I had been exposed - stripped naked -and then left alone to deal with my shame.
Then, after telling her everything, she firmly told me to pull myself together . . . and that was the end of it. That nearly drove me over the edge.
Kasey wanted a mother-figure to give her compassion and support. Her teacher's discovery of her abortion, although frightening at first, had also been a moment of hope. Sadly, she instead simply heard, "Pull yourself together." At that point Kasey felt completely abandoned, and her trauma got the best of her. She was unable to work through it because there was no one who would help. Eventually she had a nervous breakdown.
During her hospitalization Kasey informed numerous doctors and therapists that her problems began after the abortion. Despite her explanations, no one would consider abortion as a counseling issue. Everyone thoroughly dismissed her abortion as irrelevant.
They treated me with drugs: tranquilizers, antidepressants and anxiety medication. That's how they handled my grief and pain. They turned me into a zombie.
For six years Kasey was treated with medications and viewed herself as a "mental case." But after doing extensive grief work related to her abortion, she made a full recovery.
Unfortunately, Kasey's pain was unnecessarily prolonged because the people around her, and especially counselors and mental health workers, were unable or unwilling to assist her in dealing with her abortion as a traumatic grief experience. How long will other women and men be denied the permission to grieve their past abortions?
1 James Davison Hunter, Before the Shooting Begins: Searching for Democracy in America's Cultural War (New York: The Free Press, 1994) 93. [Back]
2 J.R. Ashton, "The Psychosocial Outcome of Induced Abortion," British Journal of Ob&Gyn., 87:1115-1122 (1980); C.A. Barnard, The Long-Term Psychosocial Effects of Abortion (Portsmouth, NH: Insitute for Pregnancy Loss, 1990); E.M. Belsey et al., "Predichve Factors in Emotional Response to Abortion: King's Termination Study - IV," Soc. Sci. & Med., 11:71-82 (1977); B. Lask, "Short-term Psychiatric Sequelae to Therapeubc Termination of Pregnancy," Br. J. Psychiatry, 126:173-177 (1975); A. Lazarus, "Psychiatric Sequelae of Legalized Elective First Trimester Abortion," Journal of Psychosomatic Ob&Gyn., 4:141-150 (1985); W.B. Miller, "An Empirical Study of the Psychological Antecedents and Consequences of Induced Abortion," Journal of Social Issues, 48(3):67-93 (1992); P.G. Ney and A.R. Wickett, "Mental Health and Abortion: Review and Analysis," Psychiatr. J. Univ. Ottawa, 14(4):506-16 (1989). [Back]
Theresa Burke, Ph.D., is a psychotherapist and founder of Rachel's Vineyard, a post-abortion training and healing ministry that annually serves thousands of women and couples throughout North America and overseas.
David C. Reardon, Ph.D., is one of the nations's leading researchers and authors on post-abortion issues and the founding director of the Elliot Institute.
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