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LargerWork: The Human Life Review
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Publisher &Date: The Human Life Foundation,Inc., Fall 1996
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This article brings our attention to the physical and
mental trauma that a woman goes through and continues
to go through after having an elective abortion. E.
Description: Joanne Angelo explains why thepost-abortion woman
suffers differently from other women who have
experienced the loss of a child, and gives suggestions
to the type of therapy needed to recover.
Submittedby: DardenBrock ( darden.brock@trincomm.org )
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By E. Joanne Angelo
Every woman whosubjects herself to an induced abortion suffers the death
of her ownchild. She is at risk not only for the surgical and medical
complicationsof abortionÑuterine rupture, sepsis, infertility, increased
incidence ofcancer. She is also at high risk for pathological grief, which
often bringswith it severe and long-lasting negative sequelae for herself,
her partner,her surviving children and the whole of society. Grief
following adeath in the family is a universally accepted experience. A
period ofmourning following the loss of a loved one is a normal
expectation inevery culture. It is also generally understood that if this
mourningprocess is blocked or impacted, there will be negative
consequences.Shakespeare, in his tragedy Macbeth, says, "Give sorrow
words, thegrief that does not speak knits up the o'erwrought heart and
bids itbreak" (Act IV, scene 3). Yet a mother's grief after an induced
abortion hasheretofore seldom been acknowledged.
The death of achild is perhaps the most difficult loss to mournÑeven the
death of apremature baby, a stillborn child, or a miscarriage. The medical
literature inrecent years has increasingly acknowledged the significance
of perinatalloss for parents. Obstetrical journals describe "perinatal
griefteams" consisting of nurses, doctors, social workers, clergy and
volunteers whohelp parents cope with the loss of children who die in
neonatalintensive care units. Parents are encouraged to name and hold
their deadbaby, and to take photographs. Religious services assist them in
their mourning,and they are encouraged to bury the child with their loved
ones in afamily grave which they can visit as often as they wish.1
Abortion,whether spontaneous or induced, is part of the same continuum of
perinatalgrief. However, grief after elective abortion is uniquely
poignantbecause it is largely hidden. There are no provisions made to
assist thepost-abortion woman in her grievingÑshe has no child to hold, no
photographs, nowake or funeral, and no grave to visit. After an elective
abortion, awoman typically finds herself alone to cope not only with the
loss of thechild she will never know, but also with her personal
responsibilityin the child's death with its ensuing guilt and shame. She
may havedifficulty understanding her ambivalent feelingsÑon the one hand,
relief (oftenvery temporary) that she is no longer pregnant, and, on the
other hand, aprofound sense of loss and emptiness. In her book, The
Anatomy ofBereavement, Beverley Raphael explains, "A woman may have
required a highlevel of defensive denial of her tender feelings for the
baby to allowher to make the decision for termination. This denial often
carries herthrough the procedure and hours afterward, so that she seems
cheerful,accepting but unwilling to talk at the time when supportive
counseling maybe offered by the clinic."2 This may explain why research
intopsychiatric sequelae of abortion in the immediate post-abortion period
often yieldsnegative results.
The Emotional Effects
In the weeksand months after the abortion, feelings of sadness and guilt
often threatento overwhelm the post-abortion woman, yet society offers her
no assistancein mourningÑshe is expected to be grateful that "her problem
is solved"and to "get on with her life" as though nothing significant had
happened. Atthe same time, pain and bleeding remind her of the assault on
her body, thesudden endocrine changes cause her to become emotionally
labile orunstable. She is poignantly aware of the date her child would
have been born.Reminders threaten her defensive denial and repression all
too frequently:anniversaries of her abortion, other children of the age
her child wouldhave been, Mother's Day, the omni-present abortion debate
in the media, avisit to the gynecologist, the sound of the suction machine
at thedentist's office, or the sound of a vacuum cleaner at home, a baby
in a televisionad, a new pregnancy, a death in the family, a film
depictingprenatal development or abortion, or a pro-life homily. Any of
these maytrigger a sudden flood of grief, guilt, anger and even despair,
which in turn,calls forth even more intense defensive responses.
Thepost-abortion woman's attempts to comply with society's expectations
that sheproceed with her life as though she had undergone an innocuous
procedure arebought at great personal expense. She may turn to alcohol or
drugs to get tosleep at night or to deaden the pain of the intrusive
thoughts, whichhaunt her day and night, "I killed my baby! I killed my
baby! I don'tdeserve to live!" Flashbacks to the abortion procedure may
occur at anytime. She may throw herself into intense activityÑwork, study,
or recreation,or attempt to deal with her feelings of loneliness and
emptiness bybinge eating alternating with purging or anorexia, or by
intense effortsto repair intimate relationships or develop new ones
inappropriately, becoming sexually promiscuous, riskingsexually
transmitteddiseases, and repeating pregnancy and abortion. Complaints of
vague abdominalpain or pain on sexual intercourse may cause her to seek
medicaltreatment from one physician after another unsuccessfully, and the
veryexaminations to which she is subjected may cause flashbacks to the
abortionexperience. Her life spirals downward as her general health,
personal relationshipsand job performance become more and more impaired.
Discouragement,despair, clinical depression and suicide attempts often
follow.3Typically, in presenting symptoms over a period of many years, she
is treated bynumerous physicians and mental health professionals without
ever receivinghelp for the root cause of her problems, her abortion or
abortions.Psychiatric textbooks subsume all of the above symptoms under
the diagnosisof a Pathological Grief Reaction.
Effects On Marriage And Subsequent Children
Short-termresearch into the psychiatric sequelae of abortion fails to
document itsdevastating long-term negative effects on women and on their
forming andsustaining stable spousal relationships, and of caring
appropriatelyfor subsequent children. They may have difficulty bonding
with a newbaby, or, conversely, become overprotective and inappropriately
attached to thenext child who bears the burden of replacing the aborted
baby. These childrenare often referred to child psychiatrists because of
separationanxiety, or because they are judged to be at risk for physical
abuse. Couplesmay be treated for infertility or dysfunctional marriages,
which stem froma previous abortion or abortions. Substance abuse,
"burnout" on the job, psycho-somatic symptoms,eating disorders, chronic
depression andsuicide attempts which routinely bring women into
psychiatriccare can often be traced to an abortion experience several
years beforethrough a careful and complete history.
In addition toimmediate intervention for the presenting problem,
successfultreatment of women who have suffered the tragedy of abortion
requires thatthe underlying traumatic loss be acknowledged and
appropriately grieved.Psychotherapy involves facilitating the work of
mourning whichhas been so long delayed. Within a therapeutic relationship,
the woman isencouraged to share her traumatic loss and to acknowledge her
role in it. Sheis helped to share the mental image she has formed of her
childÑoften one of a baby being torn to pieces orcrying out in pain. As
the grief workproceeds, her image is transformed into a less disturbing
picture of herchild at peace. She may name the child and arrange for a
religiousservice to be performed for him or her. She accepts God's
forgiveness andmay be able to forgive herself and ask forgiveness of her
child.Eventually she is able to put the child to rest in her mind. Only
then is shefree to resume her life productivelyÑto make new relationships
or repair oldones, to work, to play, and to be creative once again.4
With 30 millionabortions in this country since Roe v. Wade, and the
continuing rateof 1.5 million abortions per year, we can no longer deny
the publichealth significance of their psychological and psychophysical
sequelae.Epidemiological studies are urgently needed which are
statisticallysound and which follow women and men for at least ten years
postabortion.However, it is axiomatic that the best treatment for any
epidemic isprimary prevention. Abortion is an elective surgical procedure
performed onhealthy women (pregnancy is not a disease). The immediate
abolition ofelective abortion would eradicate the iatrogenic epidemic of
post-abortionpathology and would serve the best interests of women and
society. InEvangelium Vitae (no. 99) John Paul II spells out the pastoral
approach of thechurch:
The wound inyour heart may not yet have healed. Certainly what happened
was and remainsterribly wrong. But do not give in to discouragement and do
not lose hope.Try rather to understand what happened and face it honestly.
If you have notalready done so, give yourself over with humility and trust
to repentance.The Father of mercies is ready to give you his forgiveness
and his peacein the Sacrament of Reconciliation. You will come to
understand thatnothing is definitely lost and you will also be able to ask
forgivenessfrom your child, who is now living in the Lord. With the
friendly andexpert help and advice of other people, and as a result of
your ownpainful experience, you can be among the most eloquent defenders
of everyone'sright to life.
Notes
1. Wathen,N.C., "Perinatal Bereavement," British Journal of Obstetrics and
Gynecology 97[1990]: 759-760.
2. Basic Books:New York, 1983.
3. Speckhard,A. & Rue, V. "Complicated Mourning: Dynamics of Impacted
Post-AbortionGrief," Journal of Pre- and Perinatal Psychology 8 [1993]:
6-12.
4. Angelo, E.J."The Negative Impact of Abortion on Women and Families," in
Post-AbortionAftermath, Mannion, M. ed. [Sheed and Ward: Kansas City, MO,
1994].
E. JoanneAngelo, M.D. is Assistant Clinical Professor of Psychiatry at
TuftsUniversity School of Medicine and a psychiatrist in private practice
in Boston. Sheis a Corresponding Member of the Pontifical Academy for
Life. Thisarticle originally appeared in the November 1995 issue of Ethics
& Medics, amonthly publication of the Pope John Center.
© The Human Life Review., The Human Life Foundation, Inc.,Editorial
Office, Room840, 150 E. 35th St., New York, N.Y. 10016.
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