Rachel's  Hope

After Abortion Healing and

Reconciliation for Catholic Women

(or Catholic friendly)


Abortion Aftermath:

Post Abortion Syndrome


Rosemary Benefield, RN, MA, MPC
Rachel's Hope
P.O. Box 17363
San Diego, CA 92177
rachels_hope@juno.com
(858) 581-3022
 

The effects of abortion on women are examined in the context of the diagnostic
criterion of Post-Abortion Syndrome.  Attention is given to health care workers
on recognition of abortion sequelae as it relates to post-traumatic stress disorder.
Symptoms of post abortion maladjustment are listed along with the authors
experience of statements made by post-abortive women.

 

     In the past few years there has been a great upsurge of information on the
psychological effects of elective abortion.  Fifteen to twenty years ago some
resources stated that there were no psychological sequelae, but there are currently
many sources that state that some women have aftereffects.
     In Women's Mental Health (1997), Burt and Hendrick state: "Although most
women experience few or no adverse psychological sequelae after an elective
abortion, some women do experience post-abortion psychological distress." The
San Diego Union Tribune ran an article on October 1, 1996, titled, "Healing the
Hurt: Therapist Supports Legal Abortion, but Says It's Vital to Acknowledge
Trauma It Can Cause." In the article, the therapist, Ava Torre-Bueno, LCSW,
made it clear that she was pro-choice.  However, she stated that, "a significant
number suffer long-term distress and need help to work through the trauma
abortion causes." She further states that "while the political debate rages on, some
emotionally damaged women are not getting the help they need." In an interview
with Torre-Bueno in the December, 1996 issue of San Diego News Notes, she
states, "Around 10 percent of women have some significant emotional or spiritual
difficulty after an abortion." In her book, Peace After Abortion, Tore-Bueno states
that
 

Most women feet great relief after an abortion and most of these
women continue to feel comfortable with their decision for the rest of

 

The Journal of Christi n Healing, Volume 2 1, #2, Summer, 1999, pp. 24-4 1.

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their lives.  Between one and six percent of women, however, experience
long-term depression after an abortion.  Seventeen percent experience guilt.
Some women know they will be in emotional pain after an abortion.  Other
women who find themselves in emotional pain are completely surprised by these
feelings.  They believed they were comfortable with their decision but experience
sudden, powerful, and disturbing feelings during or just after the procedure (p. 7).

In the book The Healing Choice (1997), Candace De Puy states,
 

Psychological studies show that only 10 percent of the 1.6 million American
women who undergo abortions every year experience severe emotional trauma
following the procedure, and those women were most often psychologically
unstable prior to their pregnancy.  Unfortunately, most studies dismiss the other
90 percent of women as if they had no reaction whatsoever.  Because the
majority of women move forward with their lives, any unusual grief, confusion or
ambivalence they might feel is dismissed.

 

David Reardon, Ph.D., (1990) a biomedical ethicist and the director of the Elliot
Institute, conservatively estimates in his research that 40-60 percent of the
women questioned reported at least some negative reactions (Ashton, 1980;
Reardon, 1987; Zimmerman, 1977).  In one study of 500 aborted women,
researchers found that 50 percent expressed negative feelings, and up to 10
percent were classified as having developed "serious psychiatric complications"
(Friedman, et. al., 1974).  Julius Fogel, MD, a psychiatrist and abortionist who
has been a long-time advocate for abortion and has personally performed over
20,000 abortions feels that a significantly higher percentage of women are
affected by abortion.  He states (in Rearden, 1996):
 

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.  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 in the
pro-abortion crowd insist
.  A psychological price is paid [and this author

believes that a spiritual price is paid].  It may be alienation; it may be a pushing
 

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Health care professionals need to be, aware 

of the affects abortion has on women 

in nearly all areas of life. 

 

 

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 (p. 2).

 

Ava Torre-Bueno speaks about spiritual injury, "The heart of heating from spiritual
injury related to abortion is self-forgiveness." She further states that talking about
the abortion to someone safe can be profoundly healing.

Symptoms of Post-abortion Maladjustment
     Health care professionals need to be aware of the affects abortion has on women in
nearly all areas of life.  Post-abortion syndrome was originally identified by Vincent
Rue, Ph.D., (1981) as a variant of "post traumatic stress disorder," delineated in the
Diagnostic and Statistical Manual of Mental Disorders-Revised DSM-III (1987).
Subsequently, additional clinicians/ researchers have confirmed this diagnostic
impression: Stanford-Rue, 1986; Spechard, 1987; Fisch & Tadmor, 1989; Selby
1990; DeVeber, Azenstat & Chisholm, 1991; and Angelo, 1992.  Although this
syndrome is not specifically identified in the DSM-IV, the mental health "stressor"
of abortion can be considered in several diagnostic categories, i.e. Post-Traumatic
Stress Disorder (PTSD), Adjustment Disorder, Anxiety Disorder, Major Depression,
Dysthymia, Somatoforth Disorders, Eating Disorders, Sleep Disorders,
Substance Related Disorders, Complicated Bereavement, Pathological Grief or
Panic Disorders and Phobias.  Abortion as a stressor can also be considered in Brief
Psychotic Reaction.  This in no way eliminates the possibilities
for additional diagnoses available in the Diagnostic Manual, Dsm-IV.
     Basically, post-traumatic stress disorder happens as a result of a particular
stressful event, a stressor.  Victims of PTSD experienced, witnessed, or were
confronted with an event or events involving actual or threatened death, serious
injury, or a threat to the physical integrity of self or others; and the person's
response involved intense fear, helplessness, or horror.  This event could be any
number of things, including rape, witnessing a murder, being a victim of an
attempted rape or murder, or surviving the devastation of an earthquake or
hurricane.  In post-abortion syndrome, the stressor is the abortion experience,
that is, the intentional destruction of one's baby/embryo/ fetus.  One may question
the presence of intense fear in post-abortion syndrome, since the abortion was
performed at the request of the patient.  Louis
 

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Gaston, Ph.D. (1998), in his article "The Complexity of Treating Trauma," states
that "PTSD is primarily associated with reactions other than fear, such as anger,
confusion, guilt, and shame." Consequently, fear is not necessarily associated with
PTSD or post-abortion trauma.  The reactions of anger, confusion, guilt and shame
are clearly distinguished in post abortion syndrome.  For the woman who has had
an abortion, it is the act of taking the life of her unborn baby.

Post-Abortion Syndrome Diagnostic Criteria
     Following are diagnostic criteria of post-abortion syndrome as defined by of Dr.
Vincent Rue in Post-Abortion Syndrome (Doherty, 1995, p. 27-28) with further
elucidation from this author's experience and that of Sharon Pearce (1995).

I. Stressor
     The abortion experience, i.e. the intentional destruction of one's unborn
child, is a sufficiently traumatic event so as to cause significant symptoms Of
reexperience, avoidance, and impacted grieving.
     Some women who have undergone this procedure find it sufficiently traumatic as
to cause significant symptoms of reexperience and avoidance.  The reexperience of
the stress can take several forms.  An aborted woman may have recurrent, intrusive
recollections or dreams of the abortion or of the child she might have had.  She
may have dreams or sudden panic feelings that the abortion is reoccurring.
However, a woman may not be able to relate to the abortion procedure itself as the
stressor, especially if she had general anesthesia during the procedure and did not
consciously experience the removal of the baby/embryo/fetus.

 II. Reexperience
     The abortion trauma is reexperienced in one of the following ways:
     A. Recurrent and intrusive distressing recollections of the abortion experience.
 Some women have stated that "there isn't a day that goes by that I don't
 think of the abortion(s)."
     B. Recurrent distressing dreams of the abortion or the unborn child.
The dreams are often of blood, darkness and despair.  These are also called "baby
dreams" or "fetal fantasies." The woman may dream about babies or small
animals that are being dismembered, killed or are in danger.  Another may hear a
baby or child calling out in fear or pain that she is unable to save.  A frequent
dream is one involving a child that is drowning; the woman tries to rescue the
child but is unable to do so.  She may also have dreams about her own personal
safety - that someone is after her to kill her, or that she is being chased by
someone who has a knife.  One case was that of a woman
 

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Diagnostic Criteria of Post_Abortion Syndrome - Part I 

 
I. Stressor 
The abortion experience, i.e. the intentional destruction of one's unborn 
child, is a sufficiently traumatic event so as to cause significant symptoms of 
reexperience, avoidance, and impacted grieving. 

II. Reexperience  

The abortion trauma is reexperienced in one of the following ways:  
* Recurrent and intrusive distressing recollections of the abortion experience. 
* Recurrent distressing dreams of the abortion or the unborn child. 
* Sudden acting or feeling as if the abortion were recurring (including reliving 
   the experience, illusions, hallucinations, and dissociative (flashback) episodes 
   including upon awakening or when intoxicated). 
* Intense psychological distress at exposure to events that symbolize or resemble  
   the abortion experience (e.g., abortion clinics, pregnant mothers, 
   subsequent pregnancies). 
* Anniversary reactions of intense grieving and/or depression on subsequent  
anniversary dates of the abortion or on the projected due date of the 
aborted child. 

III.  Avoidance: Persistent avoidance of stimuli associated with the abortion trauma or numbing of general responsiveness (not present before the  
abortion), as indicated by at least three of the following:  
* Efforts to avoid or deny thoughts or feelings associated with the abortion. 
* Efforts to avoid activities, situations, or information that might arouse recollections  
   of the abortion. 
* Inability to recall the abortion experience or an important aspect of the abortion 
   (psychological amnesia). 
* Markedly diminished interest in significant activities. 
* Feeling of detachment or estrangement from others. 
* Withdrawal in relationships and/or reduced communication. 
* Restricted range of affect 
* Sense of a foreshortened future, e.g., does not expect to have a career, marriage, 
   children, or a long life. 
 

 

    who stated that since her abortion she had frequent feelings of paranoia.
    C. Sudden acting or feeling as if the abortion were recurring (including reliving
the experience, illusions, hallucinations, and dissociative (flashback) episodes
including upon awakening or when intoxicated).
     The women may have times when they actually feel that they are going through the
abortion all over again with flashbacks or hallucinations about
 

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the abortion.  These occur most commonly when women are in an altered state of
consciousness, such as when using alcohol or drugs, or waking up from a deep
sleep.  Some women have shared that they have woken up out of a deep sleep
feeling like they are on the abortion table screaming "stop, stop!" It is very common
for women to share that they have used alcohol and drugs since their abortions.
Those who share that they have abused substances prior to the abortions said they
increased their consumption after the abortion.  Clinicians who are working in
Substance Abuse facilities and Mental Health facilities which include Dual
Diagnoses need to be particularly aware of the role abortion may have in a patient's
recovery.
     D. Intense psychological distress at exposure to events that symbolize or
resemble the abortion experience (e.g., abortion clinics, pregnant mothers,
subsequent pregnancies).
     Many women feel great distress when they are confronted with something. that
reminds them of their pregnancy and abortion.  It is not uncommon for post-aborted
women to feel anxious around other pregnant women, infants or small children.
Some women say that they love children once they're walking and talking, but they
can't tolerate being around babies.  Some women will go out of their way to avoid
driving past the clinic or doctor's office where the abortion was performed because
they feel anxious or distressed by seeing the building again.  If the doctor that
performed the abortion was their gynecologist, many women will change to another
doctor.  Some women will move out of the city where the abortion was performed.
     Many post-aborted women also struggle with negative feelings when they become
pregnant again - even if the pregnancy is planned and wanted.  It is often during this
time that they will look at pictures of the developing baby/ fetus and realize what the
development of the aborted baby/fetus was at the time of the abortion.  It is often a
shock to them when they learn that the babies heart starts beating at 21 days, that
brain waves can be detected and recorded at 40 days and that the nervous system is
developed enough to respond to touch at six weeks.
     Should miscarriages occur, women may experience guilt and fear that their
abortions may be the cause of the miscarriages.  Indeed their fear is well grounded.
A researcher (Wynn, 1973) found that the risk of second trimester miscarriages
increases tenfold following a vaginal abortion.  Though normally only five percent
of all babies are born prematurely, this rate jumps to 40 percent among women who
have had abortions.  This is sometimes due to an "incompetent cervix," which was
forcefully dilated in an abortion, thus weakening it.  This results in the inability to
support the growing fetus, causing prematurity or miscarriage.  In Wynn's (1973)
study of first pregnancy abortions, the women had a 48 percent abortion-related
complication in later
 

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wanted" pregnancies.  It is estimated that approximately 60 percent of abortions
are for first pregnancies.  Emotionally, when a miscarriage occurs, some women feel
that it is a punishment.  This fear of punishment is somewhat dependent on their
religious background, but even those who have expressed no religious philosophy
have expressed a fear that they will be punished for their past abortions.  Some
women go to extremes in having prenatal testing in order in insure their future
children will be normal.  One woman kept a score card of how many abortions she
had had and how many miscarriages she had had, stating "I took one, two, etc.
babies from God, so God has taken one, two, etc. babies from me."
     Aborted women also face much more difficult and dangerous deliveries in later
pregnancies.  These women face at least three times more labor complications than
non-aborted women.  Some women have stated that the labor room, and more
specifically the delivery room, reminded them of their abortions.  This sometimes
produces a great deal more emotional and physical tension, coupled with the
physical complication of a more difficult delivery.
     Infertility clinics have a significant number of women who are struggling with
remorse and anxiety that their abortions are the cause of their inability/ difficulty to
become pregnant.  Numerous studies (quoted by Wynn, 1973) have found that three
to five percent of all aborted women are inadvertently left sterile by the operation.
If women are also infected by a venereal disease at the time of their abortions, the
risk of being rendered sterile is even greater.  Some women have difficulty
conceiving after their abortions due to possible emotional blockages.  Women, in
this situation, who have been trying to conceive for years, sometimes will conceive
after they have experienced a healing of the emotional aftermath of abortion.  One
woman had a five-year cessation of her menstrual cycle after multiple abortions.
After she went through a healing process of the abortion effects, her menses came
back.
     Ectopic pregnancy is another physical and emotional complication of abortion.
Saitenberger (1984) has shown that a woman's risk of an ectopic pregnancy
dramatically increases following an abortion.  One study (quoted in Saitenberger,
1984) suggests that the risk increases 100 to 150 percent, another study (quoted in
Saitenberger, 1984) suggests a 400 percent increased risk.  One woman mourned the
loss of her baby in an ectopic pregnancy stating, "I messed myself up so bad that the
poor baby couldn't make it's way down to the uterus.,,
     Post-partum depression after the delivery of a baby, even a healthy child, is more
common in post-abortive patients.  Women sometimes feel that they do not deserve
the child that was born.  One woman stated, "I couldn't even look at my baby
because she was so beautiful and I don't deserve her." This
 

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The reactions of anger, confusion, guilt 

and shame are clearly distinguished 

                             in post abortion syndrome.  
 

 

woman may be afraid to bond with her child because she is waiting to be punished.
Some women have problems breast-feeding their children because of their difficulty
bonding with them.  They may be trying too hard to give to the children what they
did not give to the child/embryo/fetus which was
aborted.
     E. Anniversary reactions of intense grieving and / or depression on subsequent
anniversary dates of the abortion or on the projected due date of the
aborted child.
     These "anniversary reactions" are experienced consciously or subconsciously.  The
woman may be unaware that she feels depressed or sad at the same time of year
because it is the anniversary of her abortion or due date of her aborted
child/embryo/fetus.  Mild to severe depression with suicidal ideation or attempts is
not uncommon during these anniversary reactions.  When the woman "cannot
remember" when she had her abortion, she should be encouraged to think back over
the last several years to see if there are times when she routinely experienced
depression or anxiety.  It is possible that her abortion took place around that time of
year.  It is especially difficult if the abortion took place around a significant time of
the year.  One woman had her abortion a day before her birthday.  Ever since the
abortion, her birthday has been a very unhappy event.  Another woman had her
abortion right before Christmas.  Ever since the abortion, Christmas has been a
disturbing time for her.  Many women say that Christmas is a difficult season for
them, regardless of when their abortion was because of the religious focus on the
"Christ child." Other women find that sometimes future children are born near the
time of the abortion.  This also may cause a great deal of grief.
III.  Avoidance: Persistent avoidance of stimuli associated with the abortion
trauma or numbing of general responsiveness (not present before the abortion),
as indicated by at least three of the following:
     A. Efforts to avoid or deny thoughts or feelings associated with the abortion.
     The abortive woman generally avoids feeling anything about her abortion by using
defense mechanisms, see R. Benefield (1998).
     B. Efforts to avoid activities, situations, or information that might arouse
recollections of the abortion.
     If the woman is pro-life, there is an avoidance of going places where she knows
abortion will be discussed.  For her, if abortion comes up in a group
 

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conversation, she often walks away, "tunes out" the discussion, or remains mute.
"I don't know what to say so I don't say anything." She will sometimes change the
channel on her radio or TV if the subject of abortion comes up. When she does
speak up in defense of women who have had abortions she is often criticized.
     If she is already pro-choice, having an abortion is congruent with her beliefs.
However, if she recognizes post-abortion sequelae operating within her, she may
take a stronger pro-choice stand to justify her abortion in order to reduce her
immediate stress.  She may seek out other pro-choice women or organizations to
have a continual reaffirmation of her position.
    C. Inability to recall the abortion experience or an important aspect of the
abortion (psychological amnesia).
     The woman is unable to remember important details of the abortion, like how far
along she was, where she had the abortion, who the doctor was, etc.  She may
"blank out" or disassociate when she is asked to talk about her abortion.  She
consciously or subconsciously chooses not to remember her abortion.  Her mind
subconsciously uses this defense to help her to be able to function.
     D. Markedly diminished interest in significant activities.
     There will be a loss of interest in things that were important to those women before
the abortion.  Many choose abortion so they can finish school or establish their
career, only to find that after the abortions they don't care about finishing school or
succeeding in their chosen professions.  Many report that their grades fall
significantly or they quit school.  Others say they find themselves sabotaging their
work so they can not succeed.  Some feet that any job that they seek or become
successful in will come to an end so they sabotage it before this can happen.  On the
other hand, some women need to prove to themselves that having the abortions was,
to them, something that "made sense." They can prove to themselves the "rightness"
of their actions by compulsively, or almost compulsively, directing their efforts
towards the pursuit of their original goals.  After these abortions there may be an
obsessive-compulsive drive towards success in that career, even to the point of
dysfunctionality, i.e. great anxiety or depression when difficulty arises.  This could
also involve doing whatever it takes to "move up the ladder." The excuse behind
their actions on a subconscious level is to maintain a sense of self-integrity which
can make sense out of the decision to have the abortions.  In addition to this
justification to themselves, one woman stated, "I needed to be successful in my
career to compensate to my child that their loss wasn't in vain."
     Some women find that they lose interest in significant relationships, specifically the
fathers of their baby/embryo/fetus.  Many women have abortions
 

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Many choose abortion so they can finish school or 

establish their career, only to find that after the 

abortions they don't care about finishing school or 

succeeding in their chosen professions. 

 

 

at the request of the fathers, whether they be boyfriends or husbands, in order to
maintain the relationships.  Statically (see Ney, 1993) 80% of these relationships
end within several months of the abortions.
  Another 15% breakup in one to two
years.
  Approximately five percent of the relationships stay together.  Relationships

that are committed to marriage, many have difficulties but stay together because of
those commitments.  Conversely, in a small percentage of cases, the grief that the
couple openly shares with each other binds that relationship together.  They
commiserate in their guilt and grief, thus finding a commonality in their relationship.
     There are women who lose interest in hobbies, such as drawing, writing or
running.  These used to be life-giving activities.  For some, the abortions truncated
their instinctual creative ability of maternity, which can bring about a deterioration
in their ability to be creative in other areas that originally were more natural to them.
     E. Feeling of detachment or estrangement from others.
     A woman does not feel that she can "make a connection" with other people.  She
is always faced with an invisible barrier that she can not penetrate.  She often feels
that she is an "observer" rather than a "participant." Often there is a fear of
abandonment.  One feels that any relationship she will get into will fail.  She may
want deeply to trust but feels unable to trust, nor does she feel deserving of trust
from
others.  Much of this comes about because she feels that she "let my child
down," and subsequently feels she also deserves to be let down by those
significant others in their life.  One might almost think that there is a rationality at
work that goes something like this, "Since I have abandoned my child in utero, I
deserve also to be abandoned.  I expect to be abandoned, and therefore I will be
abandoned when I least expect it." One might further say that there is a
self-fulfilling prophecy waiting to unfold.  The fear of abandonment is working
with the expectation of abandonment by significant others.  Of course this
expectation of abandonment moves easily into areas where there is an expectation
for failure in not only relationships, but also in one's aspirations for life.  In many
ways one brings about elements of undermining her aspirations because she does
not feel she deserves success.
     In addition, a woman who has been neglected or abandoned during her
childhood fears that this could happen again during the pregnancy.  If this is
 

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the case, she easily submits to undergoing an abortion when she is threatened by
the abandonment of her partner or family.  If she has not resolved the
abandonment issues of her childhood, she tends to pick a partner that will help
her recreate the unresolved problems of her childhood.  If she is abandoned
during her pregnancy, she feels very angry and easily becomes bitter.  She dumps
her unsupportive boyfriend or husband and all too often finds a new one much
like the old one.
     F. Withdrawal in relationships and / or reduced communication.
     Women "pull back" and erect protective barriers around their lives so that others
will be unable to hurt them.  They lose their ability to be vulnerable and open with
others.  Many, if not most women are encouraged by their partners to get
abortions.  Research (Ney, 1993) indicates that the number one reason for abortion
is a "lack of partner support." They feet unsupported, that their partner let them
down.  Many women trusted their partner and the relationship they were in, only to
have that trust deeply damaged by their partners emotional and often physical
abandonment.  If women stay in these relationships, they often have trust issues
that were not there before the abortion.  They may distance themselves,
withdrawing from emotional and/ or physical intimacy.  They may also withdraw
from other friendships or family members.  If they do not stay with these partners,
they may stay away from future relationships.  When they lose their ability to trust,
they also feel alienated and isolated.

     G. Restricted range of affect.
     A woman has a restricted range of emotions: she does not usually experience
extremes of emotion.  She feels that if she allows herself to be sad, that the sadness
of the abortions may overwhelm her.  When she experiences feelings of happiness,
she may feel she does not deserve to be happy so she will repress or sabotage these
feelings.  One woman stated that whenever she was feeling happy with her
boyfriend, she felt that she could not allow herself to be happy, so she would say
something derogatory to her boyfriend to change her mood of happiness to one of
anger and sadness.  Needless to say, her relationship with him was in constant
turmoil.
     A abortive woman probably feels "numb", "empty," or "blah." A woman "numbs
herself out" to get the abortion, then after the abortion, she has to maintain this
numbness.  Many different levels of depression can be operating for the post-abortive
woman.  Depression will be discussed in greater detail under "Associated Features."
     H. Sense of a shortened future, e.g., does not expect to have a career,
marriage, children, or a long life.
     A woman may not feel that anything good will happen now that she has had an
abortion.  She may feel that she does not deserve to have a husband
 

34



 

Research ... indicates 

that the number one reason for abortion 

is a "lack of partner support." 

 

 

or children, and may sabotage relationships to reinforce her feelings of unworthiness.
IV.  Associated Features: Persistent symptoms not present before the abortion,
as indicated by at least two of the following. (If a woman has already experienced a
trauma before her abortion, such as rape or molestation, she may have some of these
symptoms.  It would be expected that they become more of a problem after the
abortion).
     A. Difficulty falling or staying asleep.
     Sleep disorders are very common after an abortion.  If a woman has trouble failing
to steep this could indicate anxiety because of the thoughts that continue to ruminate
in her head.  If she wakes up early this could also indicate anxiety.  If she has
difficulty failing to steep or waking up, or does not want to wake up, this could be
indicative of depression.  She may have had a full night's sleep but still does not feel
rested, again, indicating a possible depressive disorder.
     B. Irritability or outbursts of anger.
     Many women struggle with uncontrollable anger after their abortions.  The anger
can be directed at herself in verbal and physical expressions.  It could be directed at
physicians, especially those who did the abortion or gave the referral.  The anger is
particularly intense for those who come from deprived homes, because once again
they have been deprived.  It is even more intense when they have been persuaded,
coerced or threatened into having an abortion when they did not want to have one.
Abortion highlights a person's early deprivation.  This anger or rage may be directed
at a significant other in future relationships.  This anger is also directed at other
family or friends that have encouraged or forced the abortion - physically or
emotionally.  When the anger is directed at those who were not involved in the
abortion, the women often know that their anger is unjustified or unreasonable, but
they do not know where it is coming from or how to stop it.
     C. Difficulty concentrating.
     Many women experience an inability to "focus" on anything for any length of time.
They may feel "scattered" and may have difficulty making even simple decisions.
This may be due to a subconscious effort to "forget" their abortions, because if they
concentrate for too long on any subject, they may remember details of the abortions
they would rather forget.
     D. Hypervigilance
 

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Diagnostic Criteria of Post-Abortion Syndrome - Part II

IV.  Associated Features: Persistent symptoms not present before the 
abortion, as indicated by at least two of the following. (If a woman has already 
experienced a trauma before her abortion, such as rape or molestation, she may 
have some of these symptoms.  It would be expected that they become more of a 
problem after the abortion). 
* Difficulty failing or staying asleep. 
* Irritability or outbursts of anger. 
* Difficulty concentrating. 
* Hypervigilance. 
* Exaggerated startle response to intrusive recollections of reexperiencing of the 
   abortion trauma. 
* Physiologic reactivity upon exposure to events or situations that symbolize or 
   resemble aspects of the abortion (e.g. breaking out in a profuse sweat upon 
   pelvic examination, or hearing vacuum pump sounds). 
* Depression and suicidal ideation. 
* Guilt about surviving when one's child did not. 
* Self devaluation and/or an inability to forgive oneself. 
* Secondary substance abuse. 
V. Course of the disturbance of more than one month's duration, or onset  
may be delayed usually greater than six months after the abortion. 

 

     Post aborted women are often overly concerned about their safety, or the safety
of
their children and remain on the alert as to what is around them.  They may feel

someone is "out to get them or their children." They may experience a
preoccupation with their children's safety.  They sometimes reason that "since I
took the life of my baby, that God will take the life of my children." They may also
reason: "God will punish me by having something terrible happen to me."
     E. Exaggerated startle response to intrusive recollections of reexperiencing of
the abortion trauma.
     Some women "startle easily" when the memories of the abortions intrude into
their thoughts.  You can not walk up behind them and tap them on the shoulder
without an extreme response.
     F. Physiologic reactivity upon exposure to events or situations that symbolize
or resemble aspects of the abortion (e.g. breaking out in a profuse sweat upon
pelvic examination, or hearing vacuum pump sounds).
     When a woman is exposed to something that reminds her of her abortion, she
may experience a physiological response, such as rapid heart beat, difficulty
breathing or extreme anxiety.  Some women have difficulty getting a
 

36


pap smear, vacuuming their carpets or having dental work done because of the
dental drill and the oral suction tube.
     G. Depression and suicidal ideation
     Depression is very common after abortion, and can last for years.  Dr Philip Ney
(1997) refers to
 

... clinical depression as defined by such extensive sorrow and anger that the
person's physiology is changed.  Often people are depressed, but are so well
defended that they do not feel sad.  There are signs and symptoms of
physiological disharmony and biorhythmic disruption.  In
its adaptive form there is: (a) a slow metabolism to conserve energy
and avoid entropy (inertness), (b) regression in a search for caring, and
(c) an inward turning, in an effort to resolve psychological conflicts.
The sorrow and intense conflicts from an abortion are major contributors-
 to depression.  The person becomes increasingly desperate and anxious, with
denied grief, fear and anger, resulting in agitated depression.  Though most
depressed people withdraw, very few gain either insight or resolve their
psychological conflicts by turning inward.  The associated biological slowing may
progressively get worse until people become vegetative.  Although depressions
are on a continuum, they should be treated with antidepressants when physiology
is disrupted and people have vegetative signs.  Unfortunately, treating depression
with anti-depressants because there is a chemical imbalance, without addressing
the underlying conflicts, may perpetuate and exacerbate the symptoms.

In the lower continuum of depression, some do not feel they deserve anything
else but depression or sadness, consequently they consistently talk themselves
down from any points of elation that might lift them up out of their depression.
There are degrees to this self-imposed sadness, but the payoff is that they feel they
are "reaping what they have sown."
     Suicidal thoughts, threats and attempts are also common after abortion.
Sometimes latent suicide is committed slowly through a self destructive lifestyle;
and sometimes it is a quick, final act.  It is the final statement of anger at life and
loved ones who now must carry the woman's unresolved conflicts

and guilt.
     H. Guilt about surviving when one's child did not.
     Some women report they were prepared to die during their abortion, they felt it
was "what I deserved." When they did not die, they had to live with
the guilt of surviving.
     I. Self devaluation and / or an inability to forgive oneself
 

37



     Low self-esteem is very common after an abortion.  Because the woman is unable
to forgive herself, she may exhibit behavior that is self destructive, such as:
choosing unhealthy/violent/abusive relationships, sabotaging healthy relationships, using
drugs or alcohol, or developing an eating disorder.
     After an abortion, many women increase their intake of drugs or alcohol or may
start using these substances.  Drugs and alcohol may be a means of
self-destruction.  Also drugs and alcohol may lead to promiscuous behavior
(exposing themselves to Sexually Transmitted Diseases (STD) including AIDS), or
putting themselves in dangerous or possibly violent situations at parties, etc.
     Many women develop or have an increased drive towards an eating disorder as a
means of self-destruction.  Anorexia nervosa may be a means of slow starvation,
on the other hand they may be using food as a means of comfort.  Those who have
bulimia nervosa will "binge and purge" (i.e. overeating, then self-induced vomiting
or the misuse of laxatives, diuretics, or enemas) to get rid of the painful emotions.
Those who do not purge the excessive calories may be using excessive weight to
isolate and insulate themselves from relationships.  If they are sexually unattractive
this will help to reduce their acting out.  Some women have stated that this
excessive weight gave them the feeling of being pregnant, which on the
subconscious level was a means of compensation for not being pregnant.
Sometimes overweight is the result of a slow metabolism due to the depression
caused by the abortions.

J. Secondary substance abuse.
     It is common for a woman to begin or increase the use of drugs or alcohol as a
means of self medicating herself to help cope with her unresolved pain.
V. Course of the disturbance of more than one month's duration, or onset may be delayed
usually greater than six months after the abortion.
     For post-aborted women, reactions may occur before they are off the abortion
table, or it could be 20 or more years later.  The average amount of time elapsing
before women recognize the post-abortion aftermath is five to ten years later.

Conclusion
     Please understand that this presentation of symptomatology and effects are by no
means exhaustive.  This article merely suggests the general nature of mental and
physical dysfunctions that can occur after an abortion, either 'immediately or with a
delayed reaction, and that the clinician be alerted to the symptoms as they reveal
themselves.  All of what has been presented here will not necessarily be evident in
any one individual.  Sometimes it may take
 

38


a discerning mental health professional to uncover what are the real causes of the
maladies.  One of the objectives in this article is to alert the attending health care
professional to the possible fact that an abortion may be a major factor in the
recognition and treatment of a woman's health needs.  Needless to say, if a patient
comes in with some of the symptoms stated above and it goes unrecognized, then
there is a greater chance for misdiagnosing her medical or physical condition.
Please also refer to my article (1998) "Defense Mechanisms, Risk factors and
Interventions with the Post Abortive Client" in which listening, validating, praying
and making appropriate referrals are discussed.
     At Rachel's Hope Post Abortion Healing and Reconciliation Workshops which I
have facilitated over the last five years, I have witnessed many symptoms of
Post-Abortion Syndrome.  These individuals are at risk for an emotional disorder
along with physical maladies and spiritual distress.  To enable women to be able to
adequately process their post-abortion sequelae, benefit would come from
spiritual/psychological counseling on an individual basis with a minister/therapist
who is knowledgeable of post-abortion syndrome and its treatment, or in a group
workshop that addresses these issues.  Many programs of Post-Abortion healing
are springing up all over the world.  Individual therapy and group work are
compatible with one another.  Referrals for post-abortion healing groups listed in
many cities can be make through the National office of Post Abortion
Reconciliation and Healing, 1-800-5WE-CARE.

References

     Angelo, E. (1992).  Psychiatric Sequelae of Abortion: The Many Faces of Post¬
Abortion Grief.  Linacre Quarterly, 59,2: 69-80.
     Ashton, J. (1980).  The Psychosocial Outcome of Induced Abortion.  British Journal
of Obstetrics & Gynecology, 87(12):1115-1122.
     Benefield, J. (1997).  Misdirected Therapy for Post-Abortive Clients.  The Journal
of Christian Healing, 19:4, 32-42.
     Benefield, R. (1998).  Defense Mechanisms, Risk Factors and Interventions with
the Post-Abortive Client.
  Journal of Christian Healing, 20:2, 3-19.

     Burt, V. and Hendrick, V. (1997), Women's Mental Health.  Washington, DC:
American Psychiatric Press.
     Casey, P. (1997).  Psychological Effects of Abortion.  Elm Grove, WI: Catholic
Medical Association.
     De Puy, C. (1997).  The Healing Choice.  New York: Simon & Schuster.
     DeVeber, L., Azenstat, J. and Chisholm, D. (1991).  Postabortion Grief- Psychological
Sequclac of Induced Abortion.
  Humane Medicine, 7:203-209.

     Diagnostic and Statistical Manual of Mental Disorders-Revised DSM-III.  Washington,
DC
: American Psychiatric Press.
     Doherty, P., editor (1995).  Post-Abortion Syndrome.  Portland, OR: Four Courts
Press.
     Fisch, R. and Tadmor, 0. (1989).  Iatrogenic Post-Traumatic Stress Disorder.
Lancet, 2(8676):1397.
     Friedman, C., Greenspan, R. and Mittleman, F. (1974).  The Decision-Making
Proccss and the Outcome of Therapeutic Abortion.
  American Journal of Psychiatry,

131 (12):1332-1337.
     Gaston, L. (I 998).  The Complexity of Treating Trauma, Stepping Out of the
Confusion about PTSD.
  The California Therapist, IO: 1.

     Mannion, M., editor (1994).  Post-Abortion Aftermath.  Kansas City, MO: Sheed
& Ward.
     Ney, P., Wickett, A. and Fung, T. (1993).  Relationships Between Induced Abortion
and Child Abuse: Four Studies.  Pre- and Peri-natal Psychology Journal,
8,1:43-63.
     Ney, P. and Peeters, M. (1997).  Deeply Damaged, An Explanation For The Profound
Problems Arising From Infant Abortion And Child Abuse.
 
Victoria,
Canada
: Pioneer Publishing.
     Pearce, S. (I 995).  Post Abortion Syndrome Healing and Recovery Training
Materials, 1995.

     Reardon, D. (1987).  Aborted Women - Silent No More.  Chicago, IL: Loyola
University
Press.
     Reardon, D. (I 990).  Women at Risk.- Abortion and the High Risk Patient.
Springfield, IL: Springfield Right To Life.
     Reardon, D. (1995).  Revisiting the "Koop Report." The Post-Abortion Review.
Springfield, IL: Elliot Institute, Summer.
     Reardon, D. (1996).  The Jericho Plan, Breaking Down the Walls Which Prevent
Post-Abortion Healing.
  Springfield, IL: Acorn Books.
     Rue, V. (1981).  Abortion and Family Relations.  Testimony presented before the
Subcommittee on the Constitution of the US Senate Judiciary Committee, US Senate,
97th Congress, Washington, DC.
     Saitenberger, A. (1984).  Ectopic Pregnancies Increasing.  The National Right To
Life News, 16 Aug. 1984.
     Selby, T. with Bockman, M. (I 990).  The Mourning After.  Help for Post Abortion
Syndrome.
 
Grand Rapids, MI: Baker Book House.
     Speckhard, A (I 987).  Psycho-Social Stress Following Abortion.  Kansas City,
MO
: Sheed & Ward.
     Stanford-Rue, S. (1986).  Will I Cry Tomorrow?  Healing Post-Abortion Trauma.
Fleming, NJ: Revell.
     Torre-Bueno, A. (I 9%).  Peace Aj?er Abortion.  San Diego, CA: Pimpemel Press.
     Wynn, M. and Wynn, A. (I 973).  Some Consequences of Induced Abortion to
Children Born Subsequently.
  Marriage and Family Newsletter.  Vol. 4, Nos. 2-4.

     Zimmerman, M. (1977).  Passage Through Abortion: The Personal and Social
Reality of Women's FxperienceNew York: Praeger Publishers.
 
 



Rosemary Benefield is a Registered Nurse and received double masters degrees
in Marriage, Family and Child Counseling and Pastoral Counseling.  She
graduatedftom Mercy College of Nursing in
San Diego and Trinity College of
Graduate Studies in
Anaheim, CA.  She has been Director Of Counselingfor pre-
and post-abortive women at Mercy Hospital Pregnancy Counseling Center since
January 1992.  In September 1994 she became the founder and director of
"Rachel's Hope Post-Abortion Healing and Reconciliation Workshops" in San
Diego
.  She is author of a nurses' continuing education course "Beyond Grief
Strategies and Interventions of Abortion Aftermath " and a member of the
Association of Christian Therapists.  Rosemary has been married to Jim Benefield
since 1969 and has two children and three grandchildren.
 
 



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Rosemary Benefield via:  
Email: rachels_hope@juno.com  
Phone: (858) 581-3022

Jim Benefield via:  
Email: jimbenefield@juno.com  
Phone: (858) 581-0952

Fax: (858) 581-0952

Mail: P.O. Box: 17363

San Diego, CA. 92177