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
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.
24
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.
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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
26
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 II. Reexperience The abortion trauma is reexperienced in one of the following ways:
III.
Avoidance: Persistent avoidance of stimuli associated with the
abortion trauma or numbing of general responsiveness (not present before the
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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
28
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
29
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
31
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
33
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
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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 |
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.
American Psychiatric Press.
Casey, P.
(1997). Psychological Effects of Abortion.
Medical Association.
De Puy, C. (1997). The Healing Choice.
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.
Doherty,
P., editor (1995). Post-Abortion Syndrome.
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.
& 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.
Pearce,
S. (I 995). Post Abortion Syndrome Healing and Recovery
Training
Materials, 1995.
Reardon,
D. (1987). Aborted Women - Silent No More.
Reardon,
D. (I 990). Women at Risk.- Abortion and the
High Risk Patient.
Reardon,
D. (1995). Revisiting the "Koop Report."
The Post-Abortion Review.
Reardon,
D. (1996). The
Post-Abortion Healing.
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,
Selby, T. with Bockman, M. (I 990).
The Mourning After. Help for
Post Abortion
Syndrome.
Speckhard, A (I
987). Psycho-Social Stress Following Abortion.
Stanford-Rue, S. (1986). Will I Cry Tomorrow? Healing Post-Abortion Trauma.
Torre-Bueno, A. (I 9%). Peace Aj?er Abortion.
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 Fxperience.
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
Graduate Studies in
and post-abortive women at
January 1992. In September
1994 she became the founder and director of
"Rachel's Hope Post-Abortion
Healing and Reconciliation Workshops" in
Diego
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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