Identifying and Overcoming Post-Abortion Syndrome

If you have ever had an abortion, you probably feel very much alone with the memories of your experience. Perhaps the father of the baby has long since passed out of your life. Or it seems as if no one wants to hear about your pain anymore. So you've taken all those complicated feelings surrounding the abortion decision and stuffed them down and tried not to think about them,right?

Did you know that 44 percent of all American women will have an abortion at some point during their lifetime? More than a million American women will have an abortion this year, but hardly any of them talk about it. Why is that?

Many women who have abortions are very uncertain about their decision. On the one hand, their feelings say, “This is my baby…I will do what I need to in order to protect and nurture this child.” But too often, their circumstances say, “This is not a good time to have a baby…abortion is legal and easy; it'll be as if it never happened…it's the only solution to this mess.” One writer said that a woman chooses an abortion like an animal, caught in a trap chooses to gnaw off its own leg in order to escape.

Simply put, most women who choose abortion are going against their own moral codes, and this explains why they feel guilt afterward. And the guilt is what stops them from talking about it or getting the emotional help they deserve. A number of counselors who have explored this issue in some depth have identified a condition that they call “post-abortion syndrome” (PAS), defined as an ongoing inability to:

Process the painful thoughts and emotions – especially guilt, anger and grief – which arise from one or more unplanned pregnancies and subsequent abortions.

Identify (much less grieve) the loss that has been experienced.

Come to peace with God, herself and others involved in the pregnancy and abortion decision.

The Grieving Process

If a woman chooses to have an abortion in order to bring a personal crisis to an end, why on earth should she be upset afterward about losing her baby? Needless to say, the post-abortive woman faces a number of monumental barriers to moving through the process of grieving her loss, or even recognizing that she has experienced a loss at all:

There is no external evidence that her baby ever existed (no pictures or other memorabilia).

She may not believe that she has the right to grieve a loss that she has chosen to create.

There is no public forum for grieving the loss of her child (no memorial service or eulogy).

The support system that usually gathers around a bereaved mother is very limited, or absent altogether, for the post-abortive woman (because in most cases few people are even told about the procedure; the ones who do know aren't likely to be excited about rehashing it afterward).

If she confides in someone who did not know about the abortion, she risks disapproval or rejection.

The preparation for the abortion rarely includes any discussion of the possibility of emotional issues – especially grieving – afterward.

If she is troubled enough by feelings of distress after the abortion, a woman may seek help from a counselor who may not understand post-abortion syndrome.

For any or all of these reasons, a post-abortive woman may not have her grief validated as a normal and predictable grieving process; and as a result, she may repress her feelings of sadness and anger. Without an opportunity to work through it, the grieving process is interrupted and may not be resumed until years later, when another significant loss occurs or she becomes pregnant again. This may trigger, to her dismay, a response whose magnitude and intensity seem out of proportion; and she may think, “Why am I having such a horrible reaction to this? Am I losing my grip?” She may begin experiencing a number of the following symptoms at this point.

Symptoms

Guilt - results from violating one's own sense of right and wrong.

Anxiety - headaches, dizziness, pounding heart, abdominal cramps, muscle tightness, difficulty sleeping, etc.

Avoidance behaviors - anything remindful of pregnancy and children.

Psychological “numbing” - the unconscious vow to never let anything hurt this badly again can hamper the ability to enter fully into am emotional, intimate relationship.

Depression - sad mood, sudden and uncontrollable crying episodes, deterioration of self-concept, sleep and appetite disturbances, reduced motivation, loss of normal sources of pleasure, thoughts of suicide.

Re-experiencing events related to the abortion – persistent thoughts and flashback memories or nightmares involving themes of lost or dismembered babies.

Preoccupation with becoming pregnant again – representing an unconscious hope that a new pregnancy will replace the baby that was aborted.

Anxiety over fertility and childbearing issues – being convinced that God will punish by withholding future pregnancies.

Interruption or disruption of the bonding with present and/or future children – underbonding or overbonding with other children, whether born before or after a woman has an abortion.

Self-abuse/self-destructive behaviors – eating disorders, alcohol and/or substance abuse, cigarette-smoking, abusive relationships, promiscuity, failure to take care of one's self medically.

Anniversary reactions – an increase in symptoms around the time of the anniversary of the abortion, the due date of the aborted child or both.

Brief psychotic disorder – a psychotic break with reality lasting for a short period of time within two weeks of the abortion.

The Tasks of Healing

When a woman comes to a point in her life where she recognizes the need to finally deal with a past abortion, there are several tasks to be accomplished.

1) Remembering the Pain

The first step in the healing journey is peeling away the callus formed by months or years of denying and repressing the painful emotions connected with the abortion experience. Why is it necessary to dredge up that which the mind has worked so hard to forget? Because the grief, anger and guilt a woman felt about the events surrounding her abortion were never processed. They were bundled up and hidden away since they were too painful to deal with; but they continue to fester like a smoldering infection, affecting current choices and behavior.

The simplest way to access these old feelings is environment in which the woman can tell about her abortion experience.

2) Spiritual Issues: Guilt and Forgiveness

It is important for the post-abortive woman to use this painful place in her life to discover and perhaps redefine her concept of God. If a woman holds any kind of spiritual beliefs, long-term healing will come only when she feels reconciled with God. Those who are able to accept the existence of a personal God, and then ask for and receive His total and unconditional forgiveness, seem to be most successful in lifting what had previously been a relentless burden of guilt.

The woman who holds a Christian worldview is very likely to begin, at some point after her abortion, to feel like a “second-class citizen” in God's economy, even though she may know this to be incompatible with Scripture. She usually will either turn away from the church completely or try to “prove herself” by being good long enough until God will finally forgive her.

Many post-abortive women, as we have already described, are secretly convinced that their transgressions are literally in a class by themselves, beyond the reach of God's forgiveness. The more important task, then is to accept on an emotional level what they may already know on an intellectual level: that God's forgiveness is already available, and that they must decide to reach out and grasp it firmly. There are three important aspects to this “firm grasp” on forgiveness: (1) knowing Who ultimately has paid the debt, (2) allowing intimacy with God to be restored and (3) understanding the difference between punishment and consequences.

The Bible clearly teaches that God has made provision for the forgiveness of wrongdoing. But the post-abortive woman often has a very difficult time believing that forgiveness is available for her selfish and catastrophic choice. Thus, in apparent contradiction to (or ignorance of) her own theology, she cannot accept God's forgiveness. Instead, she continues to live in a compartmentalized state in which her head knowledge and her heart knowledge do not match. Like the person described in the Matthew 18 parable, she has been told of her Lord's forgiveness; but her guilty emotions still demand that she pay her debt herself.

Restoring intimacy is the second aspect of forgiveness, and it is perhaps best understood in the parent-child relationship. When a child chooses to do something wrong, a healthy, loving parent needs only to know that the child is genuinely sorry for her actions for reconciliation and intimacy to be restored. In the same way, God only needs for us to verbalize our responsibility and sorrow for our action in order to restore intimacy with Him.

Finally, the third aspect of forgiveness has to do with understanding the difference between punishment and consequences, which are all too easily confused. For the post-abortive woman. a consequence might be infertility. It is tempting for her to interpret this as a sign of God's continued judgment and rejection. Instead, she needs to understand God's care for her, and His limitless capacity to redeem the fallout from unwise choices in a fallen world. God, as a loving parent, is as grieved as we are about the losses brought on by our choices. But living with the consequences of our choices is a key part of the uncoerced relationship God desires to have with us.

3) Identifying and Releasing the Anger

Many post-abortive women have a serious resistance to verbalizing their anger. They think, “If I go to that bleak, unlit place inside me, I may get in touch with a rage that will lead to a total loss of control.” And control is everything to a person who is barely hanging on to normal functioning in the wake of unresolved trauma.

Many people are raised in homes where it is not only considered wrong to express anger, but any display of negative emotions is off limits. The woman who has been raised in a religious home may be particularly hampered in this task area, because she has heard countless sermons exhorting her not to be angry or to express anger toward another human being. Rather, she is to swallow it and forgive others, as she has been forgiven to God.

Unfortunately, until the anger is identified and disposed of, it lays beneath the surface like a pool of toxic waste, always threatening to boil up and interfere with any efforts to reach wholeness. The paradox is this: until the post-abortive woman is willing to stop denying the pain and anger she felt (and still feels) about her abortion, she will never get rid of it.

4) Grieving the Loss

The need to grieve a pregnancy loss fully is well-documented, and for good reason. When a woman becomes pregnant, she instinctively knows her life has changed forever. The bonding process between mother and child begins very soon after an initial period of dazed and conflicting emotions. When that bond is broken – yes, even when it is the mother's choice to break it – something is ripped out of the woman's very soul.

Needless to say, awareness of the need to grieve the loss of an aborted child is almost nonexistent in our culture. It is thus very common for the post-abortive woman to approach this task with confusion: “How do I grieve the death of a child when I was the executioner?” Learning how to think of the baby as a real individual, naming the baby, writing out her feelings for her child, and even having a quiet, private memorial service are ways to work through the grief. Hope for Healing

You picked up this brochure (or it was given to you by someone who cares) perhaps because you are feeling some conflict about a past abortion. A lot of women feel hopeless about ever resolving the pain connected with their abortion experience. But healing is possible. Thousands of women (and men) will seek and receive help this year; you can be one of them.

You can usually find post-abortion help at your local pregnancy resource center. Find a center near you here.

There is no need for you to continue grieving silently. Reach out to someone who understands.

Teri K. Reisser, M.S., M.F.T., is a licensed marriage and family therapist who has been counseling post-abortive women since 1984.  Paul C. Reisser, M.D., serves on the National Physicians Resource Council for Focus on the Family.  Both live in Thousand Oaks, California.