REQUIREMENT OF PSYCHOLOGICAL
In a study of post-abortion patients only 8 weeks after their abortion,
researchers found that 44% complained of nervous disorders, 36% had
experienced sleep disturbances, 31% had regrets about their decision, and
11% had been prescribed psychotropic medicine by their family doctor. (2)
A 5 year retrospective study in two Canadian provinces found significantly
greater use of medical and psychiatric services among aborted women. Most
significant was the finding that 25% of aborted women made visits to
psychiatrists as compared to 3% of the control group. (3) Women who have
had abortions are significantly more likely than others to subsequently
require admission to a psychiatric hospital. At especially high risk are
teenagers, separated or divorced women, and women with a history of more
than one abortion. (4)
many post-aborted women use repression as a coping mechanism, there may be
a long period of denial before a woman seeks psychiatric care. These
repressed feelings may cause psychosomatic illnesses and psychiatric or
behavioral in other areas of her life. As a result, some counselors report
that unacknowledged post-abortion distress is the causative factor in many
of their female patients, even though their patients have come to them
seeking therapy for seemingly unrelated problems. (5)
POST-TRAUMATIC STRESS DISORDER
(PTSD or PAS):
A major random study found that a minimum of 19% of post- abortion women
suffer from diagnosable post-traumatic stress disorder (PTSD).
Approximately half had many, but not all, symptoms of PTSD, and 20 to 40
percent showed moderate to high levels of stress and avoidance behavior
relative to their abortion experiences. (6) Because this is a major
disorder which may be present in many plaintiffs, and is not readily
understood outside the counseling profession, the following summary is
more complete than other entries in this section. PTSD is a psychological
dysfunction which results from a traumatic experience which overwhelms a
person's normal defense mechanisms resulting in intense fear, feelings of
helplessness or being trapped, or loss of control. The risk that an
experience will be traumatic is increased when the traumatizing event is
perceived as including threats of physical injury, sexual violation, or
the witnessing of or participation in a violent death. PTSD results when
the traumatic event causes the hyperarousal of "flight or fight" defense
mechanisms. This hyperarousal causes these defense mechanisms to become
disorganized, disconnected from present circumstances, and take on a life
of their own resulting in abnormal behavior and major personality
disorders. As an example of this disconnection of mental functions, some
PTSD victim may experience intense emotion but without clear memory of the
event; others may remember every detail but without emotion; still others
may reexperience both the event and the emotions in intrusive and
overwhelming flashback experiences. (7)
may experience abortion as a traumatic event for several reasons. Many are
forced into an unwanted abortions by husbands, boyfriends, parents, or
others. If the woman has repeatedly been a victim of domineering abuse,
such an unwanted abortion may be perceived as the ultimate violation in a
life characterized by abuse. Other women, no matter how compelling the
reasons they have for seeking an abortion, may still perceive the
termination of their pregnancy as the violent killing of their own child.
The fear, anxiety,
pain, and guilt associated with the procedure are mixed
into this perception of grotesque and violent death. Still other women,
report that the pain of abortion, inflicted upon them by a masked stranger
invading their body, feels identical to rape. (8) Indeed, researchers have
found that women with a history of sexual assault may experience greater
distress during and after an abortion exactly because of these
associations between the two experiences. (9) When the stressor leading to
PTSD is abortion, some clinicians refer to this as Post-Abortion Syndrome
major symptoms of PTSD are generally classified under three categories:
hyperarousal, intrusion, and constriction.
Hyperarousal is a characteristic of inappropriately and chronically
aroused "fight or flight" defense mechanisms. The person is seemingly on
permanent alert for threats of danger. Symptoms of hyperarousal include:
exaggerated startle responses,
anxiety attacks, irritability, outbursts of anger or rage, aggressive
difficulty falling asleep or staying asleep, or
physiological reactions upon exposure to situations that symbolize or
resemble an aspect of the traumatic experience (eg. elevated pulse or
sweat during a pelvic exam, or upon hearing a vacuum pump sound.
Intrusion is the reexperience of the traumatic
event at unwanted and unexpected times. Symptoms of intrusion in PAS cases
include: recurrent and intrusive thoughts about the abortion or aborted
child, flashbacks in which the woman momentarily reexperiences an aspect
of the abortion experience, nightmares about the abortion or child, or
anniversary reactions of intense grief or depression on the due date of
the aborted pregnancy or the anniversary date of the abortion.
Constriction is the numbing of emotional resources, or the development of
behavioral patterns, so as to avoid stimuli associated with the trauma. It
is avoidance behavior; an attempt to deny and avoid negative feelings or
people, places, or things which aggravate the negative feelings associated
with the trauma. In post-abortion trauma cases, constriction may include:
an inability to recall the abortion experience or important parts of it;
efforts to avoid activities or situations which may arouse recollections
of the abortion; withdrawal from relationships, especially estrangement
from those involved in the abortion decision; avoidance of children;
efforts to avoid or deny thoughts or feelings about the abortion;
restricted range of loving or tender feelings; a sense of a foreshortened
future (e.g., does not expect a career, marriage, or children, or a long
life.); diminished interest in previously enjoyed activities; drug or
alcohol abuse; suicidal thoughts or acts; and other self-destructive
previously mentioned, Barnard's study identified a 19% rate of PTSD among
women who had abortions three to five years previously. But in reality the
actual rate is probably higher. Like most post-abortion studies, Barnard's
study was handicapped by a fifty percent drop out rate. Clinical
experience has demonstrated that the women least likely to cooperate in
post-abortion research are those for whom the abortion caused the most
psychological distress. Research has confirmed this insight, demonstrating
that the women who refuse follow-up evaluation most closely match the
demographic characteristics of the women who suffer the most post-abortion
distress. (10) The extraordinary high rate of refusal to participate in
post-abortion studies may interpreted as evidence of constriction or
avoidance behavior (not wanting to think about the abortion) which is a
major symptom of PTSD.
many women, the onset or accurate identification of PTSD symptoms may be
delayed for several years. (11) Until a PTSD sufferer has received
counseling and achieved adequate recovery, PTSD may result in a
psychological disability which would prevent an injured abortion patient
from bringing action within the normal statutory period. This disability
may, therefore, provide grounds for an extended statutory period.
Thirty to fifty percent of aborted women report experiencing sexual
dysfunctions, of both short and long duration, beginning immediately after
their abortions. These problems may include one or more of the following:
loss of pleasure from intercourse, increased pain, an aversion to sex
and/or males in general, or the development of a promiscuous life-style.
SUICIDAL IDEATION AND SUICIDE
ATTEMPTS: Approximately 60 percent of women who experience post-abortion
sequelae report suicidal ideation, with 28 percent actually attempting
suicide, of which half attempted suicide two or more times. Researchers in
Finland have identified a strong statistical association between abortion
and suicide in a records based study. The identified 73 suicides
associated within one year to a pregnancy ending either naturally or by
induced abortion. The mean annual suicide rate for all women was 11.3 per
100,000. Suicide rate associated with birth was significantly lower (5.9).
Rates for pregnancy loss were significantly higher. For miscarriage the
rate was 18.1 per 100,000 and for abortion 34.7 per 100,000. The suicide
rate within one year after an abortion was three times higher than for all
women, seven times higher than for women carrying to term, and nearly
twice as high as for women who suffered a miscarriage. Suicide attempts
appear to be especially prevalent among post-abortion teenagers.(13)
INCREASED SMOKING WITH
CORRESPONDENT NEGATIVE HEALTH EFFECTS:
Post-abortion stress is linked with increased cigarette smoking. Women who
abort are twice as likely to become heavy smokers and suffer the
corresponding health risks. (14)
Post-abortion women are
also more likely to continue smoking during subsequent wanted pregnancies
with increased risk of neonatal death or congenital anomalies. (15)
Abortion is significantly linked with a two fold increased risk of alcohol
abuse among women. (16) Abortion followed by alcohol abuse is linked to
violent behavior, divorce or separation, auto accidents, and job loss.
(17) (see also
New Study Confirms Link Between Abortion and
Abortion is significantly linked to subsequent drug abuse. In addition to
the psycho-social costs of such abuse, drug abuse is linked with increased
exposure to HIV/AIDS infections, congenital malformations, and assaultive
For at least some women, post-abortion stress is associated with eating
disorders such as binge eating, bulimia, and anorexia nervosa. (19)
CHILD NEGLECT OR ABUSE:
Abortion is linked with increased depression, violent behavior, alcohol
and drug abuse, replacement pregnancies, and reduced maternal bonding with
children born subsequently. These factors are closely associated with
child abuse and would appear to confirm individual clinical assessments
linking post-abortion trauma with subsequent child abuse. (20)
DIVORCE AND CHRONIC
RELATIONSHIP PROBLEMS: For most couples, an abortion causes
unforeseen problems in their relationship. Post-abortion couples are more
likely to divorce or separate. Many post-abortion women develop a greater
difficulty forming lasting bonds with a male partner. This may be due to
abortion related reactions such as lowered self-esteem, greater distrust
of males, sexual dysfunction, substance abuse, and increased levels of
depression, anxiety, and volatile anger. Women who have more than one
abortion (representing about 45% of all abortions) are more likely to
require public assistance, in part because they are also more likely to
become single parents. (21)
Women who have one abortion are at increased risk of having additional
abortions in the future. Women with a prior abortion experience are four
times more likely to abort a current pregnancy than those with no prior
abortion history. (22)
increased risk is associated with the prior abortion due to lowered self
esteem, a conscious or unconscious desire for a replacement pregnancy, and
increased sexual activity post-abortion. Subsequent abortions may occur
because of conflicted desires to become pregnant and have a child and
continued pressures to abort, such as abandonment by the new male partner.
Aspects of self-punishment through repeated abortions are also reported.
Approximately 45% of all abortions are now repeat abortions. The risk of
falling into a repeat abortion pattern should be discussed with a patient
considering her first abortion. Furthermore, since women who have more
than one abortion are at a significantly increased risk of suffering
physical and psychological sequelae, these heightened risks should be
thoroughly discussed with women seeking abortions.
excellent resource for any attorney involved in abortion malpractice is
Thomas Strahan's Major Articles and Books Concerning the Detrimental Effects
of Abortion (Rutherford Institute, PO Box 7482, Charlottesville, VA
22906-7482, (804) 978-388.) This resource includes brief summaries of major
finding drawn from medical and psychology journal articles, books, and
related materials, divided into major categories of relevant injuries.
Ashton,"They Psychosocial Outcome of Induced Abortion", British Journal of
Ob&Gyn., 87:1115-1122, (1980).
Badgley, et.al.,Report of the Committee on the Operation of the Abortion Law
(Ottawa:Supply and Services, 1977)pp.313-321.
Somers, "Risk of Admission to Psychiatric Institutions Among Danish Women
who Experienced Induced Abortion: An Analysis on National Record Linkage,"
Dissertation Abstracts International, Public Health 2621-B, Order No.
7926066 (1979); H. David, et al., "Postpartum and Postabortion Psychotic
Reactions," Family Planning Perspectives 13:88-91 (1981).
et al., "Bereavement in Post-Abortive Women: A Clinical Report", World
Journal of Psychosynthesis (Autumn-Winter 1981), vol.13,nos.3-4.
Catherine Barnard, The Long-Term Psychological Effects of Abortion,
Portsmouth, N.H.: Institute for Pregnancy Loss, 1990).
Herman, Trauma and Recovery, (New York: Basic Books, 1992) 34.
Francke, The Ambivalence of Abortion (New York: Random House, 1978) 84-95.
"Adolescent Abortion Option," Social Work in Health Care, 12(4):87 (1987);
Makhorn, "Sexual Assault & Pregnancy," New Perspectives on Human Abortion,
Mall & Watts, eds., (Washington, D.C.: University Publications of America,
Adler, "Sample Attrition in Studies of Psycho-social Sequelae of Abortion:
How great a problem." Journal of Social Issues, 1979, 35, 100-110.
Speckhard, "Postabortion Syndrome: An Emerging Public Health Concern,"
Journal of Social Issues, 48(3):95-119.
Speckhard, Psycho-social Stress Following Abortion, Sheed & Ward, Kansas
City: MO, 1987; and Belsey, et al., "Predictive Factors in Emotional
Response to Abortion: King's Termination Study - IV," Soc. Sci. & Med.,
Speckhard, Psycho-social Stress Following Abortion, Sheed & Ward, Kansas
City: MO, 1987; Gissler, Hemminki & Lonnqvist, "Suicides after pregnancy in
Finland, 1987-94: register linkage study," British Journal of Medicine
313:1431-4, 1996.C. Haignere, et al., "HIV/AIDS Prevention and Multiple Risk
Behaviors of Gay Male and Runaway Adolescents," Sixth International
Conference on AIDS: San Francisco, June 1990; N. Campbell, et al., "Abortion
in Adolescence," Adolescence, 23(92):813-823 (1988); H. Vaughan, Canonical
Variates of Post-Abortion Syndrome, Portsmouth, NH: Institute for Pregnancy
Loss, 1991; B. Garfinkel, "Stress, Depression and Suicide: A Study of
Adolescents in Minnesota," Responding to High Risk Youth, Minnesota
Extension Service, University of Minnesota (1986).
Harlap, "Characteristics of Pregnant Women Reporting Previous Induced
Abortions," Bulletin World Health Organization, 52:149 (1975); N. Meirik,
"Outcome of First Delivery After 2nd Trimester Two Stage Induced Abortion: A
Controlled Cohort Study," Acta Obsetricia et Gynecologica Scandinavia
63(1):45-50(1984); Levin, et al., "Association of Induced Abortion with
Subsequent Pregnancy Loss," JAMA, 243:2495-2499, June 27, 1980.
"Pregnancy Complications Following Legally Induced Abortion: An Analysis of
the Population with Special Reference to Prematurity," Danish Medical
Bulletin, 26:192- 199 (1979); Martin, "An Overview: Maternal Nicotine and
Caffeine Consumption and Offspring Outcome," Neurobehavioral Toxicology and
Tertology, 4(4):421-427, (1982).
Klassen, "Sexual Experience and Drinking Among Women in a U.S. National
Survey," Archives of Sexual Behavior, 15(5):363-39 ; M. Plant, Women,
Drinking and Pregnancy, Tavistock Pub, London (1985); Kuzma & Kissinger,
"Patterns of Alcohol and Cigarette Use in Pregnancy," Neurobehavioral
Toxicology and Terotology, 3:211-221 (1981).
Morrissey, et al., "Stressful Life Events and Alcohol Problems Among Women
Seen at a Detoxification Center," Journal of Studies on Alcohol, 39(9):1159
et al., "Perinatal Cocaine and Methamphetamine Exposure Maternal and
Neo-Natal Correlates," J. Pediatrics, 111:571- 578 (1978); D.A. Frank, et
al., "Cocaine Use During Pregnancy Prevalence and Correlates," Pediatrics,
82(6):888 (1988); H. Amaro, et al., "Drug Use Among Adolescent Mothers:
Profile of Risk," Pediatrics 84:144-150, (1989)
Speckhard, Psycho-social Stress Following Abortion, Sheed & Ward, Kansas
City: MO, 1987; J. Spaulding, et al, "Psychoses Following Therapeutic
Abortion, Am. J. of Psychiatry 125(3):364 (1978); R.K. McAll, et al.,
"Ritual Mourning in Anorexia Nervosa," The Lancet, August 16, 1980, p. 368.
Benedict, et al., "Maternal Perinatal Risk Factors and Child Abuse," Child
Abuse and Neglect, 9:217-224 (1985); P.G. Ney, "Relationship between
Abortion and Child Abuse," Canadian Journal of Psychiatry, 24:610-620, 1979;
Reardon, Aborted Women - Silent No More (Chicago: Loyola University Press,
1987), 129-30, describes a case of woman who beat her three year old son to
death shortly after an abortion which triggered a "psychotic episode" of
grief, guilt, and misplaced anger.
Shepard, et al., "Contraceptive Practice and Repeat Induced Abortion: An
Epidemiological Investigation," J. Biosocial Science, 11:289-302 (1979); M.
Bracken, "First and Repeated Abortions: A Study of Decision-Making and
Delay," J. Biosocial Science, 7:473-491 (1975); S. Henshaw, "The
Characteristics and Prior Contraceptive Use of U.S. Abortion Patients,"
Family Planning Perspectives, 20(4):158-168 (1988); D. Sherman, et al., "The
Abortion Experience in Private Practice," Women and Loss: Psychobiological
Perspectives, ed. W.F. Finn, et al., (New York: Praeger Publ. 1985),
pp98-107; E.M. Belsey, et al., "Predictive Factors in Emotional Response to
Abortion: King's Termination Study - IV," Social Science and Medicine,
11:71- 82 (1977); E. Freeman, et al., "Emotional Distress Patterns Among
Women Having First or Repeat Abortions," Obstetrics and Gynecology,
55(5):630-636 (1980); C. Berger, et al., "Repeat Abortion: Is it a Problem?"
Family Planning Perspectives 16(2):70-75 (1984).
Joyce, "The Social and Economic Correlates of Pregnancy Resolution Among
Adolescents in New York by Race and Ethnicity: A Multivariate Analysis," Am.
J. of Public Health, 78(6):626-631 (1988); C. Tietze, "Repeat Abortions -
Why More?" Family Planning Perspectives 10(5):286-288, (1978).
Leach, "The Repeat Abortion Patient," Family Planning Perspectives,
9(1):37-39 (1977); S. Fischer, "Reflection on Repeated Abortions: The
meanings and motivations," Journal of Social Work Practice 2(2):70-87
(1986); B. Howe, et al., "Repeat Abortion, Blaming the Victims," Am. J. of
Public Health, 69(12):1242-1246, (1979).
1997 Elliot Institute Compiled by David C. Reardon, Ph.D.