The Unspoken Pain Of Abortion

About a year or so ago I was listening to an interview on National Public Radio with Gloria Steinem and two young third-wave feminists. At the end of the interview these women were asked about the main issue feminists are still concerned with today. They all agreed: abortion rights for women.

What an exhausting and confusing issue abortion is to know how to address. As a professional counselor I received no training on the topic. Not once were the effects of abortion discussed by my professors in any class during my graduate program. It seemed a non-issue for counselors. Something only the politically minded are qualified to address. In light of a recently published book titled Forbidden Grief: The Unspoken Pain of Abortion by Theresa Burke with David C. Reardon, it seems abortion is an issue for us counselors after all. Burke has been working for sixteen years with women who have experienced abortion. She first discovered signs of emotional trauma connected with abortion while working with women suffering from eating disorders. Though abortion came up during one of the group counseling sessions with evidence of immense grief and trauma connected to it, Burke was emphatically instructed by her supervisor, a psychiatrist, not to address the issue with the women. Since I personally have been trained to lead group counseling, I can tell you that the above instruction is the exact opposite of good therapeutic practice. Fortunately, Burke did not listen and has now worked with over 2000 women suffering from grief and trauma related to having had an abortion.

What strikes me the most about Burke’s work with women who have experienced an abortion is how much the symptoms resemble Posttraumatic Stress Disorder (PTSD). As defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-4), PTSD results after the onset of a traumatic experience that compromises the physical integrity of the victim. The individual’s normal ways of coping are overwhelmed causing them to have an exaggerated and disorganized coping response.

Burke writes: “Regardless of the reasons why they have chosen to abort, and even if they are morally comfortable with their decision, many women experience abortion as a violation of their ‘physical integrity,’ as it is termed in the definition of PTSD. In many cases, women have described their abortions as feeling like ‘surgical rape.’ This is analogy is not surprising when one considers the actual mechanics of abortion.” Burke goes on to describe these mechanics which sound like something out of a horror film. It is important to emphasize Burke’s observation that even “pro-choice” women suffer trauma.

One of the most common symptoms of PTSD is the avoidance by the individual of anything that might remind them of the trauma. For someone who has been in a severe automobile accident, a PTSD response would be to avoid at all costs driving on the same road on which the accident occurred even if it takes them 30 or 40 minutes out of the way of their destination. Burke describes the experience of one of her clients who similarly avoided a certain reminder of her abortion. For this woman it was vacuuming her home. The sound of the vacuum resembled so much the sound of the machine used to suck the fetus out of her that she never vacuumed her house. She always had a friend come over and vacuum while she left the house. She simply could not hear the noise without having severe emotional reactions.

Research on the connection between PTSD and abortion is not plentiful in part because many women refuse to participate in follow-up studies, but Burke notes numerous case examples like the one above. In addition, one particular study (p.118) found that one in five women, out of a sample of 80, after having had an abortion, met all of the criteria of PTSD, and nearly half had many of the symptoms of PTSD.

How is it that the traumatic effects of abortion are not front-page news if this is the number one issue for women today? How is it that women are not informed of these possible adverse effects? In fact, many women report that they are being told the exact opposite. Burke calls this the “abortion clinic bias.” Women are being told that the psychological effects are rare or do not exist.

Burke writes (p.41–42) “Abortion advocates justify such deliberate efforts to conceal the full range of emotional risks by citing a study published by Brenda Major that evaluated women just before their abortions and then again three weeks later…the researchers found that women who expected to cope poorly after their abortions did indeed report more emotional problems than women who expected to cope well.” Regardless of a woman’s expectation, this practice blatantly violates the patient’s right to be fully informed of any risks. Selling higher expectations is a manipulation of the truth, and most likely silences those actually having adverse effects. In addition, as Burke points out (p.42–43), “if screening of information could reduce feelings of grief, loss, regret, and guilt in the first few weeks after an abortion, there is no evidence to support the belief that this will produce any long-term benefits. Instead, it is quite likely simply to delay and aggravate negative reactions.” These false expectations combine with the trauma of the abortion to create a hellish silence for women with no way of having their grief validated.

Many abortion clinics do have post-abortion counseling programs, but as in the case of one clinic, the programs are not advertised. The head counselor of San Jose’s Planned Parenthood abortion clinic admitted that the program was not promoted for political reasons, saying “we don’t want to give ammunition to the other side.” (p.40)

What exactly does it mean to be “pro-choice” if the choice is not informed? A truly “pro-choice” position would demand informing women of all of the ramifications of their decision, including all risks. But, so thick are the politics surrounding abortion that it seems the only way to get out any information that might “give ammunition to the other side” is to shout it from the rooftops, or put it on a billboard. This is exactly what has happened in my hometown of St. Louis, Missouri. This billboard reads: “Abortion increases risk for breast cancer by 30–50%. Confirmed by 28 Medical studies.” It seems so strange to be getting important medical information from a billboard, and not from abortion clinics, or medical doctors. If abortion is the main issue that feminists are confronting today, and if indeed “pro-choice” also means “pro-woman,” they will take a hard look at the reality of post-abortion trauma. They will risk giving ammunition to the other side because it is the right thing to do. Or perhaps doing the right thing is not on their list of rights.

November 23, 2002