Reproductive Power and the Psychology of Abortion

By Nicole Gray

Women face a certain amount of vulnerability around their reproductive capabilities. In fact, much of the clinical literature that deals with depression and anxiety in women focuses exclusively on topics such as menstruation, pregnancy, infertility and menopause and the effects that these reproductive issues have on women physically, emotionally and in psychosocial terms. Abortion, another reproductive health issue, is considered ?psychologically benign? by the American Psychological Association---meaning that women do not generally suffer irreparable psychological damage from having an abortion. [1] Until January 22, 1973, potential problems associated with abortion included lack of access to legal abortions and high levels of mortality and disfigurement associated with illegal abortions. [2] Now, with the advent of legalized abortion, the conversation has shifted. The major concerns are how abortion affects a woman psychologically as well as her future reproductive options. Two important questions are: How does a woman feel when she has an abortion and how can she successfully cope with her feelings?

Abortion is, simply put, one response to an unwanted pregnancy. Women have numerous responses and options, but for many women, abortion resolves an agonizing crisis. Women who opt for abortion may feel that it makes sense at a given time due to personal, financial, and cultural concerns. These concerns and feelings are legitimate for women and underscore a healthy desire to maintain some control over the situation in which they bear children. [3] So, although there is a great deal of religious and moral debate attached to the issue of abortion, in strictly logical terms, abortion gives women more power over their reproductive lives. For this reason, the legalization of abortion has caused profound sociologic changes in reproductive behavior. In 1996, there were 1.37 million abortions performed in the United States. That year, 2.3% of women between the ages of 15 and 44 had abortions. [2]

Women who have abortions often feel guilty and experience a sense of loss, but clinical research shows that these feelings are normal and self-limiting. Physically, induced abortions are not associated with subsequent infertility (link to infertility), miscarriage (link to miscarriage), or ectopic pregnancy. However, there is a slightly increased risk of pre-term delivery. 2 Researchers have looked extensively at women faced with unintended pregnancies. They found that women who chose to have children although their pregnancies were unintended faced a heavier psychological toll than women who had abortions. In one study, they found that the rate of psychosis was ten times higher post-delivery than post-abortion. [4] Nonetheless, each woman faces unique circumstances in which she finds herself pregnant. Also, each person has different values that are a result of a complex interplay between religious beliefs, financial circumstances, partnership status, family history, reproductive history and personal will. According to data from the Centers for Disease Control, 52% of women who have abortions are under the age of 25 and 80% are unmarried and are not prepared to become parents. [5] However, some women who have abortions feel depressed (link internally to depression) afterwards. For example, women living in chaotic or abusive situations have unique reproductive problems. For them, contraception is problematic and sexual relations may be coerced or dangerous. Although abortion offers them some control over reproduction, the context in which they decide to terminate their pregnancies can leave them feeling more powerless and hopeless. Other risk factors for depression after abortion include, pre-existing psychiatric illnesses, a lack of social support, ambivalence and advanced maternal gestational age. When you add the problem of antiabortion protests and harassment of women seeking abortions, it can be a harrowing experience. [6]

Before an abortion, women generally undergo counseling, including some type of informed consent process, a discussion of plans for dealing with contraception after abortion, an attempt to identify potential psychological problems, and a discussion of the procedure, including risks and the likelihood of success.3When a woman feels powerless to make a decision that works for her or feels that she has no alternatives, the result is likely to be depression. However, most women who want and seek abortions eventually express a mixture of happiness about having a choice, guilt about the situation and relief that it?s behind them. Those who fare the best seek support from their partner, a friend or family member. For more information and to seek support, visit: Planned Parenthood.