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Friday, February 24, 2012

The Psychological Effects Of Abortion



The Psychological Effects of Abortion
Deacon Patrick Kearns, RN-BC
Board Certified Psychiatry / Mental Health

     The topic of abortion has been a controversial issue for over 40 years and continues to create debate amongst political, academic, and religious groups. Although many people have strong feelings regarding this issue, often they lack factual knowledge regarding the potential associated psychological repercussions. There are two distinct types of abortion, spontaneous and elective. A spontaneous abortion is the action of the body expelling a fetus and the woman having no control over the action. An elective abortion is the act in which a woman makes a cognitive decision to terminate her pregnancy and often seeks professional assistance to accomplish the act. In 1973, with the case of Row versus Wade, the Supreme Court of the United States of America established that a woman has the legal right to terminate her pregnancy by having the human fetus removed from within her womb. Since the legalization of abortion, there has been an enormous response with the utilization of medical technology in separating the growing fetus from the woman’s womb and terminating the pregnancy. There are many reasons why some women desire to terminate a pregnancy ranging from the perception of not having enough money to raise a child, to not being mature enough, to feeling that the child will interfere with their plans of education or work, or plainly that they just do not want the child. Apart from having the legal right to abort and terminate a pregnancy, there have been many claims that there might be residual side effects from an abortion act. This research paper will explore the potential psychological effects of an elective abortion, specifically looking for a post-abortion correlation with mental health complications, long-term psychological issues, residual relationship deterioration, changes in sexual attitude, and lifestyle adjustments. Further research is important in exploring the complexity of these issues and to give additional insight into the psychological effects of abortion, however, this paper will clearly show through an intensive review of credible studies that current research does confirm that having an abortion often leads to mental health problems, relationship issues, and unhealthy behavior.

     Although the physical process of having an abortion may only take an hour or two, abortions may trigger significant and long-lasting mental health problems. A psychological study completed in 2006 showed that 65% of women who chose an elective abortion possessed a significantly higher risk for subsequent depressive illness (Fergusson, Horwood & Ridder, 2006). Possessing a higher risk does not necessarily mean that the woman will need treatment for depression but does imply that the population of women who do terminate their pregnancies will be more likely to experience a depressive life episode than women that did not terminate their pregnancy. Further research by Coleman (2009) established that 10-30% of women who chose to terminate their pregnancy suffered significant psychological complications. For example, Speckhard (1997) identified that after the abortion many women claim to suffer incidents of flashbacks related to emotions of great attachment to the terminated child and these episodes frequently contain images of a torn apart fetus, visual images, and emotions experienced at the time of the abortion, and great distress regarding judgment and grief. This research not only identifies an elevated risk for mental health complications but also confirms that the act of terminating a pregnancy may lead to significant mental health issues in a substantial amount of women.

     For years, the personal choice of having an abortion had been considered a woman’s issue and thought that whatever she choose in respect to maintaining or terminating the pregnancy would only affect her and no one else. For some women, they described that once the pregnancy was terminated they felt free from physical and emotional distress. However, evidence suggests that many women who have aborted their child mentally suppress the memories and emotions related to the abortion and subsequently experience physiological sequela such as headaches, concentration problems, social isolation and weight changes (Boulind & Edwards, 2010). In addition, research conducted by Coleman, Rue, Spence and Coyle (2008) claims that 18% of men who have had exposure with a terminated pregnancy report that they suffer negative psychological symptoms. This important research established that having an abortion is not just a personal decision of the impregnated woman, isolating potential negative repercussions, but rather affects the lives of others as well.
    
     Elective abortion is not only an adult woman’s issue. Since the legalization of abortion, many have advocated to allow teenagers and minors to terminate pregnancies as well. With the promotion for adolescents and teenagers participating in abortions there has been a huge impact on the lives of adolescent women that has increased the possibility of a higher risk of mental health complications than in older women. For example, Ely, Flaherty and Cuddeback (2010) established that there is a significantly elevated rate of depression among adolescent women who have had an abortion, increasing the associated rate from 8% in the general adolescent population to 40% in the population who chose to abort. This respected study supports the claim that the younger a woman chooses to abort, in respect to an older woman, may attribute a higher risk of psychological complications, especially among adolescents and teenagers.
    
     With increasing research showing that in fact there is a negative psychological impact on women who choose to terminate their pregnancies, there was concern that subsequent abortions might also have a multiplying effect on complications and that there might be long-term residual effects as well. This unanswered question motivated additional studies in which provided factual evidence that did support the claim that with repeated abortions the rate of psychological complications also increased (Coleman, Coyle & Rue, 2010). Establishing that having an abortion does contribute to stress and subsequent mental health issues, there was still a need to evaluate if the effects were time-limited, or if there would be long-lasting complications for women who choose to terminate a pregnancy. In response to the need for additional information, Dykes, Slade and Haywood (2011) conducted a study with women who were at the age of menopause and had previously chosen to terminate a pregnancy. The study focused on establishing evidence to either support or negate the possibility that by having an abortion one might experience residual psychological complications that would not diminish over time. Their studies suggest that there are long-term repercussions from participating in the act of an abortion, specifically that at five years post-abortion there is an elevated risk for anxiety and depression, and at 10 years post-abortion many women report a continuation of negative thoughts regarding the abortion and a persistent fear of judgment (Dykes, Slade & Haywood, 2011). In light of this research, there appears to be evidence that confirms enhanced negative psychological effects with multiple abortions and long-term consequences for those associated with the abortion event.
    
     The question of terminating a pregnancy has led some to contemplate if the removal of a growing fetus has a significant impact on the couple associated with the pregnancy while also having the possibility of affecting future relationships. As a result of this pending question, a study by Coleman, Rue and Spence (2007) provided evidence that post-abortion many women experience the development of an insecure attachment condition that affects relationships and relationship communication through forming emotions of betrayal, mistrust, insecurity, and thoughts of abandonment. In contrast, many women find that as they mature their ability to openly share their feelings and thoughts with others also grows. Yet for those who have chosen to abort a child, they may experience a somewhat different growth experience. For instance, studies suggest that many women who experience an abortion event have difficulty describing their feelings and develop avoidance symptoms (van Emmerik, Kamphuis & Emmelkamp, 2008). The inability to freely express and voice feelings can have a serious effect on relationships. If men and women have difficulty with honest communication, one could only imagine the possible repercussions preventing the maintenance of a healthy relationship. These barriers can become huge obstacles as further stressful life events challenge the relationship. These studies confirm that the decision to terminate a pregnancy may not only affect the woman in her current relationship but also supported the claim that the act of abortion might also affect subsequent relationships as well.
    
     Most people understand that love, commitment, and a satisfying sex life are important in maintaining a healthy relationship. For years, the idea of love has been associated with sex, and sex has been associated with love. Many poets and spiritual writers have eloquently described that the union of two individuals is the most beautiful of love events here on earth. However, for those who have experienced an abortion event there seems to be a modification or evolution of what sex and love mean to them. For example, research completed by Coleman, Rue, Spence and Coyle (2008) suggest that after an abortion, both men and women have reported that there has been a change in their original view that sex should only happen if in love and that their number of sexual partners had increased after the abortion. The understanding that a man and woman do not need to be in love to have sex changes the whole concept of relationship and diminishes the beauty and significance of the conjugal embrace to nothing more than a recreational act and removes the need for commitment. In 2008, further research was conducted that explored the residual effects of abortion and the reported sex lives of women. Research suggested that 24% of women experience negative sexual effects post-abortion, 33% experiencing a decline in sexual desire, and 26% reported a decrease in sexual enjoyment (Coleman, Rue, Spence & Coyle, 2008). These studies appear to confirm that a woman who terminates a pregnancy may experience a significant change in her concept of relationship, commitment, love, and even her sexual satisfaction.
    
     There is also a concern that one who has had an abortion might experience a serious negative condition known as detachment. This condition represents an inability to form a healthy attachment to children and can be a significant obstacle for healthy parenting. A study reinforcing this concept was completed in 2009 investigating the effects of having an abortion and parenting. The results of the study identified evidence that 69% of women who experienced an abortion reported having a sense of numbness and detachment often felt for years. This condition of numbness and detachment can affect the bonding with other children, specifically, that many women possess the sense that they are now not worthy to have a child and that to compensate for the abortion they need to be a perfect parent (Coleman, 2009). This psychological state can become problematic for women who possess unrealistic expectations in regard to parenting and can cause residual problems not only for themselves but for the child as well.
  
     Individuals who have a balance of work, play, proper nutrition, rest, positive friendships, and possess functional coping mechanisms usually exhibit a healthy lifestyle. There has been some concern that by having an abortion one might experience a negative change in their lifestyle, adopting unhealthy behaviors, and due to this concern there was a need for further research. This concern for further investigation did inspire Coleman (2009) to explore this issue more deeply. Her research found that by having an abortion a change did occur in the woman’s lifestyle but more specifically in her ability to cope in general. Her research provided evidence to support that there is an associated psychological connection between having an abortion and an increase in unhealthy behaviors such as excessive use of alcohol, drugs, food, spending, work, and sex (Coleman, 2009). With the identification of this link between having an abortion and the development of unhealthy behaviors there was also concern in identifying why and how this actually occurs. In 2011 a study was completed that explored why this phenomenon occurred and found further evidence that suggested that women who have had an abortion are more often associated with using substances to cope with additional pregnancies (Dykes, Slade & Haywood, 2011). In spite of these scientific studies, there are still many questions unanswered regarding how the participation in an elective abortion affects the psyche of a woman. Taking into account what we do know in the field of mental health, it is common for men and women to experience a significant event in their lives and then either consciously or subconsciously develop negative psychological repercussions from that event. Similarly, when a person feels justified in their rationale for making a significant life decision, many seem to experience unresolved guilt and emotions related to the event that can linger causing instability in their lives. Supporting such a claim, in a study by Speckhard (1997) it was identified that by choosing to have an elective abortion there is an association with the retention of feelings that linger regarding the abortion and the inability to reconcile with those emotions. This condition has led some women to an increase in aggressive actions and even violence (Speckhard, 1997). In light of these scientific studies, it appears that there is factual evidence supporting the association with terminating a pregnancy and a change in lifestyle with an increase in unhealthy behaviors.
 
     In review and conclusion of this evaluation of the psychological effects of abortion, it appears that there is sufficient evidence that supports the claim that by having an abortion there is a higher associated risk of mental health issues, not only affecting women, but also the men who participated in the experience. The research has also shown that by having an abortion experience many women will be subject to long-lasting complications with partner relationships as well as parenting issues. The studies also seem to suggest that for many having an abortion leads to unhealthy behaviors such as substance abuse, aggression, and excessive use of work and sex as coping mechanisms. There is a great need for further research in the area of discovering the association with choosing to abort a growing fetus and the psychological effects of abortion. This further research will allow an honest evaluation of the complexity of this issue and should give additional insight not only for the women contemplating abortion but for the greater society as well. However, it is apparent that current research does confirm that having an abortion often leads to mental health problems, relationship issues, and unhealthy behavior.

Reference List

Boulind, M., & Edwards, D. (2010). The Assessment and Treatment of Post-Abortion Syndrome: A Systematic Case Study From Southern Africa. PCSP: Pragmatic Case Studies in Psychotherapy, 6(4), 539-547.

Coleman, P. (2009). The psychological pain of perinatal loss and subsequent parenting risks: could induced abortion be more problematic than other forms of loss. Current Women’s Health Reviews, 5(2), 88-99.

Coleman, P. K., Coyle, C. T., & Rue, V. M. (2010). Late-Term Elective Abortion and Susceptibility to Posttraumatic Stress Symptoms. Journal Of Pregnancy, 1-10.

Coleman, P. K., Rue, V. M., Spence, M. & Coyle, C. T. (2008). Abortion and the sexual lives of men and women: Is casual sexual behavior more appealing and more common after abortion? International Journal Of Clinical Health & Psychology, 8(1), 77-91.

Coleman, P. K., Rue, V. M., & Spence, M. (2007). Intrapersonal Processes and Post-Abortion Relationship Challenges: A Review and Consolidation of Relevant Literature. Internet Journal Of Mental Health, 4(2): 34p

Dykes, K., Slade, P., & Haywood, A. (2011). Long-term follow-up of emotional experiences after termination of pregnancy: women’s views at menopause. Journal Of Reproductive & Infant Psychology, 29(1), 93-112. doi:10.1080/02646838.2010.513046

Ely, G. E., Flaherty, C., & Cuddeback, G. S. (2010). The Relationship Between Depression and Other Psychological Problems in a Sample of Adolescent Pregnancy Termination Patients. Child & Adolescent Social Work Journal, 27(4), 269-282.

Fergusson, D. M., Horwood, L., & Ridder, E.M. (2006). Abortion in young women and subsequent mental health. Journal Of Child Psychology & Psychiatry, 47(1), 16-24. doi:10.1111/j. 1469-7610.2005.01538.x

Speckhard, A. (1997). For some teens, abortion as a means of coping can become a stressor. Brown University Child & Adolescent Behavioral Letter, 13(1), 1.

van Emmerik, A., Kamphuis, J., & Emmelkamp, P. (2008). Prevalence and prediction of re-experiencing and avoidance after elective surgical abortion: a prospective study. Clinical Psychology & Psychotherapy, 15(6), 378-385.


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