Abortion

Coping Mechanism Turned Stressor

Abortion is normally resorted to as a coping mechanism—as a means to escape the stressor of a pregnancy by terminating it. While most women are believed to fare well after abortion, there is clear evidence that for some women abortion precipitates negative psychosocial consequences, with symptoms ranging from short-term mild distress to major psychological disorders including depression, anxiety, panic disorder, acute and posttraumatic stress disorder (PTSD), and even psychotic responses. This entry examines (a) the ways in which abortion can act as a traumatic stressor; (b) the numbers of women likely involved; (c) how preexisting conditions, as well as issues inherent in the abortion itself, may make it more likely for abortion to be experienced as traumatic; (d) the types of symptoms that unfold when abortion acts as a traumatic stressor—including complicated grief and guilt responses; and (e) the controversies over postabortion stress research.

Estimates of the Numbers of Women Involved

To estimate the numbers of women psychologically distressed by their abortions, a representative study is necessary comparing women terminating pregnancies by all possible forms (i.e., induced abortion, miscarriage, stillbirth, and birth), one that takes into account preexisting conditions that may factor into a distress response. Thus far, no such study of American women exists. It is possible, however, to extrapolate from small-scale clinical studies of women who are distressed following their abortions and see that the numbers of symptomatic women generally hovers around 20%. Given the huge numbers of women having abortions, even a small percentage having negative psychological symptoms constitutes a significant number of women.

Controversies over Postabortion Stress Research

In the 1980s, when posttraumatic responses to abortion were first being documented by researchers, there was considerable controversy in the United States over the possibility of abortion to act as a traumatic stressor and over the numbers of women affected. Even today, those who oppose abortion rights often claim large percentages of women are affected, whereas those who favor abortion rights diminish the numbers and cite preexisting conditions (poor mental health, abusive relationships, coercion, etc.) as the main, or only, reasons women are distressed after abortion rather than anything inherent in the abortion experience itself.

While preexisting conditions do make women more vulnerable to postabortion distress, there is no doubt that some subset of women, with or without preexisting vulnerabilities, do suffer psychologically as a direct result of their abortion experience. Some suffer severely and immediately; others have delayed responses.

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