Abortion can be a traumatic experience for women whether it is wifully done or forced. The psychological impact abortions tend to have need to be scientifically treated.

By Balaji Subramanian

Psychological sequelae of abortionis often discussed but it is an ill studied domain. It is common for people to talk about abortion being harmful to the mother’s psyche but how exactly does it affect and what are the factors which determine how much any woman will be affected by this the procedure differs widely.

There are bound to be emotional side effects after an abortion or pregnancy termination, whether it was planned or not. All humans have coping mechanisms within them, therefore a woman may recover from this termination of pregnancy quickly or in some cases, depression may occur.

However, the link between pregnancy termination and depression remains unclear because the guilt or sadness may be due to reasons like abortion in the second trimester of pregnancy and religious beliefs or those of their social environment are disapproving of abortion.

The decision to terminate a pregnancy is rarely an easy one and the fact of the matter is in most cases it is not the preferred choice of the individual. However, even if the termination was based on free will, they can have mixed feelings after the procedure. However, in countries where abortion is legal, the number of women dying from getting a botched back-alley abortion has dropped significantly.

In research, we usually see that there are three categories in which the psychological effects may be studied.

Elective abortion and its psychological sequelae

When we look at elective abortion in which the mother and the family make an informed decision to terminate the pregnancy, usually due to congenital defects in the fetus or maternal ill health, the health of the mother, age, financial consideration and reproductive control.

The effects have been seen to be transient and consist of depression and anxiety which usually subsides within a few months akin to a grieving process. If the family are allowed to mourn and allowed to see the formed fetus, the process of grieving is expedited according to studies.

Abortion as a trauma

The second category is a difficult domain to study as can be expected. These abortions are forced upon the women by social, financial, criminal acts or political situations. These women suffer from symptoms ranging from severe depression, anxiety, posttraumatic stress disorder and even psychotic disorders and many may attempt or commit suicide.

An example of the social causes of abortion is female feticide. In such situations, women may experience shame and guilt at not being able to save her child who is of the same gender as her. Women who have born female children are judged in some parts of the world as being unlucky for the family and this is a huge source of stress during the pregnancy which may affect the fetus.
Psychological factors in the mother which lead her to have a vulnerability to post-abortion sequelae.

Horrific abuse and rape (including marital rape) resulting in pregnancy may lead a woman to seek an abortion. As these situations are highly stigmatizing, such abortions may happen in shady places by non-medical people or quacks which results in high rates of infection leading to adhesions and even death. Such situations are highly traumatic for the woman and lead to severe consequences like PTSD, depression, anxiety disorders and suicide. Such women should be provided psychiatric help and therapy however it is very unlikely that they are able to access such help.

Political situations like social unrest, war, migrant population, refugees and One-Child policy as in China – are sometimes reasons for abortion to be done. This may be against the woman’s wish. This can lead the woman to feel trapped and extremely guilty at having been unable to protect her child. She may fall into depression and even psychosis.

Research shows that although many women experience feelings of guilt, sadness, or loss after choosing to have an abortion, however, in many cases these emotions typically last for a very short period of time and often overcome without professional help. However, hormonal changes that occur after the termination of the pregnancy may also lead to sadness in some individuals.

When we analyse the psychological factors which may lead a woman to be vulnerable to psychological effects of abortion, the following are often quoted in studies: past history of mental health issues, history of abuse especially sexual abuse, growing up in a family or culture where gender inequalities and patriarchy are rampant, domestic violence and where the abortion is coerced by family or society due to political pressure.

We can conclude saying that abortion is consistently associated with elevated rates of mental illness compared to women without a history of abortion; (b) the abortion experience directly contributes to mental health problems for at least some women; (c) there are risk factors, such as pre-existing mental illness, that identify women at greatest risk of mental health problems after an abortion.

A 2008 report of the American Psychological Association’s (APA) Task Force on Mental Health and Abortion (TFMHA) concluded that “it is clear that some women do experience sadness, grief, and feelings of loss following termination of a pregnancy, and some experience clinically significant disorders, including depression and anxiety.”

In saying this, the opposite is also true in that is the family or the lady does not want to keep the child and is denied an abortion, it may lead to depression and anxiety, neglect of the child and child abuse.

The emotional needs of a woman who has had an induced abortion may differ from a woman who has experienced a spontaneous abortion. In case of a miscarriage, a woman may feel guilty, however, she may also be glad if the abortion was induced because it was an unwanted pregnancy.

Balaji Subramanian is a freelance writer who writes in the field of mental health, music and politics. He tweets @LaxmanShriram78