Women's Perspectives on Abortion Relative to PTSD

The abortion debate tends to cause people to project their own beliefs about abortion onto what they perceive to be the experience of women who have abortions.

But in fact, each woman has her own unique and individual views on her abortion experience. And it is her own views, not the opinions of others, which has the most important effect on whether or not she will experience abortion as trauma.

That means that if she perceives her pregnancy as involving a human life (i.e. in our research we keyed this as recognition of human life) and then furthermore attaches to that life (i.e. feels any type of attachment, refers to the embryo/fetus as "my baby", or herself as a mother, etc.) she has perceived/defined the abortion event in a manner that will make it likely to experience it as a criterion A stressor event capable of causing posttraumatic stress disorder.

In our research we have found these two variables -- (1) the woman's own recognition of life and (2) feelings of attachment to the pregnancy -- to be the highest predictors of PTSD responses after an abortion.

On the other hand if a woman sees the abortion as nothing much for her, i.e. she has no feelings of attachment or perception that a life is destroyed by abortion, she is far less likely to experience her abortion as a traumatic event. Such a woman is unlikely to experience PTSD symptoms unless she is traumatized by other things which can also be additive in the first case (coercion to get the abortion, a very painful invasive experience, an abusive doctor or clinic protocol, etc.)

From a pro-choice outsider's perspective the first case (recognizing fetal life and attaching to it) can be seen as "sick" if the outsider believes that sick to experience a pregnancy so personally and relationally because after all it is not really a human child.

From a pro-lifer's outsider's perspective, it is the second case (not feeling loss and trauma) can be seen as sick - morally detached, insensitive, or unhealthy because for her the abortion doesn't carry enough weight to be likely to cause her trauma.

Both outsiders perspectives can be argued strongly, but such arguments depend on the view of pregnancy that each outsider holds. But what is operational for the woman who actually has an abortion is not the view of the outsider but rather her own view. In other words, her risk of experiencing abortion trauma is primarily relative to own perceptions.

It should also be noted that her own unique view can change overtime.

A woman who was originally unmoved by abortion may have a delayed traumatic reaction years later, for example when she has a sonogram of a later pregnancy that deconstructs her first view that it's not a fetal life worth worrying about. In such cases, a woman who was coping well may become deeply traumatized because she now perceives the past experience in a new way (again, from her own viewpoint)and may even feel a need to create or restore a relationship to the aborted pregnancy (i.e. creating psychological presence of an aborted fetal child that she can now grieve). Again, all of this must be considered from her perspective. That is the most important factor in regard to her experiencing PTSD--including, in this case, as a delayed reaction.

Of course how others define things can also cause mental health problems. A woman who is traumatized but is told by her society to "buck up" as if it was nothing, feels pressured to hide or repress her feelings. Conversely, a woman who feels condemned for not feeling remorse, guilt, or grief after an abortion may also find that difficult to deal with.

In either case, I want to emphasize for the argument over whether abortion causes PTSD has to be considered within the framework of each woman's own perspective.

It is often too easy for outsiders to define "sick" from the framework of their own perspectives. Whereas, from my clinical experience, it seems clear that the risk of becoming "sick" from an abortion experience has much more to do with the individualistically defined view of the woman herself.

-- Anne Speckhard, Ph.D. Adjunct Associate Professor of Psychiatry Georgetown University Medical School