Impact of Abortion On Others
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Men And Abortion
Adverse Pregnancy Outcomes and Subsequent First-Time Use of Psychiatric Treatment Among Fathers in Denmark. Christiansen F, Petersen J, Thorius IH, et al. JAMA Netw Open. 2024;7(5):e249291. doi:10.1001/jamanetworkopen.2024.9291
- Of the 192 455 fathers included (median age, 30.0 [IQR, 27.0-34.0] years), 31.1% experienced an adverse pregnancy outcome. Most of the fathers in the study had a vocational educational level (37.1%). Fathers experiencing a stillbirth had a significantly increased risk of initiating nonpharmacological psychiatric treatment (adjusted hazard ratio [AHR], 23.10 [95% CI, 18.30-29.20]) and treatment with hypnotics (AHR, 9.08 [95% CI, 5.52-14.90]). Moreover, fathers experiencing an early induced abortion (≤12 wk) had an increased risk of initiating treatment with hypnotics (AHR, 1.74 [95% CI, 1.33-2.29]) and anxiolytics (AHR, 1.79 [95% CI, 1.18-2.73]). Additionally, late induced abortion (>12 wk) (AHR, 4.46 [95% CI, 3.13-6.38]) and major congenital malformation (AHR, 1.36 [95% CI, 1.05-1.74]) were associated with increased risk of nonpharmacological treatment. In contrast, fathers having an offspring being born preterm, SGA, or with a minor congenital malformation did not have a significantly increased risk of any of the outcomes.
Men’s Experience of Elective Abortion: A Mixed Methods Study of Loss. Coyle, C.T. & Rue, V.M. . The Journal of Pastoral Counseling, (2010) XLV, 4-31.
- In-depth interviews were conducted with 10 men to explore the men’s experience with abortion. In addition, clinical assessments of anger, anxiety, and grief were administered. The men’s ages were 21 to 43 years. The time lapse between the abortion and the first interview ranged from 6 months to 22 years. Half of the men were opposed to their partners’ abortions. One man was supportive of the abortion initially and one was not told of the abortion until after it occurred. The rest of the men deferred the decision to their partners.
- The predominant theme identified in the interviews was that of profound loss and this was further evident in several subthemes including relationship problems, helplessness, grief, and guilt. Each of the men’s relationships with their partners ended and the men unanimously identified the abortion experience as the cause of relationship failure. All of the men reported feelings of helplessness and grief and a majority of men experienced guilt as well. Clinical assessments revealed clinically significant levels of anxiety and intense grief.
Inadequate Pre-abortion Counseling and Decision Conflict as Predictors of Subsequent Relationship Difficulties and Psychological Stress in Men and Women. Coyle, C., et al. (2010). Traumatology: An International Journal, International Journal, 16, 16-30.
- The purpose of this study was to examine associations between perceptions of preabortion counseling adequacy and
partner congruence in abortion decisions and two sets of outcome variables involving relationship problems and individual psychological stress. Data were collected through online surveys from 374 women who had a prior abortion and 198 men whose partners had experienced elective abortion. For women, perceptions of preabortion counseling inadequacy predicted relationship problems, symptoms of intrusion, avoidance, and hyperarousal, and meeting full diagnostic criteria for posttraumatic stress disorder (PTSD) with controls for demographic and personal/situational variables used. For men, perceptions of inadequate counseling predicted relationship problems and symptoms of intrusion and avoidance with the same controls used. Incongruence in the decision to abort predicted intrusion and meeting diagnostic criteria for PTSD among women with controls used, whereas for men, decision incongruence predicted intrusion, hyperarousal, meeting diagnostic criteria for PTSD, and relationship problems. Findings suggest that both perceptions of inadequate preabortion counseling and incongruence in the abortion decision with one’s partner are related to adverse personal and interpersonal outcomes.
Man’s involvement in the experience of abortion and the dynamic of the couple’s relationship: A Clinical Report. Naziri, D. (2007). The European Journal of Contraception and Reproductive Health Care, 12 (2), 168-174.
- OBJECTIVES: To investigate the way men experience abortion from a psychodynamic perspective in order to understand better the impact of this experience on their own image as men and on the couple's relationship.
- METHODS: In-depth semi-structured interviews with 16 men in Belgium and 14 men in Greece.
- RESULTS: Intrapsychic factors seem to play for men an important role in their experience of abortion, whatever their cultural context and contraceptive practices. Two-thirds of the men who agreed to participate in the research disagreed with their partner's decision to have an abortion. Such men may feel that it is impossible for them to fulfill themselves, in particular as potential fathers. This impossibility is, according to men, linked to women's attitudes, but may also be related to their own difficult identification with parental images and to socio-professional concerns.
- CONCLUSIONS: Abortion can create tensions and/or conflicts between partners by revealing their contradictory desires. It is suggested that institutions where men and women are heard can help both partners to outlive this experience as a constructive step in their personal psychosocial evolution and in their relationship.
A Critical Response to Exploring Men’s Roles in Women’s Decisionsto End Pregnancies: A Literature Review with Suggestions for Action. (Ipas Working Paper, 2009)
- An excellent review of the literature
Bibliographies and Review Articles Regarding Men and Abortion Alliance for Post-Abortion Research & Training. (2014)
- Men and Abortion Fact Sheet (Summary of observations and findings from the scientific literature concerning men and abortion.)
- Men and Abortion: A Table of Scholarly Papers (Table of studies, scholarly papers, and reviews concerning men's experience of elective abortion that have been published since 1973)
- Publications concerning Men and Abortion. (List of academic papers, books, and articles concerning men and abortion.)
The Effects of Abortion on Men. Rue VM. Ethics and Medics. 21(4):3, 1996.
"Psychopathological effects of voluntary termination of pregnancy on the father called up for military service," DuBouis-Bonneford et al, Psychologie Medicale 14(8): 1187-1189, June 1982
- Several case studies are presented of 18-22 year old males who came from disadvantaged backgrounds and were recent military recruits. All had extreme depression and/or attempted suicide brought on by the news of their wives or girlfriends having had a voluntary induced abortion. The men believed that becoming a father would make them more mature or respectable and the abortion brought on feelings of self-recrimination and self-punishment.
"Emotional distress among couples involved in first-trimester induced abortions," P Lauzon et al, Canadian Family Physician 46:2033-2040, Oct 2000
- A study of short term distress reactions following abortion found that many men were highly distressed with both men and women having similar reactions.
"Early Adult Psychological Consequences for Males of Adolescent Pregnancy and Its Resolution," M. Buchanan, C. Robbins, J. Youth and Adolescence 19(4): 413, 1990.
- In a Texas study of 2522 young men who were first surveyed as 7th grade students in 1971, 15% had been involved in a non-marital pregnancy by age 21. 56% of black men had girlfriends who had the child but did not marry or cohabitate, while 28% married and had the child while 16% were ended by abortion. White adolescent males tended to end non-marital adolescent pregnancies by abortion (58%) and 34% chose to marry or cohabitate. Although numbers were small, 55% of Hispanic men married or cohabitated as a result of an adolescent pregnancy. Men whose girlfriends had abortions were more distressed than the men whose girlfriends continued the pregnancy to term.
"Portraits of Post-Abortive Fathers Devastated by the Abortion Experience," Thomas Strahan, Association for Interdisciplinary Research in Values and Social Change 7(3): 1- 8, Nov/Dec 1994.
- Grief patterns, repressed feelings and emotions, loss of manhood or fatherhood, substance abuse, guilt, suicidal behavior and loss of relationships are described by men following abortion of the child they fathered.
"Abortion Attitudes and Experiences in a Group of Male Prisoners," Lindy A. Pierce, Association for Interdisciplinary Research in Values and Social Change 6(2): 1-8, Jan/Feb, 1994
- This study is based on interviews during 1987-1988 of men in a Kentucky prison. The men were predominantly pro-life. 62% opposed abortion without stating any exceptions; 14% opposed abortion except for health, rape, or incest; and 24% said they would permit abortion more generally but still had reservations.
"Adolescent Males' Abortion Attitudes: Data from a National Survey, W," Marsiglio, C.L. Shehan, Family Planning Perspectives 25(4): 162, July/Aug, 1993
- A national survey of 1880 males aged 15-19 found that a majority of males disagreed with abortion if the woman couldn't afford to care for the child, if the man would not support the child, if the woman wanted the abortion for any reason, and if the woman wanted an abortion but the man did not.
"Restoring Fatherhood Lost," Warren Williams; "Remembering Thomas: Case Study," Phil McCombs; "Forgotten Fathers and Their Unforgettable Children," David Reardon; "Men and Abortion, Grief and Healing," W.F. Brauning, Post-Abortion Review 4(4): 1-8, Fall, 1996.
- Valuable collection of brief articles.
Post-Abortion Trauma: 9 Steps To Recovery, Jeanette Vought, (Grand Rapids: Zondervan, 1991) 131-143.
- Describes anecdotal reports of men in postabortion counseling who feel extreme anger and helplessness in not having a voice in the abortion decision. The anger may turn inward and lead to depression which further damages relationships and creates isolation.
"Husband mourns outcome of wife's painful decision," R. Christopher Moore, American Medical News, October 24, 1991, p.24.
- The husband was a medical doctor, his wife a lawyer. The wife decided on an abortion over the husband's objections. He said, "Even though I was the father and wanted to care for my child, I couldn't unless my wife wanted to have it. She controlled new life, our child's life and my life. I controlled nothing."
"Men and Abortion," Wayne Brauning, address to Healing Visions VI Conference, June 1992, National Office Post-Abortion Reconciliation and Healing, P.O. Box 07477, Milwaukee, Wl, 53207.
- In counseling men whose partners aborted, rage, powerlessness and isolation have been predominant.
"Many in Survey Who Had Abortion Cite Guilt Feelings," G. Skelton, Los Angeles Times, March 19, 1989, p.28.
- In a random telephone survey conducted in March, 1989 by the Los Angeles Times, 7 % of the 1050 men interviewed acknowledged as having been the father of an aborted child. Guilt was felt by almost two-thirds and regret by more than one-third.
"Fathers and Fetuses," George W. Harris, Ethics 96:594-603, April 1986.
- Conspicuously absent from most discussions of the abortion issue are considerations of third-party interests, especially those of the father. A survey of the literature reveals an implicit assumption by most writers that the issue is to be viewed as a two-party conflict- the rights of the fetus versus the rights of the mother-and that an adequate analysis of the balance of these rights is sufficient to determine the conditions under which abortion is morally permissible.
"Men's reactions to their partner's elective abortions," A.A. Rothstein, American Journal of Obstetrics and Gynecology 128:831-837, August 15, 1977.
- In a study of 60 men who accompanied their wives or girl friends for elective abortion, less than half knew the type of abortion their partners were having. When asked what they knew, just over one third who claimed understanding were able to give fully accurate explanations of the procedure.
"Adolescent Males. Fatherhood and Abortion," A.A. Rothstein, Journal of Youth and Adolescence 7(2):203-204 (1978).
- In a study of 35 adolescent males, most prominent were regressive wishes for nurturance, competition with one's own father, and efforts to meet paternal ego ideals of maturity and responsibility. Cases examined in detail revealed rage, fear of abandonment and total despair.
"Doesn't a Man Have Any Say? Fathers Go to Court to Stop Abortions," Newsweek,May 23, 1988 p. 74.
- Thwarted fathers in unhappy relationships are more likely to go to court to attempt to stop abortions.
"How Abortion Affects Fathers," Regis Wailing, Liguorian, Liguori Publications, Box 701, Liguori, MO 63057, January 1988, pp. 26-31.
- The article describes a university psychology class viewing a film on pre-natal development when suddenly a young male student rushed from the room and leaned against the wall outside, sobbing, and said, "I didn't know it was a baby. I never would have paid for it if I had known it was a baby.' Another man was described as a former seminarian who left the seminary in the late 1960's and had a hard time adjusting. When his girl friend became pregnant, he pleaded in vain with her not to have an abortion. He has had a major alcohol problem ever since.
"Pregnancy Termination for Genetic Indications: The Impact on Families," R. Furlong and R. Black, Social Work in Health Care 10(1): 17-34, Fall 1984.
- Fathers were particularly adversely impacted by genetic abortion and many would not even talk about it.
"Abortion and Men." Linda Bird Francke, Esquire, September 1978, pp. 58-60.
- The article cites several ways in which repressed emotions in men following induced abortion will reveal themselves in various ways: one man feared that a living son would be sacrificed for the aborted one; another felt sadness when he heard a certain song; another experienced periodic impotence and depression. The author concludes, "Abortion is a far greater dilemma for men than researchers, counselors, and women have even begun to realize ... and [men] sometimes have more trouble dealing with abortion than women."
"Abortion as Fatherhood Lost: Problems and Reforms," Arthur Shostak, The Family Coordinator 28:569-574(1979).
- In a study of the impact of abortion on males many relationships between unmarried partners appeared unable to survive the strains inherent in the abortion experience. A sizable minority reported the persistence of day or night dreams about the chiild-that- never-was, and some represented these moments as times of guilt, sadness and remorse.
"Whose Freedom of Choice? Sometimes it takes two to untangle," Judith Paterson, The Progressive 46(l):42-45, April 1982.
- Article includes case histories of men adversely impacted by abortion and also has an extensive discussion by professional psychologists and psychiatrists who have counseled men on the after-effects of abortion. The article quotes Andre Watson, health educator for the Men's Center of Planned Parenthood in Washington, who like many others in his field thinks conflict over abortion often affects a relationship and sometimes destroys it. "For better or for worse, an abortion brings out the stark, naked truth of a relationship." Psychologist Arnold Medvene was quoted as saying, "Abortion is undeniably a death experience, a loss experience with immense reverberations for everybody. If all of that gets blocked, it is bound to have a dramatic and destructive impact on the relationship." Dr. Neil Bernstein, a clinical psychologist, emphasizes the effect of "denial and distancing." Psychiatrist Richard Epstein says that abortion evokes powerful and complex feelings in men as well as women, and that the individuals react in accord with the psychological level at which they experience the abortion. The article notes that many women handle the implications of abortion alone, while men repress them to a dangerous degree.
- One man worried about the negative spiritual consequences and thought women have trivialized the issue by emphasizing the right to control their own bodies. Another was amazed at the intensity of his objections to the destruction of his offspring and surprised at the rift between his political posture and his paternal feelings. A black man expressed a sense of heritage and importance of perpetuating himself.
"Abortion: How Men Feel About One of Biggest Issues in a Woman's Life," James L. Collier, Glamour Magazine, February 1980, pp. 164-165, 243-244.
- The article quotes Uta Landy of the National Abortion Federation: "They [men] behave much differently from the women who call in too. They'll never admit they're directly involved. It's always "this girl, ' never 'my girl friend.' And they're mainly concerned about safety. Frequently, women ignore what you tell them about the guidelines, they're so anxious to get the abortion over with, but men will pay strict attention. Many take down what you tell them word for word." The National Abortion Federation was quoted as saying that 40% of the calls on their hotline are from males. Clinical psychologists who studied male reactions to abortion concluded men had even stronger guilt feelings than women. Men wanted to be present or even go through the abortion themselves.
"Abortion: Are Men There When Women Need Them Most?," Carol Lynn Mithers, Mademoiselle, April 1981, p. 231.
- The author notes that about 3 million people had abortions last year. Only half of them were women. A program director for family planning clinics observed, "Abortion is a difficult experience for everyone concerned. That includes men. A man may escape the physical trauma, but it's unlikely he'll come through unscathed." A woman, in describing a boyfriend's reaction to abortion, said it "freaked him out."
- A macho 29-year-old male said, "Yeah, I still think about it. Not often but sometimes My brother and his wife are having a baby in the next few months and that brings it to mind- they're having a kid. I'm not."
- A 34-year-old man: "I wasn't broken up by the experience. I was saddened though. Even if you have no set moral or philosophical problems with abortion, it's still taking something away from both of you." A 28-year-old said, "I thought. What a shame! This is the combination of her and me and would be such a beautiful child."
- Another 28-year-old expressed a lack of empathy and said, "I thought I knew all about abortion and I thought it was a real routine procedure but it didn't hit me till afterward that it's also very emotionally distressing. I'm more sympathetic about that now. Maybe I would have been before if I'd known what to expect."
- A casual relationship broke up following abortion. A 28-year-old male said, "I was 22, she was 17. We had only been casual lovers. When she discovered she was pregnant I first tried to deny it. I feared I might be trapped into marriage. She said she wanted the child but I insisted abortion was the best idea. I didn't even like her very much."
- A 28-year-old man: "We were students; our biggest problem was where to go for dinner. Afterward, there was a loss of freedom. We were more sober. After the abortion there was no way that relationship was going to work. That's what makes me so sad, because in many ways it was the nicest one I'll ever have."
- A 29-year-old businessman whose girlfriend began seeing another man after her abortion: "The whole experience was like being hit by an emotional battering ram. It broke her down where she was in a real weak and vulnerable condition. I wasn't there for her."
"How abortion affects men," John Stanhope, Faith Today, May/June 1988, pp. 26- 27.
- The article quotes abortionist Henry Morgentaler as saying abortion is a silent agony for many men. There is still little information on the subject. From what is available, there seems to be some indication that men go through the same grief, remorse and sadness that characterize post-abortion syndrome in women.
The Anatomy of Bereavement, Beverly Raphael, (New York: Basic Books, 1983) 240.
- Some fathers will feel angry and cheated by the women's decision to terminate their child, whether or not they would be prepared to care for it as a father. Many men involved in the termination of a pregnancy they have fathered will experience grief too and may need recognition of mourning for the lost child.
"Psychiatric Sequelae of Abortion: The Many Faces of Post-Abortion Grief, E," Joanne Angelo, Linacre Quarterly 59:69-80, May, 1992.
- In a clinical case, an 18 year old male gas station attendant shot himself and died 3 months after his father's unexpected death. Only his closest friend knew that at the time of his suicide he was despondent over his girl friend's abortion. The child had been conceived on the day of his father's death. He had formed a mental image of the child and told his friend he planned to name his son after his father. The loss of the child and what he represented was more than he was able to bear.
"The Effects of Abortion on a Marriages," Janet Mattinson, Abortion: Medical Progress and Social Implications, Ciba Foundation Symposium 115, 1985, pp. 165-177.
- Marriage problems involving adverse reactions of men to induced abortion are reported in a British study of several case histories at Tavistock Clinic. Inability to conceive, withdrawal, inability to function to seek employment, sexual and interpersonal conflicts, extramarital affairs, loss of trust, seeking abortion as a form of punishment for a spouse and a heightened sense of inferiority were identified.
"A Program of Group Counseling for Men Who Accompany Women Seeking Legal Abortions," Robert A. Gordon and Cheryl Kilpatrick, Community Mental Health Journal 13(4):291- 295 (1977).
- In a program of group counseling for men developed at a Wisconsin abortion clinic, men expressed anxiety, helplessness, guilt, self-blame and regret. Men used denial, intellectualization, rationalization and withdrawal in an attempt to cope with stress. Men often attempted to be invulnerable, a "real man" by denying any expression of feelings. Many men said they did not express their feelings to their partners and instead felt the need to be a source of support by presenting a strong front. Themes of discussion included (a) issues of right and wrong, particularly in connection with religious beliefs; (b) viewing fetal material as non-human; (c) disinterest in bringing a child into such a "troubled" world.
Men and Abortion. Lessons. Losses and Love, Arthur Shostak and Gary McLouth, (New York: Praeger, 1984).
- In follow-up of 75 post-abortion men 25% had broken up with their partner although only 3% had stated on the day of the abortion that abortion was contributing to the breakup. Unexpected guilt and remorse, relief from tension, anger at the woman, were cited as some of the reasons for breaking up. Sex relations and contraceptive questions caused new stress immediately after the abortion. This study involved people in committed relationships (only 4% were casual).
"Psychological Factors That Predict Reaction to Abortion," D.T. Moseley, Journal of Clinical Psychology 37(2):276-279, April 1981.
- A woman's relationship with her partner was determined as a crucial factor in her post- abortion adjustment. Liberated women tended to devalue the significance of the partner in conception.
"Fatherhood and Abortion: Psychological and Psychopathological Reactions," P Benvenuti, P. Borri, P. Buzzoni, L. Clerici and M.R. Monti, Rivista di Patologica Nervosa e Mentale104:255-268(1983).
- Despite the scant psychological and medical interest in the reactions of men to abortion, there is considerable emotional involvement in lost parenthood both for the man and the woman. The involvement by men may manifest itself in persecutory or depressive anxiety and psychosomatic symptoms. Rarely, psychopathological symptoms such as depression and behavioral disorders may appear. The appearance of these reactions is linked to problems and conflicts aroused by prospective fatherhood leading to a comparison between fulfilled fatherhood and fatherhood lost.
"Adolescent Males: Fatherhood and Abortion," A.A. Rothstein, Journal of Youth and Adolescence 7(2):203-204 (1978).
- A study of 35 adolescent males whose sexual partners were undergoing abortion at Bronx Municipal Hospital found that males had regressive wishes for nurturance, competition with one's own father, and efforts to meet parental ego ideals of maturity and responsibility. In the cases examined in detail rage, fear of abandonment and total despair were observed. Little is known about the reaction or developmental difficulties of adolescent males as a result of their implication in abortion. This is one of the few studies on the subject.
Abortion's Impact on Siblings
Slow Brain Growth In Babies Linked To Depression During Pregnancy 2012.
A study by Hanan El Marroun published in Archives of General Psychiatry reports that babies whose mothers are depressed during pregnancy have a greater chance of retarded growth. Antidepressants may also increase the risk of slow growth of the child's brain.
Associations between voluntary and involuntary forms of perinatal loss and child maltreatment among low-income mothers. Coleman PK, Maxey CD, Rue VM, Coyle CT. Acta Pædiatrica, 2005; 94.
- Compared to women with no history of perinatal loss, those with one loss (voluntary or involuntary) had a 99% higher risk for child physical abuse, and women with multiple losses were 189% more likely to physically abuse their children. Compared to women with no history of induced abortion, those with one prior abortion had a 144% higher risk for child physical abuse. Finally, maternal history of multiple miscarriages and/or stillbirths compared to no history was associated with a 1237% increased risk of physical abuse and a 605% increased risk of neglect. Perinatal loss may be a marker for elevated risk of child physical abuse, and this information is potentially useful to child maltreatment prevention and intervention efforts. http://journalsonline.tandf.co.uk/link.asp?id=xr05355225rk21wk
Post-Abortion Survivor Syndrome: Signs And Symptoms. Ney PG, Sheils CK, Gajowy M. Journal of Prenatal and Perinatal Psychology 2010;26:107-129.
- Clinical observations indicated that those psychiatric patients who survived when a preborn sibling died were adversely affected by the experience. It seemed that being a survivor of a pregnancy loss, particularly abortion, contributed to psychiatric illnesses. Data was collected from a sample of 293 adults - 98 patients and 195 counseling trainees. A self-report questionnaire with visual analogue, rating, and descriptive questions was used to ascertain the extent of common psychiatric symptoms. These were analyzed to determine if there were any significant associations with various types of pregnancy outcome. Correlations and stepwise regression analyses demonstrated a cluster of existential symptoms for those surviving when their preborn siblings were aborted. The symptom expressed by the subjects in the study that was most closely associated with abortions in the first pregnancy of their mothers was, “I feel I don’t deserve to be alive.” There were different and more loosely clustered symptoms found in patients whose mother miscarried. Conclusion: there is a reasonably definable syndrome of symptoms in patients associated with the abortion of their sibling, which we have termed, the Post Abortion Survivor Syndrome.
Post-Abortion Survivor Syndrome: Signs And Symptoms Revisited. Ney PG, Sheils CK. http://www.abortionrisks.org/Ney2012/PASS.pdf 2012.
- This is an expanded form of the above 2010 study published in the Journal of Prenatal and Perinatal Psychology.
"Obstetric Complications and Risk for Severe Psychopathology in Childhood" J Autism and Developmental Disorders (2001;31:279-285 ) Eaton WW, Mortensen PB, Thomsen PH, Frydenberg M.
- Children born to women with prior history of induced abortion had 72% higher relative risk of later being diagnosed as mentally retarded, and a 40% greater risk of being diagnosed with a learning disorder, and a 47% risk of being diagnosed with some other psychological disorder.
Prenatal and perinatal risk factors for autism. J Perinat Med. 1999;27(6):441-50. Burd L, Severud R, Kerbeshian J, Klug MG.
- Abortion and low birth weight are significantly associated with increased risk of autism in subsequent born children.
Post abortion survivor syndrome (PASS): signs and symptoms. Ney PG, Sheils C, Gajowy MA Southern Medical Journal 99:1405-1406, 2000
- Data from a sample of 293 adults indicates those whose mother had an abortion were significantly more likely to experience depression and other symptoms which may be associated with a post-abortion survivor syndrome. According to the authors:
- If the data and clinical impressions are correct, there appears to be a definable and diagnosable syndrome of symptoms and problems that arise in people whose parents have aborted their unborn siblings: the Post Abortion Survivor Syndrome (PASS). This constellation of existential guilt, risk-taking behaviors, sense of impending doom and prepsychotic terror appears to be distinct from symptoms that may arise in other types of pregnancy-loss survival situations, from childhood mistreatment, or from an abortion experienced by the individual or the individual's partner. (5) These symptoms are specific enough to point to a likely cause being the loss of a sibling by abortion. Unless the conflicts behind this existential dilemma are addressed, it is unlikely that the expression of these, ie, the need for psychiatric admission, or repeat depressions, are likely to be successfully treated by any other modality.
"Children's Disturbed Reactions to their Mother's Miscarriage," A.C. Cain et al Psychosomatic Medicine 26:58-66(1964).
- Important background article on the subject.
"Effects of Sibling Death on the Surviving Child: A Family Perspective," R. Krell and L. Rabkin, Family Process 18:471-477, December 1979.
- Describes such family maneuvers as conspiracy of guilt, survivor reactions, substitution for the lost child, the haunted child (silence), the resurrected child (substitution). Therapy with survivor families is described as a difficult task involving the working through of short- circuited and unresolved grief reactions, unraveling of multiple distortions of identity and clarifying of mystifying communication.
"A Consideration of Abortion Survivors." Philip G. Hey, Child Psychiatry and Human Development 13(3): 168-178, Spring 1983.
- It is hypothesized that approximately 50% of the children in the Western world are or soon will be abortion survivors, i.e., they are children who have had siblings terminated by induced abortion.
"The Surviving Sibling: Another Victim of Abortion," National Right to Life News[Washington D.C.], September 25, 1986.
- The article quotes Dr. Edward Sheridan of Georgetown University Hospital who observed that children may become aware of an induced abortion through overheard conversations or by being directly told by their parents. Frequently, even a very young child will "sense", the mother's pregnancy and then become confused when the anticipated brother or sister does not materialize. If no explanation is given, this confusion may lead the child to somehow feel responsible for the loss. If the child becomes aware that the mother actively chose to "get rid" of the sibling, the survivor may begin to fear her. The mother becomes the agent of death instead of life.
"The Survivor Syndrome: Siblings and Abortion," National Right to Life News[Washington D.C.], January 15, 1987, p. 19.
- The article quotes Dr. E. Joanne Angelo, a practicing psychiatrist and assistant clinical professor at Tufts University School of Medicine, who observed that siblings of aborted children may be children who are having trouble going to school and being separated from their parents. The children are "replacement children", born after their parents suffered the loss of another child through sudden infant death syndrome, miscarriage or abortion. The children picked up their fears from their parents, not from outside the home. If abortion was the catalyst for the "replacement child, " the child may also suffer from the mother's often unresolved, and perhaps unacknowledged, grief over the loss of the unborn child.
"The Aborted Sibling Factor: A Case Study," A.H. Weiner and E.C. Weiner, Clinical Social Casework Journal, Human Services Press (1984), pp. 209-215.
- Case study of 5-year-old girl whose mother had multiple abortions. The girl was very frightened of her mother, dreamed of being killed and tore her doll's head and arms off.
"Child's Reaction to Mother's Abortion: Case Report," J.O. Cavenar, J.G. Spaulding and J.L. Sullivan, Military Medicine 144(6):412-413 (1979).
- A five-year-old boy was referred for psychiatric evaluation because of aggressive behavior toward his sister, poor peer relationships and multiple tics. He learned of his mother's abortion when he was only slightly over 2 years old. He thought he had undergone mutilative surgery as punishment for his aggressive and hostile impulses and via identification with his mother viewed himself as mutilated and castrated.
"Ritual Mourning for Unresolved Grief After Abortion," K. McAll and W. Wilson, Southern Medical Journal 80(7):817-821, July 1987.
- Includes several case studies drawn from the experience of the authors with the effects of induced abortion or miscarriage on over 400 people with whom they have counseled. A report is given of a 7-year-old girl initially diagnosed as epileptic. She had unpredictable episodes of shouting at her parents, stamping her feet and falling unconscious. She often hurt herself when she fell. Drugs were of no help to her. When in counseling with her parents she added the name of a sibling who she said was her best friend. When her parents attempted to correct her she called her mother a murderer who had thrown her sister away. The mother then admitted to a pregnancy where the doctor gave her a rough examination and she lost the baby. Following prayer and mourning for the lost child the family was helped to recover.
"Infant Abortion and Child Abuse," Philip G. Ney in The Psychological Aspects ofInfant Abortion and Child Abuse, eds. D. Mall and W.F. Watts, (Washington D.C.: University Publications of America, 1979) 33.
- Describes a case of severe child neglect where the mother was depressed as a result of an earlier coerced abortion and the father had rejected the child and had left the family.
"Ritual Mourning in Anorexia Nervosa," RK McAll and FM McAll, The Lancet, August 16, 1980, p. 368.
- The authors report on 18 patients who were treated in a hospital without initial improvement. Fifteen experienced a total relief of symptoms after ritual mourning. Two patients were male. In 17 of the cases, family histories revealed a total of two violent deaths or deaths by suicide, five terminations of pregnancy for non-medical reasons and eight miscarriages. In one case a 17-year-old girl who had anorexia nervosa since 14 and had been hospitalized three times. Her mother had an earlier pregnancy aborted. She admitted the existence of her unborn "sister" but had not mentioned it for fear of being locked up in a mental hospital.
"Parental high concern and adolescent-onset anorexia nervosa," . A case-control study to investigate direction of causality, P Stonebridge, SG Gowers, Br J Psychiatry 176:132- 137, 2000
- Mothers of adolescent girls who had anorexia nervosa were found to have a history of second trimester abortion as well as other identified pregnancy losses.
"Pregnancy Termination for Genetic Indications: The Impact on Families," R. Furlong and R. Black, Social Work in Health Care 10(1): 17-34, Fall 1984.
- A study was made of 22 children whose mothers had undergone induced abortion because of a serious fetal defect. Nineteen of the 22 exhibited some adverse reaction according to observations of the parents. The children included several adult children and reactions ranged from mild to severe. Of four young children who supposedly knew nothing about the abortion, three exhibited some adverse reaction including sleep walking, regression in motor behavior and searching for the baby by touching the mothers stomach. Sadness, guilt and separation anxiety were noted. A 7-year-old girl who was given a full explanation exhibited a severe reaction of horror, had trouble sleeping, refused close physical contact with the mother, had a morbid interest in the abortion procedure raising questions about her attitude about future childbearing.
"Ritual Mourning for Unresolved Grief After Abortion," K. McAll and W. Wilson, Southern Medical Journal 80(7):817-821, July 1987.
- A professional man had conducted a long search for therapists on behalf of his 26-year- old daughter who was sexually promiscuous with men about 30 years older. She was the cause of much gossip, impeded the attainment of his goals and the cause of violent arguments in the family. The woman's mother had undergone an abortion several years before the marriage to the father and the mother's life prior to her marriage had many parallels to her daughter's. After the mother mourned for the aborted child and expressed her love for it, the problems of the daughter ceased.
Healing the Family Tree. by K. McAll This is a more detailed book by Dr. McAll on his observations and efforts to heal inter-generational losses.
"Psychiatric Sequelae of Therapeutic Abortions," Jesse O. Cavenar, A.A. Maltbie and J.L. Sullivan, North Carolina Medical Journal 39:101-104, February 1978.
- A 28-year-old professional man who had entered psychoanalysis for anxiety, career indecisiveness, and inability to become emotionally involved with a woman. He visited his mother to ask about various memories he had recovered in analysis. His mother confessed to an abortion when she was 17 and pressured her son to marry and provide her with grandchildren apparently as an attempt to atone for or undo her own abortion. The authors concluded that abortion may have a profound emotional effect on other family members and permanently alter intrafamilial relationships.
"Great Joy for All-Praise Reports," newsletter of Pastor and Mrs. Timothy D. Hansen, Igreja Evangelica da Renovaqao, Brazil, December 1, 1987.
- A woman was married for a number of years but was apparently unable to bear children. Upon prayer with the woman it was discerned that the woman's mother had been involved in deep sin. When mentioned to the woman she began to weep and weep and said, "Yes, my mother is a prostitute and has had 29 abortions." After prayer for the woman she forgave her mother. The missionaries reported, "That was five months ago. We have just learned [the woman] is five months pregnant." Ed. Note: This is the highest number of abortions known to us.
Abortion's Impact on Subsequent Pregnancies
Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy. McCarthy F, et al. BJOG. 2015 Jan 6. doi: 10.1111/1471-0528.13233.
- OBJECTIVE: To investigate whether women with previous miscarriages or terminations have higher levels of anxiety, depression, stress, and altered behaviours in a subsequent pregnancy.
- DESIGN: A retrospective analysis of 5575 women recruited into the Screening for Pregnancy Endpoints (SCOPE) study, a prospective cohort study.
- SETTING: Auckland, New Zealand, Adelaide, Australia, Cork, Ireland, and Manchester, Leeds, and London, UK. Healthy nulliparous women with singleton pregnancies.
- METHODS: Outcomes were recorded at 15 and 20 weeks of gestation. Short-form State-Trait Anxiety Inventory (STAI) score, Perceived Stress Scale score, Edinburgh Postnatal Depression Scale score, and pregnancy-related behaviour measured using behavioural responses to pregnancy score.
- RESULTS: Of the 5465 women included in the final analysis, 559 (10%) had one and 94 (2%) had two previous miscarriages, and 415 (8%) had one and 66 (1%) had two previous terminations of pregnancy. Women with one previous miscarriage had increased anxiety (adjusted mean difference 1.85; 95% confidence interval, 95% CI 0.61-3.09), perceived stress (adjusted mean difference 0.76; 95% CI 0.48-1.03), depression (adjusted odds ratio, OR 1.26; 95% CI 1.08-1.45), and limiting/resting behaviour in pregnancy (adjusted mean difference 0.80; 95% CI 0.62-0.97). In women with two miscarriages, depression was more common (aOR 1.65; 95% CI 1.01-2.70) and they had higher scores for limiting/resting behaviour in pregnancy (adjusted mean difference 1.70; 95% CI 0.90-2.53) at 15 weeks of gestation. Women with one previous termination displayed elevated perceived stress (adjusted mean difference 0.65; 95% CI 0.08-1.23) and depression (aOR 1.25; 95% 1.08-1.45) at 15 weeks of gestation. Women with two previous terminations displayed increased perceived stress (adjusted mean difference 1.43; 95% CI 0.00-2.87) and depression (aOR 1.67; 95% 1.28-2.18).
- CONCLUSIONS: This study highlights the psychological implications of miscarriage and termination of pregnancy.
- EDITOR's NOTES: The number of abortions reported in this study are half of what should have been reported in New Zealand. In the year 2012, New Zealand's Abortion Supervisory Committee report shows there was a total of 14,745 induced abortions and from this number 3,648 (24.7%) had one previous abortion and 1,937 (13.1%) had 2 or more previous abortions. The abortion ratio was 193/1000 (rate of abortion/known pregnancies, not counting miscarriages; 19.3%). Therefore, in the above study of 5,495 pregnant woman there should have been approximately 1060 abortions (rather than 415) with 139 (rather than 66) having had 2 or more previous abortions. All of this suggests that many women participating in the study chose to not disclose their abortion history. If non-disclosers had more emotional problems related to their abortions (which is why they may have been unwilling to disclose their abortions) this would mean the results under estimate the mental health problems associated with abortion.
Impact of Abortion on Relationships, Sexual Behavior, and Sexual Dysfunction
The effect of voluntary termination of pregnancy on female sexual and emotional well-being in different age groups Limoncin E, D’Alfonso A, Corallino C et al. Journal of Psychosomatic Obstetrics and Gynecology (2017) 38(4) 310-316
- Introduction: To evaluate the impact of voluntary termination of pregnancy (VTOP) on the psycho-sexological well-being of females before/six months after the abortion.
- Methods: A sample of 194 women was recruited from three obstetrics and gynaecological divisions. The women were evaluated for the variables "sexual functioning" with the Female Sexual Function Index (FSFI), "depression" with the Beck Depression Inventory (BDI-II), and "anxiety state" with the Self-Rating Anxiety Scale (SAS) at time 0 (the beginning of the abortion procedure) and time 1 (six months after the abortion). Since 24 women refused to fill out the questionnaires, the final sample was composed of 170 women.
- Results: The women showed a slight although significant improvement in the mean FSFI score from time 0 (16.7 ± 12.9) to time 1 (20.9 ± 13.8) (p < 0.001) which paralleled with a slight decrease in the incidence of clinically significant sexual dysfunction [49% (84/170) (time 0) versus 34.1% (58/170) (time 1)], (McNemar's test; p = 0.0241). The sub-group of younger women (18-25) showed a lesser increase in FSFI score from time 0 to time 1. In addition, both depression (p = 0.048) and anxiety (p < 0.001) significantly decreased over time. However, the female sexuality remained impaired since more than two thirds (69.5%) of women were sexually dysfunctional six months after VTOP.
- Discussion: Voluntary TOP may influence the sexuality of younger females differently from how it influences that of older women. Hence, the sexuality of younger female should be regularly supervised in follow-up examinations.
Abortion and Partner Relationships. Alliance for Post-Abortion Research & Training. 2014.
- An excellent summary of research findings concerning elective abortion and partner relationships.
Publications concerning Abortion and Relationships. Alliance for Post-Abortion Research & Training. 2014.
- List of academic papers and articles concerning abortion and relationships.
See also Sexual Promiscuity and Casual Sex
"Intrapersonal Processes and Post-Abortion Relationship Challenges: A Review and Consolidation of Relevant Literature" Coleman PK, Rue VM, Spence M. The Internet Journal of Mental Health. 2007; Volume 4, Number 2.
- (Abstract) While the study of the psychological effects of abortion has received increased research attention over the past few decades, scholarship devoted to the topic of post-abortion partner relationship quality has been minimal. In this report, existing empirical work on abortion and intimate relationships is analyzed in the context of related research and theory. Evidence indicating possible adverse effects of abortion on the quality of relationships is initially reviewed. Then several logical intrapersonal mediators of associations between abortion experience and relationship outcomes are explored. Finally, adult attachment dynamics are described as a theoretically plausible moderator of associations between abortion experiences and relationship difficulties. Throughout the paper, the most salient gaps in the literature on abortion and relationship quality are highlighted with suggestions for future research provided.
"Abortion and the sexual lives of men and women: Is casual sexual behavior more appealing and more common after abortion?" Coleman PK, Rue VM, Spence M, Coyle CT. Int J Clin Health Psychol, Vol. 8, Nº 1
- (ABSTRACT) Previous research indicates that abortion increases risk for experiencing difficulties maintaining committed relationships, sexual dysfunction, and psychological problems. In the present descriptive study, associations between abortion and attitudes and behaviors associated with casual sexual activity were examined after controlling for family of origin, socio-demographic, reproductive history, and sexual history variables. The National Health and Social Life Survey (NHSLS), a multistage probability sample of 3,432 men and women between the ages of 18 and 59 was the data source. Among women, abortion was associated with more positive attitudes toward sex with strangers and with being forced to have sex; whereas the male experience of a partner abortion was correlated with attitudes endorsing sex with more than one partner and with strangers. Abortion among men and women predicted disagreement relative to restricting sexual activity to love relations, more sex partners in the last year, and endorsement for having sex with an acquaintance. Male experience of a partner abortion also increased the likelihood of having sex with a friend. Finally, abortion predicted engagement in various impersonal sexual behaviors over the previous 12 months among males and females. Strengths of the study include the large nationally representative data source and employment of a variety of control variables.
The prevalence of post-abortion syndrome in patients presenting at Kalafong hospital's family medicine clinic after having a termination of pregnancy. van Rooyen M, Smith S. South African Family Practice (2004) 46 (5), pp 21-24.
- Seventy nine percent of those interviewed had decreased libido following their abortions.
"Inadequate Preabortion Counseling and Decision Conflict as Predictors of Subsequent Relationship Difficulties and Psychological Stress in Men and Women" Catherine T. Coyle, Priscilla K. Coleman, and Vincent M. Rue, Traumatology first published on November 16, 2009 as doi:10.1177/1534765609347550
- (Abstract)The purpose of this study was to examine associations between perceptions of preabortion counseling adequacy and partner congruence in abortion decisions and two sets of outcome variables involving relationship problems and individual psychological stress. Data were collected through online surveys from 374 women who had a prior abortion and 198 men whose partners had experienced elective abortion. For women, perceptions of preabortion counseling inadequacy predicted relationship problems, symptoms of intrusion, avoidance, and hyperarousal, and meeting full diagnostic criteria for posttraumatic stress disorder (PTSD) with controls for demographic and personal/situational variables used. For men, perceptions of inadequate counseling predicted relationship problems and symptoms of intrusion and avoidance with the same controls used. Incongruence in the decision to abort predicted intrusion and meeting diagnostic criteria for PTSD among women with controls used, whereas for men, decision incongruence predicted intrusion, hyperarousal, meeting diagnostic criteria for PTSD, and relationship problems. Findings suggest that both perceptions of inadequate preabortion counseling and incongruence in the abortion decision with one’s partner are related to adverse personal and interpersonal outcomes.
Burke T, Reardon D. Forbidden Grief (Acorn Books)
- A survey reported in an appendix to this book, revealed that following their abortions, 58% reported pain in the cervix or abdomen, 33% reported increased pain during intercourse, 59% reported loss of pleasure from intercourse, 47% developed an aversion to intercourse or became unresponsive, 43% reported becoming promiscuous, 49% had greater fear regarding becoming pregnant when waiting for each period to begin, and 9% had themselves sterilized to avoid another abortion.
SEXUAL DISFUNCTION AND QUALITY OF LIFE IN PATIENTS WITH BREAST CANCER: A CASE-CONTROL STUDY S de Paula, PS Carneiro, CM de Lucena, CM Antunes. IEA World Congress of Epidemiology. August 17, 2014.
- INTRODUCTION: Breast cancer is the most prevalent neoplasia among women, responsible for 20% of deaths in this population. The treatment (mastectomy) always alters patients self-image, perception about their own body and their self-esteem. The objective of this case-control study, is to evaluate the quality of life using World Health Organization Quality of Life abbreviated, WHOQoL-bref and the sexual dysfunction using Female Sexual Function Index, FSFI questionnaires.
- METHODS: Women with breast cancer (cases) and women without this disease (controls), identified at Santa Casa de Belo Horizonte, were included. Social demographic, anthropometric and clinical information were also obtained. Multivariate statistical analysis (ordinal regression) was conducted; two models were implemented: (a) the scores of each WHOQoL-bref domain as response variable and (b) the scores of each FSFI domain, as well as the total score, as response variables.
- RESULTS: Breast cancer diagnosis and treatment are associated to sexual dysfunction Regarding quality of life, this same association was not detected. Age, report of using hormonal oral contraceptive and abortion history were the other independent risk factors associated to sexual dysfunction. Age at last parity, although not being associated to sexual dysfunction, could not be removed from the final model; this seems to indicate a possible effect modification. In reference to individual domains, results showed that breast cancer is associated to desire, excitation and satisfaction lower scores and not associated to lubrication, orgasm and pain. Age is inversely associated to scores in all domains, except satisfaction. History of abortion inversely associated to desire and excitation. Use of oral contraceptive (inverse association) and education (direct association) to excitation and satisfaction, respectively. Age at last parity, as observed in the total model, have to be kept in the models of all individual domains.
- CONCLUSIONS: Breast cancer diagnosis and treatment, age, report of using hormonal oral contraceptive and abortion history are associated to sexual dysfunction.
Impact of Abortion on Marriage, Family, and Parenting
[http://www.standapart.org/index.php?route=information/information&information_id=8 Abortion and Parenting Fact Sheet. Alliance for Post-Abortion Research & Training. 2014.
- Overview of research on associations between abortion and compromised parenting with exploration of reasons why abortion may increase risk of parenting problems.
Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Med Sci Monit. 2003 Apr;9(4):CR105-12. Cougle JR, Reardon DC, Coleman PK.
- Women with a history of abortion were significantly more likely to have a subsequent divorce.
"The Psychological Pain of Perinatal Loss and Subsequent Parenting Risks: Could Induced Abortion be more Problematic than Other Forms of Loss" Coleman PK. Current Women’s Health Reviews, 2009, 5, 88-99
- (ABSTRACT) This dual purpose of this review was to organize and synthesize what is known about women’s psychological and behavioral responses to perinatal loss and examine perinatal loss as a predictor of compromised parenting. The conditions surrounding distinct losses (miscarriage, relinquishment of a child for adoption, and abortion) are highly variable necessitating examination of the differential impact of the various forms of loss on women’s mental health and parenting. Preliminary assessment of relevant literature suggests the psychological experience and the cultural context of abortion may render this form of perinatal loss particularly damaging to the parenting process.
Associations between voluntary and involuntary forms of perinatal loss and child maltreatment among low-income mothers. Coleman PK, Maxey CD, Rue VM, Coyle CT. Acta Pædiatrica, 2005; 94.
- Compared to women with no history of perinatal loss, those with one loss (voluntary or involuntary) had a 99% higher risk for child physical abuse, and women with multiple losses were 189% more likely to physically abuse their children. Compared to women with no history of induced abortion, those with one prior abortion had a 144% higher risk for child physical abuse. Finally, maternal history of multiple miscarriages and/or stillbirths compared to no history was associated with a 1237% increased risk of physical abuse and a 605% increased risk of neglect. Perinatal loss may be a marker for elevated risk of child physical abuse, and this information is potentially useful to child maltreatment prevention and intervention efforts. http://journalsonline.tandf.co.uk/link.asp?id=xr05355225rk21wk
"The quality of the caregiving environment and child developmental outcomes associated with maternal history of abortion using the NLSY data." Coleman PK, Reardon DC, Cougle J. J Child Psychol Psychiatry 2002; 43: 743-58.
- (ABSTRACT)BACKGROUND: Studies suggest that experiencing a perinatal loss may leave women vulnerable to mental health problems and may compromise parenting. Unfortunately, compared to miscarriages and stillbirths, very little research has examined the potential for grief and feelings of loss associated with elective abortion. Therefore, the aim of this study was to compare the quality of the childcare environment and children's development among children of mothers with a history of abortion prior to childbirth (n = 672) and children of non post-abortive women (n= 4,172). METHOD: Data were derived from the National Longitudinal Survey of Youth (NLSY), with comparisons based on two assessments of the caregiving environment and scores on four child outcome variables. The sample was divided into three child age categories: 1-4 years (n = 1,502), 5-9 years (n = 2,121), and 10-13 years (n = 1,524). RESULTS: After controlling for numerous potentially confounding socio-demographic variables, lower scores were observed for the post-abortion group relative to the level of emotional support in the home among first-born children in the youngest age category. Further, among 5-9-year-olds, more behavior problems were revealed for the children of women with a history of abortion. Finally, no main effects were detected between the abortion history groups relative to the level of cognitive stimulation in the home. CONCLUSION: Although it is widely recognized that at least 10% of post-abortive women experience negative psychological consequences, the potential effects of negative subjective experiences on parenting need more systematic attention.
"Induced abortion and child-directed aggressive behaviors among mothers of children who have been maltreated." Coleman PK, Rue V, Coyle C, Maxey DC. Int J Pediatr Neonatol 2007.
- Background: The purpose of this study was to explore the relationship between maternal history of induced abortion and subsequent frequency of child-directed aggressive behavior in a sample of mothers of children who have been abused or neglected. The mothers were either the perpetrators of the maltreatment or they allowed someone else to mistreat their children.
- Methods: The participants were 237 mothers who were residents of Baltimore and were receiving Aid to Families with Dependent Children (AFDC) at the time interviews were conducted in the 1980s. Women with and without a history of abortion were compared relative to child-directed physical aggression after controlling for the experience of a non-voluntary perinatal loss as well as socio-demographic, family of origin, and partner aggression variables associated with the choice to abort.
- Results: Abortion history was associated with more frequently maternal slapping, hitting, kicking or biting, beating, and use of physical punishment in general.
Conclusion: In addition to contributing to the literature on factors related to the frequency of engaging in physically aggressive behaviors, this study adds to our knowledge of variables associated with the choice to abort.
"Associations between voluntary and involuntary forms of perinatal loss and child maltreatment among low income, single mothers." Coleman PK, Maxey DC, Coyle C, Rue V. Acta Paediatr 2005; 94.
- AIM: This study explored maternal history of perinatal loss relative to risk of child physical abuse and neglect. METHODS: The 518 study participants included 118 abusive mothers, 119 neglecting mothers, and 281 mothers with no known history of child maltreatment. Interviews and observations were conducted in the participants' homes, and comparisons were made between women without a history of perinatal loss and women with one and multiple losses relative to risk for child maltreatment. RESULTS: Compared to women with no history of perinatal loss, those with one loss (voluntary or involuntary) had a 99% higher risk for child physical abuse, and women with multiple losses were 189% more likely to physically abuse their children. Compared to women with no history of induced abortion, those with one prior abortion had a 144% higher risk for child physical abuse. Finally, maternal history of multiple miscarriages and/or stillbirths compared to no history was associated with a 1237% increased risk of physical abuse and a 605% increased risk of neglect. CONCLUSION: Perinatal loss may be a marker for elevated risk of child physical abuse, and this information is potentially useful to child maltreatment prevention and intervention efforts.
"The Effects of Abortion on Marriage and Other Committed Relationships," Teri Reisser, Association for Interdisciplinary Research in Values and Social Change 6(4): 1-8, May/June 1994
- Anecdotal reports include breakup of relationships, communication problems, threats to family loyalty, increased isolation, loss of self-concept, sexual dysfunction, and interference with relationships to existing or future children as problems related to induced abortion.
"The Impact of Previous Perinatal Loss on Subsequent Pregnancy and Parenting" Lamb E. J Perinat Educ. 2002 Spring; 11(2): 33–40.
"Post-Traumatic Stress Disorders in Women Following Abortion: Some Considerations and Implications for Marital/Couple Therapy," Dennis A. Bagarozzi, Int'l Journal of Family and Marriage (Dehli, India) Vol. I, No. 2: 51-68, 1993
- A clinical study of 18 women referred for sexual/marital therapy found that the women suffered from post-traumatic stress disorder although women denied that the abortion was a traumatic experience. Impacted grief, guilt, and unresolved mourning were primary issues. See also "Identification, Assessment and Treatment of Women Suffering from Post-Traumatic Stress After Abortion." Dennis A. Bagarozzi, Journal of Family Psychotherapy 5(3): 25,1994.
"Post-Abortion Survivors Syndrome," (letter), Philip G. Ney, Canadian Journal of Psychiatry 38 (8): 577-578, Oct., 1993.
- Post-Abortion survivors syndrome is found in children and adults. It consists of symptoms stemming from deep conflicts because they may have been aborted. All have existential guilt, a sense of worthlessness, and a feeling of impending disaster. Eight types of abortion survivors syndromes are described.
Invisible Loyalties, I. Boszormeny and G. Spark (New York: Harper and Row, 1973) 149.
- Until the post-Victorian age the issues of family loyalty were largely unformulated because they were taken for granted. Our age, on the other hand, denies these issues with the help of myths of individual material success and the endless struggle against the threat of authority.
- From earliest times great playwrights and novelists have always pictured man as part of a relational motivation system. Autonomy purchased through outwardly complete separation and denial of relatedness tends to be offset inwardly by the accumulation of guilt and responsibility.
"Childbirth is A Family Experience," John G. Howells in Modern Perspectives in Psycho-Obstetrics (1980) 127-149
- The family is a complete organism, a unity in its own right, as well as an individual. The individual is an organized system; so too is the family. The family has a structure, paths of communication, characteristics, elements as any organized system. Like an individual, it has a psyche-the family group psyche. Any event in every part of this organized system impinges on every part of the rest of the system. Every experience within the organized system belongs to the system. Thus, childbirth and its attendant pregnancy is an experience that belongs to the family as a whole.
"Social Stresses on the Family," Reuben Hill, Social Casework 39:139-150(1958).
- Stressor events must be seen as a variable rather than as a constant in family crisis research. Family crises can be classified as dismemberment, accession or demoralization. Various stages of adjustment include [1] attempts to deny the problem; [2] attempts to eliminate the problem; (3] disorganization; (4] attempts to reorganize in spite of the problem; [5] efforts to escape the problem; [6] reorganization of the family without the missing member; (7] reorganization of the entire family. These stages parallel closely the stages of adjustment and recovery to bereavement.
- The sexual area is one of the most sensitive areas of family life. In crises involving interpersonal recriminations, where the crisis is regarded as the fault of any one member, the position of that member is greatly devalued. Intrafamily events such as illegitimacy, nonsupport, mental breakdown, infidelity, suicide and alcoholism are usually more disorganizing to the family because they arise from troubles that reflect poorly on the family's internal adequacy.
"Family Boundary Ambiguity: A New Variable in Family Stress Theory," Pauline Boss and Jan Greenberg, Family Process 23:535-546(1984).
- Boundary ambiguity is defined as the family not knowing who is in and who is out of the system. The family may perceive a physically absent member as psychologically present or a physically present member as psychologically absent. The culture can support the denial of a physical loss and thereby make it more difficult for the family to grieve and close out the missing member. An example is given in regard to stillbirth where the belief system only accorded viable babies mourning rites.
"The Fund of Sociability," Robert S. Weiss, Trans-Action, July/August 1969, pp 36- 43.
- Relationships with other people are essential and their loss can be traumatic. Relational functions necessary for well-being are intimacy, social integration, opportunity for nurturant behavior, reassurance of worth, assistance or guidance.
"The Effects of Abortion on a Marriage," Janet Mattinson, in Abortion: Medical Progress and Social Implications, Pitman (London: Ciba Foundation Symposium, 1985)165-177.
- Patients seeking help for troubled marriages may have a past abortion experience for which they have been unable to mourn at the time of the abortion and they may show a delayed grief reaction. It may be mild or persistent or may occur in more extreme form many years later. Sometimes husbands are more affected than wives. Examples of counseling issues included inability to function, sexual and interpersonal conflict, compulsive sexual affairs outside marriage, development of inferiority feelings, inability to conceive.
"Predictive Factors in emotional Response to Abortion: Kind's Termination Study- IV," E.M. Belsey, H. Green, S. Lal, S. Lewis and R.W. Beard, Social Science and Medicine (2) 71- 82(1977)
- In a British study of marital adjustment 3 months post abortion, 42% of the women said they were less close to their sexual partners vs. 22% who said they were more close. Unsatisfactory or mediocre marital adjustment before the abortion increased the likelihood of marital or sexual adjustment problems following the abortion.
"Induced abortion and psychosexuality," F Bianchi-Demicheli et al, J Psychosom Obstet Gynecol 21(4): 213-217, 2000
- Reviews the limited published literature on the subject. Sexual dysfunction was reported in up to 30% of women after abortion.
"Sexuality, partner relations and contraceptive practices after termination of pregnancy," F Bianchi-Demicheli et al, J Psychosom Obstet Gynecol 22(2): 83-90, 2001
- A Swiss study interviewed women before abortion and 6 months postabortion. 18% reported a decrease in sexual desire, and 17% reported orgasmic disorders.
"Sexual Dysfunction Related to Induced Abortion," Thomas Strahan, Association for Interdisciplinary Research in Values and Social Change Research Bulletin 11 (4): 1-8, Sept/ Oct, 1997
- Various studies and anecdotal reports reveal that both men and women may have sexual impotency, aversion to sex, loss of intimacy, unexpected guilt, and extra-martial affairs as a result of induced abortion.
"The Hostility of Parents to Children: Some Notes on Infertility. Child Abuse and Abortion," Victor Calef, International Journal of Psychoanalytic Psychotherapy l(l):76, February 1972.
- A case report by psychiatrist Victor Calef of marital difficulty following induced abortion included anxiety, sexual dissatisfaction, husband's lack of interest in wife and in sex. The wife said she had no guilt over the abortion. The psychiatrist concluded that the guilt over the abortion was displaced onto the doctor who performed the abortion, while guilt over the pregnancy was displaced onto the husband. It was concluded that the woman experiences the request and permission for abortion as a rejection of her sexuality.
"Abortion As A Stigma: In the Eyes of the Beholder," Gerdi Weidner and William Griffitt, Journal of Research in Personality 18:359-371(1984).
- A recent study among university students in an introductory psychology course at a large midwestern U.S. university revealed that involvement in an abortion has a stigmatizing effect for both men and women. Abortion involvement produced a negative perception in members of the opposite sex who considered them less desirable partners to date or marry. Males involved in abortion received strong ratings of rejection only from female subjects , and females involved in abortion were rejected only by male subjects.
"Low Birth Weight in Relation to Multiple Induced Abortions," M.T. Mandelson, C.B. Madden, J.R. Daling, Am.J. Public Health, 82(3): 391, March, 1992.
- In a Washington State Study of 6541 white women who gave birth to their first child between 1984-87, 33.5% of the women reported 4 or more abortions were unmarried compared to 27.5% of women (2 abortions), 24.0% of women (1 abortion) and 20.5% of women (no abortions).
"The Rights and Responsibilities of Men in Abortion Situations," Shirley Rosenwasser, L.S. Wright and R.B. Barber, Journal of Sex Research 23:97-105, February 1987.
- Abortion adversely impacts upon the parental attitude towards the legal obligation of a parent to provide for the care and support of a child. In a study conducted at a state supported university in Texas, male and female students were asked whether or not a woman should be able to legally sue the father for child support if he was willing to pay for an abortion and the woman decided to keep the child. Some 59% of the men and 40% of the women thought the woman should not be able to sue for child support under those circumstances.
Men and Abortion. Lessons. Losses and Love, Arthur Shostak and Gary McLouth, (New York: Praeger, 1984).
- In a study of 1,000 men who accompanied women to abortion clinics in the U.S., 48% of the males did not think a man should be required to pay child support as at present-if the woman refused his request that she have an abortion.
"Emotional Distress Patterns Among Women Having First or Repeat Abortions," Ellen Freeman, K. Rickels, G. Huggins, C. Garcia and I. Palin, Obstetrics and Gynecology55(5):630-636, May 1980.
- Lack of communication by partners following induced abortion is reported. In a study on emotional distress patterns among women following induced abortion it was observed that "repeat aborters continued to have significantly higher emotional distress scores in dimensions relating to interpersonal relationships." In other words, they had trouble getting along with others.
"Psychological Problems of Abortion for the Unwed Teenage Girl," Cynthia D. Martin, Genetic Psychology Monographs, 88:23-110(1973)
- In a San Diego study of unmarried adolescents who obtained abortions for mental health reasons two out of three had poor relationships with both parents prior to the abortion which tended to further deteriorate following the abortion.
"Repeat Abortion: Is it A Problem?," C. Berger, D. Gold, D. Andres, P. Gillett and R. Kinch, Family Planning Perspectives 16(2):70-75, March/April 1984.
- In a study comparing first-time aborters with repeaters, 45% of the repeaters said they made the decision by themselves compared with 33% of the first-time aborters.
"Pilot Surveys of Repeated Abortion," E. Szabady and A. Klinger, International Mental Health Res. Letter 14:6(1972).
- In a Hungarian study, those women having a repeat abortion were less likely to be in a happy marriage and were more likely to have an abortion independent of their partner.
"First and Repeat Abortions: A Study of Decision-Making and Delay," M Bracken and S. Kasl, Journal of Biosocial Science 7:473-491(1975).
- A 1975 report of social relationships of women following induced abortion concluded that women having repeat abortions are in less stable social situations compared with women who seek abortion for the first time. Their relationships were of shorter duration than unmarried women having first abortions.
"Maternal Perinatal Risk Factors and Child Abuse," M. Benedict, R. White, and P. Comely, Child Abuse and Neglect, 9:217-224(1985).
- A study of 532 Baltimore mothers (two thirds black) found that mothers who maltreated their children were significantly more likely to have had a prior stillbirth or reported abortion (18.2% vs. 12.4%). With two prior stillbirths or abortions or combination thereof, the abuse rate was nearly doubled (4.3% vs. 2.4%). It was concluded that reproductive history may provide important clues in eliciting more precisely what family dynamics may be related to subsequent maltreatment.
"Motivation of Surrogate Mothers: Initial Findings," Philip Parker, American Journal of Psychiatry 140(1): 117-118, January 1983.
- In a Michigan study of 125 women who applied to be commercial surrogates, 35% either had a voluntary prior abortion (26%) or had relinquished a child for adoption (9%). Women felt, often unconsciously, that surrogate motherhood would help them master unresolved feelings through previous voluntary loss. Women stated, "It would be their baby, not mine"; "I'd be nest watching"; and,"I'll attach myself in a different way-hoping its healthy."
Living Through Personal Crisis, Ann Kaiser Steams (New York: Ballantine Books, 1984).
- Describes a delayed reaction in a woman who became pregnant and underwent an abortion. Her relationship with the man who got her pregnant had ended without his being able to share in her troubled feelings over the abortion. Later, when she fell in love again, she found herself mistrusting her new lover and men in general. She also had a renewed sadness over the prior abortion. (Illustrates how abortion circumstances may impair new attachments.)
Taking Chances: Abortion and the Decision Not to Contracept, K. Luker (Berkeley: University of California Press, 1975).
- A study based upon interviews with 50 predominantly unmarried women who had repeat abortions found that many had become pregnant to either test their partners' commitment to the relationship, or to hurry it along to a marriage. When their partners did not commit, the women resorted to abortion.
"Psychiatric Sequelae of Therapeutic Abortions," Jesse O. Cavenar, A.A. Maltbie and J.L. Sullivan, North Carolina Medical Journal 39:101-104, February 1978.
- (Grief in a grandmother over a lost grandchild is reported; a 28-year-old professional man who had entered psychoanalysis for anxiety,career indecisiveness and inability to become involved emotionally with a woman visited his mother to ask about various memories he had recovered in analysis. His mother confessed to [having] an abortion when she was 17 and pressured her son to marry and provide her with grandchildren apparently as an attempt to atone for or undo her own abortion. The authors conclude abortion may have a profound emotional effect on other family members and permanently alter intrafamilial relationships.
"Therapeutic Abortion. Clinical Aspects," Edward Senay, Archives of General Psychiatry 23:408-415, November 1970.
- Patients who mention problems following induced abortion almost invariably want help for long-term marital problems. Rarely do they talk about the abortion spontaneously.
Rachel Weeping: The Case Against Abortion, James Burtchaell (San Francisco: Harper and Row, 1982,1984) 13
- There seems to be some hostility at work which alienates women choosing abortion from even the helpful enjoyment of whatever intimate trust they had previously (and possibly unrealistically) thought they shared with their kinfolk and mates. A decision is produced- apparently the result of freshly independent and straightforward deliberation-yet shadowed by much unspoken and undigested thought. Then it is rushed to completion without the sharing of minds and hearts one would hope for even in matters of far less importance.
"The Family at Bay," Donald DeMarco, Human Life Review 8(4):44-54, Fall 1982.
- The family as the fundamental unit of society is the reality. But legislators and judges, knowingly or unknowingly, can and do ignore this reality. A great deal of judicial thinking in recent years has been grounded in the premise that the individual is the fundamental social unit. A prime example of a woman's newly created "right" to individual privacy in the matter of abortion... Once the mother was legally relieved of the duty to care for her unborn child and was given the liberty of destruction, the stage was set for the severing of every other family relationship.
"The Abortion Experience in Private Practice," David H. Sherman et al in Women and Loss: Psychobiological Perspectives, ed. William F. Finn et al., The Foundation of Thanatology Series, Volume 3, (New York: Praeger Publ., 1985) 98-107.
- In a study of 100 women at a private clinic at Mount Sinai School of Medicine, 75% of the women were married or had long-term ongoing relationships. All had knowledge about contraception and had easy access to medical care; 66% had at least a college degree; 71% were employed full-time; 57% had incomes over $20,000 per year; 81% had one abortion, 14% two) and 5% (three); one-third had a pregnancy before abortion, one-third had a child since aborting, and for one-third the abortion was their sole obstetrical history. Some 46% agreed that the abortion was a major crisis in their lives. Most women experienced loss and grief rather than joy and freedom. Relationships were suddenly and unexpectedly shaken. Some 48% believed their relationship with their male partner was significantly altered (approximately equally split positive and negative); 33% felt their sexual life was negatively affected to some degree; 52% were reluctant to tell people they had an abortion. Sadness, a sense of loss or emptiness, guilt, anger, anxiety and/or confusion was recalled by many. None ever expressed joy. Residual emotions diminished with time. Women with Catholic backgrounds and those with previous abortions more frequently expressed abortion as a form of infanticide.
"Personal Communication," (letter from Sarah J.O. Ricketts to Thomas W. Strahan), April 3,1989.
- In working with post-abortion support groups involving women who are seeking counseling and healing, usually one third to one half of the women are siblings of those who had been aborted as well as having had abortions themselves. They frequently report a generational abortion pattern in the family, including grandmother, aunts, uncles, brothers, sisters. These women appear to have a more impenetrable denial (numbness) of emotions of grief following their own abortions.
"Ethical Issues in Clinical Obstetrics and Gynecology," Benjamin Freedman, Current Problems in Obstetrics, Gynecology and Fertility, 8(3): 1-47, March 1985.
- Obstetrics and gynecology is among several medical specialties... that are especially likely to perceive the family unit, rather than a single patient, as the proper focus of primary health care.
"The Post-Abortion Experience-Abortion's Secondary Victims," National Right to Life News, January 15,1987.
- Includes articles on The Survivor Syndrome: Siblings and Abortion, Men and Abortion,and A Grandmother Grieves for Her Lost Grandchild.
"The Aborted Sibling Factor: A Case Study," A. Weiner and E. Weiner, Clinical Social Work Journal, 1984, pp. 209-215.
- A 5-year-old girl tore her doll apart and drew a picture of a child falling down the stairs following her mother's induced abortion.
"Child's Reaction to Mother's Abortion: A Case Report," Jesse O. Cavenar, J.E. Spaulding and J.L. Sullivan, Military Medicine 144(6): 412A13 (1979).
"A Consideration of Abortion Survivors," Philip Ney, Child Psychiatry and Human Development 13(3): 168-169, Spring 1983.
- Argues that since approximately 50% of Western children are abortion survivors, there is a need to analyze their individual and collective responses.
"Ritual Mourning in Anorexia Nervosa," R.K. McAll and F.M. McAll, The Lancet, August 16,1980, p. 368.
- Concludes that hidden guilt, either in the patient or in a close member of the family, or lack of adequate recognition or mourning for a lost family member may be a causative factor in anorexia nervosa-the article includes two abortion related examples involving family members.
"Seesaw Response of a Young Unmarried Couple to Therapeutic Abortion. I," Wallerstein and M. Bar-Din, Archives of General Psychiatry 27:251-254 (1972)
"Men's Reactions to Their Partner's Elective Abortion," A.A. Rothstein, American Journal of Obstetrics and Gynecology 128:831-837 (1977)
"Out of Wedlock Abortion and Delivery: The Importance of the Male Partner," James M. Robbins, Social Problems 31(3):334-350 February 1984
- Women who aborted tended to be less strongly tied to their partners following abortion.
Parental Loss of a Child, ed. Therese A. Rando, esp. chapter on "Induced Abortion." Betty Harris, (Champaign, Ill: Research Press Co., 1986)
"The Effects of Abortion on a Marriage," Janet Mattinson, 1985; Abortion: Medical Progress and Social Implications, Pitman, (London: Ciba Foundation Symposium 115), pp. 165- 177.
- Patients apparently unable to mourn the loss of a child at the time of the abortion may show a delayed grief reaction. Therapeutic work needs to concern itself with the earlier loss. Sometimes husbands are more affected than wives. Husbands and fathers are much neglected in the British follow-up studies of abortion, except [rarely] through the subjective reports of the women.
Men and Abortion. Lessons. Losses and Love, Arthur B. Shostak, (New York: Praeger Publishers 1984) xiv.
- Men are seriously affected by their abortion experiences, and their memories are extremely sharp and cogent when recalling these experiences.
"The Psychological Sequelae of Abortion Performed for a Genetic Indication, B," Blumberg, M. Golbus and K. Hanson, American Journal of Obstetrics and Gynecology122(7):799-808, August 1,1975.
- Stresses attendant to selective abortion produce undesirable marital consequences. Two families out of 13 experienced separation during the pregnancy, even prior to the performance of amniocentesis; in each case the separation was related to problems engendered by their genetic circumstances. Separation occurred in two families after the selective abortion; although the separations were for less than six weeks, they produced repercussions which threatened marital stability for many months or years afterward.
"Repeat Abortion: Is It a Problem?," C. Berger, D. Gold, D. Andress, P. Gillett and R. Kinch, Family Planning Perspectives 16(2):70-75, March/April 1984.
- Repeaters described their relationships as being less satisfactory than first-time abortion patients; more repeaters than first-timers said they had made the decision by themselves [45% vs. 33%]. Abortion tends to be communication restricting rather than communication enhancing.
"Abortion: Predicting the Complexity of the Decision-Making Process. M," Friedlander, T. Kaul and C. Stimel, Women and Health 9(1):43-53, Spring 1984.
- Observes that "women experience difficulties in decision-making which exceed immediate concern and may include moral dilemmas, problems in relationships, role conflicts and career decisions, among others."
"First and Repeat Abortions: A Study of Decision-Making and Delay. M," Bracken and S. Kasi, Journal Biosocial Science 7:473-491 (1975).
- Fewer women repeaters were pregnant by husbands, and unmarried women having repeat abortions had been in relationships of shorter duration than unmarried women having first abortions.
Rachael Weeping: The Case Against Abortion, James Burtchaell, (San Francisco: Harper and Row, 1982,1984) 8.
- One has the impression that the pregnancy crisis and abortion disclosed rather than caused the falling away of friends and mates. In case after case there seem to have been no previous bonds generous and giving enough - despite the frequency with which they were anointed as "caring" and "loving -to sustain much claim on either good sense or energetic support. In many instances, the women simply woke up to find that they had been on their own all along, despite the couplings. When the emergency erupts, bonds that have long been frayed and rotted simply snap. Comments on case histories of abortion circumstances described in The Ambivalence of Abortion, Linda Bird Francke (1978).
"Therapeutic Abortion. Clinical Aspects," Edward Senay, Archives of General Psychiatry 23: 408-415, November 1970.
- Alter some months most patients appear either to have resolved the abortion crisis completely or to have successfully repressed it, for they report not having thought about the experience in some time. Patients who mention problems almost invariably want help for long-term marital problems. Rarely do they talk about the abortion spontaneously.
"Abortion in Relationship Context," Vincent M. Rue, International Review of Natural Family Planning, 9:95-121, Summer 1985
- Like the Trojan horse, abortion is only beginning to be seen for what it truly is and does. There is evidence to suggest that induced abortion promoted "mystification and masking" within the family, which is dysfunctional for the individual. In relationships abortion provides "pseudo-homeostasis," that is, a stability through non-adjustment which promotes even more serious relational disequilibrium. For men it increases masculine insecurity and provides alienation, role conflict, and for some, limited relief. For women it provides relief, but also induces a heavy burden of guilt, secrecy and intra-psychic conflict. Clinically, if an unwanted pregnancy is a mistake or problem, then abortion becomes a denial of the problem. Psychologically, then, abortion reinforces defective problem-solving behavior. The article concludes that abortion exists for women, yet it is against women, men and children. Like an anesthetic, abortion comfortably numbs all from experiencing the burden of pregnancy. Abortion has become a social eraser of choice, individually, quickly/and secretly eliminating all traces of the pregnancy problem. And yet, traces always remain. Within the depths of male-female relations, the indelible marks of violation reappear.
"A Report on 1.000 Men and the Impact of Abortion on Their Family Life," Arthur Shostak, presented at the 1984 meeting of the American Sociological Society ,San Antonio, Texas, August 29,1984.
- The author interviewed 1,000 men in the waiting room of abortion clinics and gave a report on his findings. He describes his own waiting room experience as a "bruising experience." Males spoke with relief of the rapidity and resoluteness of the decision- making process, the insignificance of the cost challenge and their firm conviction that power here belonged exclusively to their sex partner. They were not entirely without discontent. Specifically, a minority worried about the moral character of abortion. Many were bitter about the treatment they received from the abortion clinic, and quite a few had objections to their status in current abortion law. Sixty-eight per cent felt males involved in abortions did not have an easy time of it; 47% worried that such individuals generally had disturbing thoughts about it afterwards [39% were uncertain about this prospect]; 52% had "occasional" and 29% "frequent" thoughts of the fetus prior to the abortion. Thirty-nine per cent thought a fetus was a person; 26% felt abortion was the killing of a child; 17% thought the act they were involved in was immoral; 10% recalled urging adoption as an option; 17% recommended childbirth followed by single parenthood which they would support financially and emotionally; 45% recalled urging abortion.
"Families. Sex and the Liberal Agenda," Allan C. Carlson, The Public Interest,Winter 1980 p. 77
- In place of the nuclear family, dominant voices in sociology and family counseling journals are now describing the emergence of new normative concepts. There should be no bias towards marriage and children. Everything is open. All habitual and cultural attitudes may be questioned. All values are on trial. Uninhibited Sexuality-Sexual gratification represents one of life's ultimate values. Access to regular sexual satisfaction should be viewed as a basic human right. The Problem of Children-Sexuality should be totally separated from procreation. Parenting should be undertaken only after a careful weighing of social, cultural and economic costs. ... Unwanted pregnancies should be aborted.