PASS / PATH:
Post-Abortion Stress Syndrome
and Post-Abortion Therapy and Healing
As a childbirth doula, counselor, and educator, I care for women who have experienced abortion, and I seek to provide resources that will encourage and empower them as they heal physically, emotionally, mentally and spiritually from its effects. Many women have abortions, not because they want to, but because they feel they have no other choice. At the time of their abortions, women are often experiencing tremendous stress, anxiety, and even coercion from their partners or family members. In fact, 64% of women report feeling pressured to have an abortion, and 84% lacked sufficient information to make a decision that was fully informed about the abortion procedure and its effects (Forced Abortion in America).
From 2007-2009, I served in an international ministry to women who had experienced sexual abuse, assault and/or trafficking (abduction and prostitution), and I learned how prevalent forced abortions are around the world. Women who are endangered, afraid, and without resources are coerced into terminating their pregnancies more often than most people realize. If they have a choice, it is frequently driven by fear, deception, and a profound sense of desperation that is complicated by their personal histories of violence and violation. Abortion in this context becomes another form of sexual assault perpetrated against them. When I did on-site work in Moldova, Eastern Europe, for instance, I met a young woman who had survived sexual abuse in an orphanage and run away when she found out she was pregnant so she could protect her baby from orphanage personnel. They'd forced other girls she knew to have abortions to cover up what was going on. Abuse in America is being covered up through abortion, too.
But I believe every pregnant woman has the right to feel safe, loved, and supported so that she can welcome new life with joy. I've created this page to explain the larger contexts of abortion and the paths to healing for those who want to understand: pregnant women, women who have had an abortion, their families and communities, and my friends and colleagues in the birth community (doulas, midwives, doctors, nurses, and so on). With all that I am -- heart, mind, body, and soul -- I hope what I have written will bring hope, life, and change.
Two years before I was born, abortion became legal in the United States through the Roe v. Wade case of 1973. The case was not resolved before Roe, whose legal name is Norma McCorvey, gave birth to her baby, whom she placed for adoption. After working with the pro-choice movement for some years and writing I Am Roe, McCorvey later became a Christian, worked with Operation Rescue in Texas, and wrote Won by Love, which tells the story of her conversion to Christianity and her realization of the humanity of unborn babies (see "Norma McCorvey.") As of 2010, abortion laws vary from state to state yet federal law allows a woman in any state to obtain an abortion with a doctor's permission or recommendation. With over 1500 abortion clinics in the US, abortion is widely available to pregnant women.
According to Planned Parenthood, the largest provider of abortions in America, 1 in 3 women has an abortion before age 45. In the 22nd edition of Williams' Obstetrics, the standard textbook for training the OB/GYNs who perform abortions, anyone can read that 22% of American pregnancies -- more than 1 in 5 -- end with "induced termination" (p. 6). Approximately 1.3 million abortions are performed in the U.S. each year, and 43 million are performed worldwide. In parts of China, for example, boys outnumber girls 125 to 100 due to the combined effects of ultrasound identifying female gender, readily available abortion, and the common practice of female infanticide (see "The Economist "Gendercide: The Worldwide War on Baby Girls" - 5 March 2010). And abortion is a profitable industry. Yet very few people have a clear understanding of what abortion is or what it does to pregnant women and their babies.
Abortion procedures fall into two categories: medical and surgical. In a medically-induced abortion, usually performed in the first trimester, a pregnant woman is given a pill with medications in it (such as the RU-486 pill containing mifepristone and misoprostol) that will block the hormones sustaining her pregnancy and cause her to shed the blood lining of her uterus, which is nourishing her 4-7 week old baby. So she miscarries.
Beginning in the second trimester, surgical abortions are performed to terminate a pregnancy. The most common are called "dilation and curettage" (D&C), performed between 13-15 weeks, and "dilation and evacuation" (D&E), performed between 15-21 weeks. In this procedure, the woman's cervix is first dilated (opened) with prostaglandins like Cervadil, with seaweed like Laminaria or with the insertion of a metal instrument that mechanically opens the closed uterus. A woman may or may not be under general anesthesia when the the doctor performs the "mechanical destruction and evacuation of fetal parts." After complete removal of the fetus, a vacuum curette is used to remove the placenta and remaining tissue.
In the third trimester, induced abortion and dilation and extraction (D&X), also known as "partial birth abortion," are performed. In an induced abortion, salt water, urea or potassium chloride is injected into the amniotic sac; this burns the baby's skin and body parts. The cervix is dilated, and pitocin is injected intravenously to cause uterine contractions to expel the fetal body and placenta. In 1977, Gianna Jessen survived this type of abortion, and has Cerebral Palsy as a result, but she is alive today and shares her story with others.
In a D&X, the doctor "evacuates the intracranial contents of the fetal body" (punctures the baby's skull and vacuums the brain out) and then scrapes and/or suctions out the baby's body and placenta. In 2004, this type of abortion was made illegal at the federal level, but then courts in SF and NY said the law was unconstitutional. In Gonzales vs. Carhart (2007), the Supreme Court upheld the constitutionality of the ban. But this type of abortion is still performed in the US and in other countries.
Pregnant women who have medically or surgically induced abortions are exposed to a variety of health risks. Although women have the "right to informed consent" in America, most are not told the full range of possible physical and emotional consequences of abortion. Among the major physical risks to mothers are death, cancer, pelvic inflammatory disease, and reduced fertility and infertility. Williams' Obstetrics notes: "The relative risk of dying as the consequence of abortion approximately doubles for each 2 weeks after 8 weeks' gestation" (p. 247). The death referred to here is the mother's.
The major emotional risks are even less well-known, and they are often ignored, yet a growing number of women who have had abortions agree that they have experienced PASS: Post-Abortion Stress Syndrome. The symptoms are very similar to those of PTSD: Post-Traumatic Stress Disorder. Symptoms include depression, anxiety, nightmares, flashbacks, and persistent feelings of loss and sadness. Anyone who experiences PASS deserves love and support from a community of people who cares for them. Women need a chance to grieve, a PATH (post-abortion therapy and healing) out of their trauma.
Restoration after Rape--Without Abortion
Some people believe that a woman's experience of rape and incest justify abortion. While pregnancies result in only an estimated 1% - 4.7% of such cases due to the trauma (trauma that can lead to miscarriage when conception does take place), still, there is a new life inside the mother. Does ending that life bring healing? In fact, abortion can compound the physical and psychological trauma of sexual assault.
In an article published in the Georgetown Law Journal, Shauna Prewitt takes issue with the social and legal pressures put upon pregnant raped women to abort. She notes that though it is difficult to determine the outcome of rape-related pregnancies, one study showed that of those women who carried their babies to term, approximately 36% placed them for adoption and 64% chose to raise their children themselves. The social and legal rhetoric arguing that victims of sexual assault should have the right to an abortion contradicts the reality that most pregnant raped women choose to keep their babies. These mothers do not regard their children merely as reminders of rape or extensions of the rapist fathers; they want and love their children, and they see their children as part of the healing process. These mothers need the protection of the law and the support of medical careproviders, not the social expectation that they will abort--a pressure that devalues their motherhood and the new life growing within them.
One of the most meaningful stories I have ever read addressing these issues is by Heather Gemmen-Wilson. After marrying and moving in to an urban area, she experienced a traumatizing rape by a stranger in her own home--and became pregnant. Because of the circumstances, even Christians in her church advised her to get an abortion. But she decided to keep her baby, and she gave birth to a beautiful baby girl, her daughter, whom she loves.
Her story shows that even in the worst circumstances, God can redeem and restore. She shares her story in her book, Startling Beauty: My Journey from Rape to Restoration.
My own ministry to women focuses on providing birth counseling and giving support to women in childbirth with the awareness that many women experience PTSD due to sexual abuse and assault experienced in childhood, domestic violence and rape experienced in adulthood, and PASS experienced after an abortion. See christiandoula.net.
In DuPage County, Illinois, where I lived and worked outside of Chicago until 2011, CareNet Pregnancy Services provides a network of support for women who are deciding between abortion and pregnancy and/or parenting. In the Denver, Colorado area, where I live and work now, similar services are provided by Alternatives Pregnancy Center, Caring Hands Pregnancy Center, and Life Choices.
The larger "pro-life" movement in the United States provides support to pregnant women while attempting to bring systemic change at the political, cultural, and faith-community levels. To learn more about this movement to end abortion, save the lives of unborn babies, and bring healing to women after abortion, visit the EndingAbortion.com webcast site, where you can listen to pro-life leaders and link to their ministry websites.
"I came that they might have life and have it more abundantly"http://www.incourage.me/2011/08/startling-beauty.html
~ Jesus (John 10:10)
~ Jesus (John 10:10)