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MSFC Update - May 2005 Promoting Post Abortion Emotional Health There is a range of how women handle the abortion experience, and abortion providers must be prepared to deal with the emotional issues as well as the physical procedure. An abortion decision is made and carried out in a fairly hostile cultural environment which can make women and their significant others feel stigmatized. Many women are isolated by the secrecy or shame they may feel which makes them even more vulnerable and less resilient. Physicians and medical professionals are in a good position
to steer every patient to good emotional outcomes by affirming her ability
to cope and her moral, responsible decision-making. Women who present
with known risk factors — such as previous mental illness, lack
of support or active opposition by someone close, the break up of a relationship,
previous loss or trauma, a wanted pregnancy, or deeply held beliefs against
abortion — may also need special attention and follow-up. In addition,
young women have a higher incidence of depression in general, and women
with a history of domestic violence or sexual abuse may need monitoring
for adverse outcomes. One rule of thumb is that when a patient signals
that her situation is different or “special”, take her at
her word and explore what is going on for her. If women do present with distress after an abortion, physicians
should explore all of the factors leading up to the decision to terminate
a pregnancy. The abortion may be the precipitating event around a relationship
break-up, the loss of hope around child-bearing or a marriage, feeling
so stigmatized that she is separated from others or from her sense of
God or spirituality, or the notion that she is not in complete control
of her fertility. Although anti-anxiety medications may be part of the
solution, a rush to medicate may cover up issues that need to be explored. While the risk of trauma is extremely low (1%) and most women do feel relief after an abortion, it is important to make room for normal feelings about a decision to end a pregnancy. Giving women — and men — a chance to talk about their experience is enormously helpful in promoting postabortion emotional health. Resources: Peg Johnston is Executive Director
of Southern Tier Women’s Services in upstate NY and president of
the Abortion Conversation Project and has created the Pregnancy Options
Workbooks.
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