Abortion Issues

Research indicates that having an abortion is a very difficult decision for the vast majority of women who have one, and that the aftermath is likely to lead to at least some emotional and psychological challenges, whether they are minor and short-lived, or more intense and long-lasting. Having second thoughts, guilt, internal conflict, grief, or other challenging emotions and thoughts is somewhat typical, and the nonjudgmental, compassionate ear of a good clinician can be very helpful in working through these thoughts and feelings. Men whose partners have an abortion may also experience internal conflict or unpleasant feelings, and should not hesitate to talk about this in therapy. Couples work may be particularly helpful – if also especially challenging at times – when an abortion has occurred in the relationship.

• Post-Abortion Psychotherapy
• Psychotherapy After Two Abortions - Case Example
• Newly Married, Accidentally Pregnant and Considering Abortion - Case Example

Post-Abortion Psychotherapy

This relatively new area of therapy is emerging as an important part of the process for many women who choose to terminate their pregnancy. The political controversy over abortion may make the process more confusing or upsetting for some women. But even leaving politics aside, 

Therapists must be keenly aware of religious and philosophical beliefs, which are often very strongly held, and must help clients to clarify their own values, beliefs, and needs, rather than imposing their own views on clients, or attempting to change their minds. Issues secondary to an abortion also may also arise, as women’s ability to carry children may be diminished by multiple abortions, and this can lead to grief, guilt, and anxiety in some women.

Psychotherapy After Two Abortions - Case Example

Zoe, 29, has had two abortions stemming from pregnancies with the same man. Now her doctor tells her pregnancy will be dangerous for her, and she is experiencing tremendous grief and guilt, fearing she will never be a mother. The therapist tries neither to dissuade her from her guilt, nor to validate it; simply listening to her express her intense sadness and guilt provides a healing effect, and after a while the therapist and Zoe begin discussing her options – adoption, foster parenting, or even going ahead with what could be a risky pregnancy. Zoe seeks a second medical opinion and decides a future pregnancy would not be so risky as to deter her from trying again. She does, however, gain a great deal of clarity about her values: she wants children (she wasn’t certain at first), she thinks her abortions could have been avoided had she been more careful in choosing a partner and practicing birth control, and she wants more emotional support from her partner, who has not been outwardly empathic in the wake of these two pregnancies.

Newly Married, Accidentally Pregnant and Considering Abortion - Case Example

Justine, 40, is newly married, accidentally pregnant, and considering an abortion. She is ambivalent about abortions and about children, and confused about what to do. Pregnancy carries some risk, as she is diabetic, but her doctors think she can handle it. She and her husband do not want to raise a family. She is considering adoption, but not sure she can handle the separation from her infant once she gives birth. In therapy, the clinician helps Justine mainly by summarizing her own stated feelings and values, and by offering information and alternative points of view that expand her awareness of choices, by validating the difficulty of her situation, and by reducing her considerable guilt and anxiety.

Jane decides to carry the pregnancy to term and works through the grief at her separation in therapy. She is able to arrange an open adoption – an option brought to her attention by her therapist – and soon after, her husband gets a vasectomy. His ambivalence about that procedure brings him to therapy for a few sessions, which seem mainly to serve as a place for him to vent his feelings and get some validation for his ambivalence.

If there is something important you'd like us to consider adding to this page, please feel free to suggest your ideas.