POST TERMINATION OF PREGNANCY TRAUMA OR POST TRAUMATIC STRESS DISORDER AFTER TERMINATING A PREGNANCY
1. Definition
Post Termination of Pregnancy Trauma or Post Abortion Stress Syndrome (PASS) are terms based on Post Traumatic Stress Disorder (PTSD) that are used to describe the psychological after effects that some women experience after an induced abortion to terminate an unwanted pregnancy.
2. Symptoms include:
- Crying outbursts
- Depression
- Guilt
- Inability to forgive self or others involved in decision-making
- Intense grief/sadness
- Anger/rage
- Regret
- Emotional numbness
- Sexual problems or promiscuity
- Eating disorders
- Lowered self-esteem
- Drug and alcohol abuse
- Nightmares and sleep disturbances
- Suicidal urges
- Difficulty with relationships
- Anxiety and panic attacks
- Flashbacks
- Multiple abortions
- Discomfort around babies or pregnant women
- Fear of pregnancy
3. Common ‘triggering events’ include:
- Anniversary dates – abortion date, due date of birth (these anniversary reactions may not start until years after the abortion)
- Birth of a child (not always the first birth following the abortion)
- Birth of a relative or friend’s child
- Miscarriage
- Daughter reaches the age when the mother underwent an abortion
- Some other event associated with children or reproduction
- A death experience (loss of a parent or close relative or a child)
- Smells, sounds, location or being in a position associated with the abortion, for example smell of a hospital, positioned for an internal medical examination, sound of a vacuum cleaner or dentist drill
- Relationship break-up
4. Why me? Why now?
A woman finding out that she is pregnant when she is not ready to have a child results in psychological distress. She finds herself in a situation where she has to decide whether she is going to keep the baby, abort, give the baby up for adoption or for foster care.
In the event that she decides to terminate the pregnancy, she may experience difficulty adjusting to her normal life. This can occur shortly after the termination for a few weeks and present with a few symptoms related to trauma or grief. However, if the symptoms do not gradually improve or if they worsen after a period of a month, then a diagnosis of Post-Traumatic Stress Disorder can follow.
Development of PTSD after an abortion is often the result of emotional distress before the termination (such as not receiving support during the decision-making process) or soon after the termination (such as a break up after the termination and a lack of support from the partner or loved ones). It can also be caused by inner conflict if the decision to terminate a pregnancy is understood as a violation of her morals, personal and family values or cultural and religious beliefs.
Although these psychological after effects are mostly reported by women, there are also men who experience similar symptoms as a result of being involved in the decision-making process with a partner, hearing detailed information about the termination procedure from their partner, or witnessing their partner experience post termination trauma-related symptoms after the procedure.
5. How women can deal with trauma related to a pregnancy termination:
Speaking to someone who they can trust
Talking to a caring, non-judgmental and supportive person like a friend, family member or a professional counsellor can be both comforting and useful.
Getting a post-abortion check-up
Most women feel physically fine shortly after an abortion. However, some women may be concerned about whether there were any physical complications as a result of their abortion or whether they will be able to get pregnant when they want to in the future. A post abortion check-up can bring relief and reassurance.
Writing down their thoughts
In a journal a woman can review the issues she faced both about the pregnancy itself and about other life issues such as relationships, workplace, education and career, as well as the alternatives she considered and the advantages and disadvantages she considered in the decision-making process. Some women find that separating all the issues involved in their decision and writing them down or saying them out loud to themselves or a friend helps them feel less overwhelmed and better able to cope with and work through their feelings afterward.
Envision the future
For many women, the decision to have an abortion is often related to their hopes and plans for their future. Envisioning what they want their life to be like in the upcoming years and thinking about how they would like to live life in the present in order to realise the future they desire can help some women gain a sense of purpose and direction. By projecting themselves into the future, some people can direct themselves toward emotional health.
Stay mentally positive
Most women believe that they made the best decision they could at the time, given their access to resources, their responsibilities, and their values. When doubt, sadness or worry overwhelms them they find it helpful to repeat a positive statement to themselves. Some people have other kinds of mantras or poetic lines or songs that they find give them comfort and reduce anxiety.
Stay mentally active
Most women return to their usual activities and interests shortly after an abortion. A woman who is finding it difficult to do that may take up a new or creative activity, such as writing poetry, painting, or keeping a journal. Some women find that a creative outlet can help them work through their feelings.
Address spiritual concerns
Some women find that performing a ritual or some kind of “letting go” ceremony helps them to find closure. This might involve lighting a candle and meditating, writing down words or symbols of the loss and then burying or burning the paper or offering a prayer to a deity (God) for forgiveness.
To prevent the development of PTSD, it is recommended that a woman or a couple seek counselling services to assist them with the pregnancy crisis and/or post termination psychological distress to process the experience.
6. YouTube Videos:
What happens after an abortion: https://youtu.be/k9NAXV6Lj3s
Abortion PTSD: https://youtu.be/ab7EMFDxXuY
The Dark Secret: Life after abortion: https://youtu.be/xE2OWkxFylY
These fathers break their silence on abortion: https://youtu.be/GtUuk5p4BCs
References
Mojapelo-Batka, E.M., & Schoeman, J.B. (2003). Voluntary termination of pregnancy: Moral concerns and emotional experiences among black South African adolescents. South African Journal of Psychology, 144-153.
Rue, V.M. (2008). Pro-life activities. Retrieved from http://www.usccb.org/about/pro-life-activities/index.cfm
Susanne, B. (2010, October 25). Psychology Today. Retrieved from https://www.psychologytoday.com/za/blog/somatic-psychology/201010/post-abortion-stress-syndrome-pass-does-it-exist
Compiled by Onelihle Makedama (Student Counsellor at Student Counselling and Development, Mahikeng Campus)
July 2020