Dr. Stephen Edmondson has been in private psychiatric practice in Atlanta for 19 years. He attended Medical College of Georgia at Augusta and served his internship at Piedmont Hospital. His first year of residency was at University Hospital in Baltimore and his last two years was at Emory University Hospital. He then served for two years as a U.S. Navy Medical Officer. In his years of private practice, he has treated many women who have post-abortion problems.
Q: What is Post-Abortion Syndrome (PAS)?
Doctor: Post-Abortion Syndrome is a category of Post Traumatic Stress Disorder, either acute or delayed. With the acute form, symptoms appear within six months of trauma and are usually resolved within six months. With the delayed form, symptoms last longer and the onset is much later. Most of the PAS category that I have seen occurred long after the abortion was done, many months to several years later.
This disorder follows a specific “stressor” event which is outside the normal experience and often has elements of a threat to life at some level. Most of these cases involve one specific incident. The disorder seems to be more severe and lasts longer when the stressor is of human design, which is certainly the case in an abortion picture.
Q: Is PAS recognized within the medical community?
Doctor: It is being widely discussed and is being accepted now. If a physician sees someone in the aftermath of an abortion and diagnoses Post Traumatic Stress Disorder, with abortion as the stressor, it would not be questioned. Post Traumatic Stress Disorder only became a listing (in the Diagnostic and Statistical Manual of Mental Disorders) in 1981 or 1982 in response to the combat-related disorders (of Vietnam veterans).
Q: Why does PAS tend to manifest itself so long after the abortion takes place?
Doctor: With an abortion, which might have carried with it a good deal of uncertainty and pressure, the individual is swept along without sorting out and thinking through issues involved. In all major crisis situations, there is a kind of helplessness, and people are very suggestive. Pressure can persuade the individual to go ahead and get the abortion done. After it is over, the interest is in going ahead with the person’s life and forgetting about it. Denial comes into play. The person doesn’t want to think or talk about it, she wants to keep it secret. There is a sealing over of the whole experience. Denial, the death of a child or a close relative, repression, or erasing from conscious awareness can lead the individual to not think of the abortion for some time afterwards. But to do this requires a good bit of mental energy.
Q: What are some common symptoms signaling PAS?
Doctor: Denial is one of the aspects of PAS. When memories do begin to come back, there may be dreams of the baby or recollections of the abortion clinic. Often guilt and grief might begin to appear. Depression is one of the first signs, along with anxiety and irritability. The woman may experience emotional numbing: a feeling of going through the motions without being emotionally connected. There may be withdrawal in a marriage (or boyfriend) relationship, acting out in the form of sexual activity, or sexual responsiveness may be blunted. Sometimes we see repeated pregnancies, as if the individual is trying to replace the aborted baby. There may be difficulty concentrating, inefficiency in work, and a blunting of memory.
Q: Is there a relation between PAS and child abuse?
Doctor: Depression, irritability and difficulty coping would make it hard to deal with children. With all cases of Post Traumatic Stress Disorder, frustration tolerance is down, and the individual is likely to explode in anger at limited provocation and might well hurt someone.
I read a journal article in which the writer made the point that people have a strong natural drive to recreate themselves by having children, but in our time there has been a progressive devaluing of children. Once we begin to abort them, their value declines even further. This undercuts the desire to recreate ourselves. This devaluation of children can be tied to our national decrease in childbearing, increase in unwanted pregnancies and subsequent abortions, as well as the marked increase in child abuse.
Q: Is there usually an event or situation that triggers PAS?
Doctor: There are some particular things that tend to bring back an awareness of the abortion, such as the woman’s admission to a hospital or going into an operating room, her child being taken in for surgery, the birth of her child or seeing a friend’s newborn or the death of a child, close relative or friend.
Q: Is every woman who has had an abortion likely to develop PAS?
Doctor: Some women may work through the aftermath of abortion with the aid of a support group, their church or family and friends. But I believe the only person who would not be affected by an abortion would be someone with severe character disorder. Such an individual can form no real attachment to other human beings and therefore has no feeling for how her actions affect others.
The better a woman’s capacity to repress, the longer the disorder will be put off, but the greater the eventual stress. Some women can talk quite glibly about the issue. They build support groups and are not consciously bothered by their abortions, but they spend a great deal of time and energy justifying them.
Q: How is PAS treated and resolved?
Doctor: I review symptoms carefully with no prejudgments. I take the person back through a life review and interview close relatives. I see the patient frequently, but it is important not to overwhelm them by bringing too much to the surface at once. In the process of resolving feelings about the abortion, the individual must understand how and why it happened. The patient must look at how she handles her life.
Q: Is grieving for the aborted child an important aspect of therapy?
Doctor: Yes, but one aspect of denial is the idea that the aborted baby was not a person. For a person in crisis, it is easy to buy into the idea that the fetus is just a piece of tissue. But this tissue in the woman’s uterus is not in any sense her tissue. The fetus is a unique individual: there has never been one like it, there will never be another. In order to resolve grief, the woman must admit that a child was aborted.
Q: How would you advise a woman suffering from PAS?
Doctor: She should turn to those who are pro-life, support groups and counselors who take a clear stand on abortion and can help restore the woman’s sense of the meaning of life. Abortion delivers a body blow to the meaning of life.
This article originally appeared in the American Association of Pro-Life Pediatricians Newsletter, Autumn 1990. Reprinted by permission in the Association for Interdisciplinary Research in Values and Social Change Newsletter, Vol. 3, No. 4 – Winter 1991