Post-abortion stress syndrome (or PASS) defines the psychological effects following an abortion. It is a form of post-traumatic stress disorder (PTSD), but in this case, the trauma was caused by the abortion.
While post-abortion stress syndrome was researched in scientific studies, this condition is not accepted American Psychiatric Association or the American Psychological Association. For this reason, many question if post-abortion syndrome does in fact, exist.
However, it is known with certainty that any traumatic event can lead to PTSD and abortion is not an exception. If a woman makes the decision to have an abortion, it is possible to experience some emotional conflict even while she has good reasons to make this choice.
According to psychologists, the most common symptoms of post-abortion syndrome are:
- Feeling guilty. Guilt has complex roots. In some cases, women may take into account fears about what others would think about them having an abortion.
- Feeling anxiety. Similarly to PTSD, those who have an abortion may experience anxiety. Anxiety may be due to the fact that an abortion can increase the risk of fertility problems, if the woman plans to have babies in the future.
- Emotional numbness and depression, are common symptoms of PTSD which can occur in post-abortion syndrome.
- Flashbacks are one of the hallmark symptoms of PTSD and can happen in this condition, too, especially as abortion involves a surgical procedure where the patient is fully conscious. This experience can be distressing on its own. Flashbacks are defined as intense, intrusive sensations and emotions in which a person relives the traumatic event and associated feelings after the event. The person is fully awake and can’t tell the difference between the reality and this “waking” nightmare. Severe flashbacks and other PTSD symptoms can interfere with day to day life.
- Suicidal thoughts. Although other traumas are more likely to cause suicidal thoughts, it is possible that a woman with post-abortion syndrome to have suicidal thoughts or tendencies. In this case, immediate treatment in the hospital is required.
It is important to note that many women who have an abortion do not suffer any emotional distress. In fact, some feel relief after having the abortion. Health experts believe these women are more likely to talk about their experience compared with women who feel guilt or shame from having an abortion.
Depression and anxiety following abortions
Research shows that abortion may be a risk factor for depression and the depression may develop within the first eight years following the abortion.
Women whose first pregnancies ended in an abortion were 65% more likely to experience clinical depression compared with women who gave birth when they became pregnant the first time in their life.
Other studies found that generalized anxiety is also more common in women who had an abortion, and they feel the anxiety is related to their experience.
Researchers admit that more studies are needed to fully understand the emotional after-effects of an abortion.
Past researchers tried to prove that abortion does not have harmful effects on a woman’s state of mind, but those studies had significant flaws. Based on the available data, mental/emotional issues may worsen after an abortion.
In addition to increased risk of depression and anxiety, women who had elective abortions tend to experience more psychological trauma compared with those who gave birth to stillborn babies. Emotional distress also tends to be more serious among women who have more than one abortion.
Furthermore, past abortions may have a negative impact on the relationship between mother and her children. Some healthcare professionals who conduct abortions may experience shame and uneasiness.
According to a review from Heartbeats.org, many women experience symptoms after an abortions, including feeling less in touch with their emotions, increased tendency towards rage and anger, loneliness or isolation, feeling less self-confident, denial, using drugs or alcohol, eating disorders, insomnia or nightmares. Many women who had an abortion reveal they felt pressure to abort, some felt they were not fully informed to make the decision, did not receive counselling or understand the alternate options.
Physical health and abortions
Roughly one million abortions are performed each year in the US. Doctors estimate that there are complications in about 2% of the cases, which can range from minor complications such as pain, bleeding, minor infection, side-effects from anesthesia to major adverse events like severe bleeding, perforation of the uterus, injury to other organs such as bladder and bowels.
Long-term complications like pelvic inflammatory diseases and subsequent infertility can also aggravate the situation. Women who have history of abortion are also at higher risk to have bleeding, miscarriages, eclampsia (pregnancy-related high blood pressure which can lead to seizures), other health complications and even pregnancy-related death.
Many of these complications affecting physical health can also have a negative impact on emotional health.
Post-abortion syndrome help
Feelings and emotions are complex and a woman who undergoes an abortion should seek out counseling if she experiences emotional distress.
While the condition called post-abortion syndrome may be controversial for some, psychologists believe that this condition is real and psychotherapy can help. Emotional symptoms should not be ignored. Psychologists and psychotherapists are highly skilled and offer advice and therapy in a compassionate, unbiased and non-judgemental manner.
There are support groups for those looking for post-abortion syndrome help that does not require professional advise, but are rather interested to connect and share their experience.
Heartbeats.org provides more information about these support groups which are free or charge and confidential. The website also includes a blog with helpful articles, information about pregnancies, abortions, sexual health and sexually transmitted infections. If you or someone you know needs immediate help for abortion recovery and support, call the 24-hour US Helpline at 1-800-712-4357.
Psychology Today. Post Abortion Stress Syndrome (PASS) - Does It Exist?
Cougle, J., Reardon, D., Coleman, P. (2003). Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Medical Science Monitor.
Cougle, J., Reardon, D., Coleman, P. (2005). Generalized anxiety following unintended pregnancies resolved through childbirth and abortion: a cohort study of the 1995 National Survey of Family Growth. Journal of Anxiety Disorders.
Ney, P.G., Wickett, A.R. (1989). Mental health and abortion: review and analysis. Psychiatry Journal of the University of Ottawa.
Sajadi-Ernazarova, K.R., Martinez, C.L. (2021). Abortion Complications. National Library of Medicine.