Psychiatric Sequelae of Abortion: The Many Faces of Post-Abortion Grief

Induced abortion is the surgical or medical intervention in a pregnancy for the purpose of causing the death ofthe embryo or fetus (If the procedure results in a live birth, the outcome is a preterm delivery, not an abortion.).Every abortion, then, is an iatrogenic death.Every post-abortion woman has undergone a real death experience -the death of her child.Grief is a natural consequence of death.Current obstetrical and psychiatric literature abounds with articles about grief following perinatal death -death due to spontaneous abortion, premature birth, stillbirth, and Sudden Infant Death Syndrome.However, it is only in recent years that the medical profession has begun to understand that perinatal loss can be followed by a grief reaction similar to the loss of an older child or an adult as illustrated by the following statement in Clinics ofOBIGYNin 1986."I can state most assuredly that couples with recurrent, unexplained or explained early pregnancy losses grieve as intensely as those with later losses or losses of live-born children.Their grief is not visible, however, since society, family, friends, press, or clergy do not support or are not trained to support them.The grief is very real and if unattended can eventually be felt by them to be aberrant, unnatural, or even unhealthy."! Hospital obstetrical units have developed teams of physicians, nurses, and social workers to help parents deal with perinatal death and the issues of grief, anger, and guilt which it raises.The September 1990 issue of the British Journal of Obstetrics and Gynecology states: "Ways of helping parents cope with their losses have been recommended and have reduced the frequency of prolonged emotional disturbance and of abnormal grief reactions .... Ways of facilitating the .grievingprocess have been identified.These include seeing and holding the dead baby, giving it a name and taking photographs; all help make the situation a reality and to create memories.It is difficult to grieve when no memory of the individual exists."2In addition to the 20 to 30 percent of pregnancies thought to end in spontaneous abortion in this country, there is now one elective abortion for