Copyright (c) 2007 William F. Harrison, M.D., FACOG -- all rights reserved
I first became aware of the term Post Abortion Syndrome in the mid 1980s. In 1984, my office, where I provide elective abortion, began to be picketed by a fellow with a doctorate in education who billed himself in the phone book as a “Christian Counselor”. After a few months of his picketing activity, I accepted a challenge from him to have a discussion about abortion on one of the local radio talk shows. He showed up with a fundamentalist Baptist preacher in tow and we had our discussion.
During this encounter, Dr. Pursley (for such was his name) mentioned that the reason that he had become interested in the abortion issue was because he had seen so many women with Post Abortion Syndrome (PAS). He characterized it as a condition marked by depression, flashbacks, severe regret, even agony and suicidal ideation about one or more abortion experiences that the women had previously experienced. Pursley maintained that he had seen scores of these women in his practice. At that time, I had done only a few hundred elective abortions since most abortions in my region were performed at other physician’s offices. This was about to change, however, because I soon became the only physician openly providing elective abortion for a wide radius around my office. Over the intervening years I have done almost 18,000 of these procedures in my office and seen almost all these patients back for short-term care, and at least 10,000 or more for longer term follow up.
During all this time, I kept reading about PAS and hearing it discussed in various Pro-Life forums. There seemed to be no question in the minds of the Pro-Life activists discussing this entity that it does in reality exist. And over the years I have talked to, read and heard the opinions honored by the vast majority of social workers, psychologists, psychiatrists, Pro-Choice ministerial counselors and others who might be expected to see women displaying symptoms of this syndrome, who swear that it does not exist, that they have never seen a patient with such a syndrome. Is PAS a myth, or is it real?
In my opinion, Post Abortion Syndrome is real. But the only people seeing it are those counselors with a strong fundamentalist religious commitment who are also strongly Pro-Life in their politics. Why are they seeing this syndrome while the vast majority of mainstream counselors are not?
There are millions of American women each year who experience and are diagnosed with major depressions. Many of these patients suffer from the symptoms of depression on a regular basis. While I am not a psychiatrist, I am told that depression is our most common psychological diagnosis. Additionally, there are now some 40,000,000 plus American women who have undergone one or more abortions since 1973. These abortions have been done for a variety of reasons, some of the problems linger long after the abortion. These include social, medical and economic difficulties as well as long-term relationship problems with spouse and significant others. Many girls and women having abortions are trapped in intolerable situations that are, in and of themselves, causes of major sadness. In my practice, I have seen thousands of women who presented with problems that they felt were overwhelming and the expressed reason they sought abortion. When first seen, nearly all patients will, if asked, relate their fear and remorse about being pregnant and feeling compelled to abort. Many think of themselves as failures for being in the position that they feel it necessary to abort. Many are tremendously angry at themselves and/or their partner. I have never seen or heard of a patient who expressed happiness at her need for an abortion.
I see well over 60% of all my abortion patients back for a 2 weeks post-abortion evaluation. Almost without exception, these patients express no regret and remorse, no guilt or fear of long-term problems. Indeed, the average woman’s almost universal emotion is an overwhelming sense of relief that she is no longer pregnant and thus no longer anticipates compounding, with the birth of a child, the problems that she was facing pre-abortion, many of which she must still confront.
Because these women are just as “at risk” of a depression at some point in the future as anyone else, they run the risk of falling into the “therapeutic” clutches of one or more of the “Pro-Life counselors” who are diagnosing all these Post Abortion Syndrome patients. Willingly or sometimes unwittingly, their history is obtained by these “counselors,” and major emphasis is placed on previous abortion experience. They are authoritatively informed that their problems all stem from the abortion(s) that they have undergone in the past.
How do women get directed to these “counselors” most likely to “find” post abortion syndrome? Some are self-referred, others are guided by anti-abortion zealots who have discovered their past, many are sent by Pro-Life ministers and ministerial counselors, some by so called “crisis pregnancy centers.” A few are even referred by supposedly legitimate physicians of fundamentalist religious bent. But all women diagnosed with PAS have three things in common – they have had one or more abortions, they are having or will have significant psychological problems, and they are now members or will become involved with an anti-abortion fundamentalist religious group.
What of the millions of women who have undergone abortion, have depression and are not diagnosed by their therapists as having PAS? Is it that their therapist is just plain inadequate and therefore unable to make this diagnosis? Or could it be that those therapists seeing and treating PAS patients are themselves creating the syndrome? Or is the patient’s new fundamentalist religious commitment somehow at fault? After all, many consider a belief in the teachings of all fundamentalist religions potentially delusional. What is one of the major elements in the diagnosis of a major psychosis? Delusions!
After long years of observation of women with depression, of others caught in the grip of religious fundamentalism, and of thousands of women who have had abortions, it is my thesis that while abortion seems a necessary component of Post Abortion Syndrome – which, again, I now believe to be real - it is not the etiological or causative factor in PAS. Following Koch’s postulates concerning factors associated with various bacteriologic diseases, the third element – after abortion and depression - that is present in every patient diagnosed with Post Abortion Syndrome, is religious fundamentalist post-abortion counseling. While many millions of religiously fundamentalist women have had abortions, and many millions of others have had depressions, unless they fall under the spell of one of the militant Christian PAS counseling “specialists,” they do not have the long-term problems that might be called “post abortion syndrome.” These religious fundamentalist psychiatrists, psychologists, social workers and the “Christian Counselors” who claim they are seeing large numbers of PAS patients are like the footbinders who worked to make women’s feet “beautiful” in China until a century or so ago. In order to prevent the feet of upper class female children from growing into the (it was thought) grotesquely ugly “big foot,” the feet of female children were bound tightly at a very young age. This resulted in tiny, grossly deformed and almost totally dysfunctional feet and reportedly was the cause of great suffering among the female children who were subjected, with the best of intentions, to the gentle mercies of the footbinders. Christian fundamentalist PAS counselors are the modern day equivalent of the footbinder, responsible for much suffering - and more than a little mental deformity and dysfunction.
We must conclude that it is not abortion per se which causes the very real entity, Post Abortion Syndrome. Rather, it is extreme anti-abortion bias of much of Christian fundamentalism and of the fundamentalist counselors who diagnose and “treat” PAS.
These counselors should come with the following Surgeon General’s warning:
Danger - If you have had or are contemplating abortion, Fundamentalist Christianity and its associated “Christian Counselors” may be Hazardous to your Mental Health!William F. Harrison, M.D., FACOG
Fayetteville Women's Clinic
1011 N. College Ave.
Fayetteville, AR 72701
Tele (479) 442-8166
E-Mail: Wharri3365@cox-internet.com
Copyright (c) 2007 William F. Harrison, M.D., FACOG -- all rights reserved
We welcome FEEDBACK! Send e-mail feedback to: William F. Harrison, M.D. - Wharri3365@cox-internet.com
Return to T.F.Barans' commentary: Women's Reproductive Self Determination