How abortion and stigma impact a person's mental wellbeing, and where to find support
CW: This article contains talk of abortion, pregnancy, grief, sexual abuse and mental health which may be distressing to some readers
The right to abortion
In England, Scotland, and Wales, abortion is still governed by the 1967 Abortion Act. The act permitted abortion under specific circumstances. This includes a gestational time limit and the requirement for two doctors to sign off on the procedure. The NHS offers pregnancy termination free of charge, with two procedures available depending on the gestation of the pregnancy. Abortion can be undertaken up to 24 weeks of pregnancy, after which point it will only be carried out in very exceptional circumstances – for example, if the mother's life is at risk or the child would be born with a severe disability.
“The 1861 Offences Against the Person Act made it a criminal offence for any woman to end her pregnancy and for anyone to assist her with doing so. Today any abortion that takes place outside of the 1967 act still, in principle, carries the penalty of life in prison [for both the woman and the abortion provider].” - Clare Murphy, Chief executive of the British Pregnancy Advisory Service
Animosity regarding abortion
The procedure of abortion is oftentimes met with resistance. Protests and demonstrations outside abortion clinics and hospitals can be traumatic and harass patients regardless of their intentions. In Glasgow, a group known as 40 Days for Life planned 40 days of anti-abortion demonstrations outside the Queen Elizabeth University Hospital. Members of the group claim they have peaceful conversations and pray to provide 'a last sign of hope for anyone who's considering an abortion'.
The Scottish Greens MSP, Gillian Mackay, referred to these protests as 'a 40-day gauntlet of harassment' as she campaigns for legislation introducing 150m buffer zones around health facilities.
Organised demonstrations are not the only form of animosity towards abortion. Often patients will experience pressure from friends, family, and partners who may attempt to influence a decision. A study conducted by the Joseph Rowntree Foundation analysed the trends regarding specifically young motherhood and abortion across the UK. The study found that parents had a strong influence on their children's decision even if they had not directly made it for them. i.e. Children who continued with their pregnancies were more likely to come from families with negative opinions on abortion; children with families who held neutral or positive opinions on the matter were more inclined to opt for the termination. Ensuring bodily autonomy is not compromised can be difficult in these cases. (Bodily Autonomy: decisions about your own body are yours to make alone.)
There was a strong correlation between the proportion of under-18 pregnancies ending in abortion and the proportion of adult pregnancies ending in abortion. This suggests that local familial and/or cultural processes also have an important impact.
Stigma and Shame
Abortion stigma aims to shame, demonise or exclude those who make the decision to terminate a pregnancy. Kumar, Hessini and Mitchell have defined abortion stigma as “a negative attribute ascribed to women who seek to terminate a pregnancy that marks them, internally or externally, as inferior to ideals of womanhood”. Ipas, in connection with Rutgers University and the London School of Economics, have conducted research around the globe. The experiences faced in countries such as Indonesia are devastating and Ipas are fighting through outreach, awareness campaigns, and collaboration with community and government organisations to promote social change.
In the UK however, the struggle with internalised stigma is underrepresented. Many feel the shame, guilt, and regret that is attributed to them based upon their decision. These feelings can result in isolation and long bouts of low mood and other symptoms aligned with mental health issues such as depression. These emotions can carry through the procedure and for some time afterwards with many experiencing prolonged grief.
Mental Health Harm
It may seem shocking that more than 50 years of international psychological research has shown that having an abortion is not directly linked to mental health problems, especially when considering the emotions and mental impact of an abortion discussed throughout this article. However, it is regarded as a separate outcome to clinical diagnoses such as depression, anxiety, and PTSD, as studies have found that these are incomparable to the experiences of those who carried babies to term with severe birth defects, for example.
'The idea that abortion causes mental health harm is used to defend laws that restrict women’s access to abortion.'
In order to still consider the effects a pregnancy termination has on a person, without discrediting formal diagnoses given in different circumstances, many healthcare providers will term this as grief. 'Grief is not a formal mental health diagnosis, while depression is. But symptoms of depression may overlap with some emotions related to grieving' because of this, the lines can become blurred. Sometimes in recurrent circumstances in which these symptoms do not resolve themselves, a diagnosis of prolonged grief disorder can be issued. The main thing to consider in situations like this is that: while everyone grieves differently, these feelings are natural and normal. Following an abortion, hormones play a tremendous role. Feelings of intense sadness, anger, grief, guilt but also relief, can appear seemingly out of nowhere.
It is important to remember that whilst medical professionals may recommend talking to a personal support network, professional support is also available. The NHS provides a confidential and free counselling service that can be accessed before, during, and after the procedure.
Cruse Bereavement Support deals with grief counselling and can help talk through the potentially confusing feelings and can help with returning to work and other day-to-day activities.
Rape Crisis England & Wales helps to deal with issues regarding sexual violence or assault, sometimes a factor in why a person may choose to have an abortion.
Relate can provide relationship counselling, whether that is with a partner, or family member, after the experience.
Samaritans are an all-round counselling support who can alleviate troubles weighing on the mind day-to-day.