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Week of 7.20.07

Head to Head: Abortion Counseling

Linda Cochrane (LC), R.N. is a consultant on post-abortion recovery for Care Net, an umbrella organization of over 1,000 Christian pregnancy centers in North America.

Faye Wattleton (FW) is president of the Center for the Advancement of Women, a women's advocacy group, and former president of Planned Parenthood Federation of America.


NOW: What makes you assert that there is or is not sufficient scientific evidence to prove that abortion in and of itself causes lasting psychological harm?

FW: The debate over whether there is scientific proof that abortion causes lasting harm has endured since the Reagan administration, which directed then Surgeon General, C. Everett Koop to examine the health effects of abortion on women. Dr. Koop reported that the available data on the psychological impact of abortion was "too ambiguous to arrive at a definitive conclusion." Follow-up research by experts in psychological trauma, including the American Psychological Association and the Association of Women Psychiatrists, concluded that severe negative reactions after abortion are rare; most women experience relief and happiness after an abortion; and diagnosed psychiatric illness and hospitalization is higher following childbirth than following abortion. Obviously, the struggle for a stable mental state will intensify among women during pregnancy, whether this is terminated or continued.

LC: More research is needed to study the women who state they regret their decision, and research needs to be conducted on the best way to help them. At present, some research findings suggest the experience of post-abortion trauma is abnormal and uncommon. When women come to Care Net centers for help, they aren't asking whether there is scientific evidence validating their post-abortion feelings. A woman experiencing the aftermath of abortion wants to know, "Will this pain ever stop?" Care Net centers help women find peace after an abortion. Women who regret their decision need to be granted societal permission to process their grief. The political debate is leaving women isolated and alienated. Pregnancy loss is real. And when their loss was their choice there is a serious combination of guilt and grief. More scientific evidence validating the suffering may help to provide resources for women who are experiencing post-abortion depression. No matter what the research states or how politics change, pregnancy centers will continue to help.

NOW: What is the best approach to helping women deal with an unplanned or unwanted pregnancy?

FW: Informed consent is the bedrock of ethical healthcare. I'm a firm believer in the right to know and that women, if given full knowledge of the options available to them, can be trusted to make decisions that are in their best interest. There is no "best approach" for all women. They should be provided with the information that they desire. Being forced to receive government-imposed messages against their will is in violation of this principle. They should be trusted to make the best decision for themselves, not by the edict of another person's morals and religious standard.

LC: Listening to the woman is the best approach in helping with a pregnancy. A woman in an unplanned pregnancy wants someone who will care enough to put aside their own agenda and really hear her concerns. A skilled caregiver will ask questions that will draw out her true desires and provide information that affirms her individual worth, as well as the worth of her child. The experts in this field are pregnancy centers, which have been providing free and non-judgmental options counseling for over thirty years.

NOW: Do you believe young women have access to enough information about the implications of getting an abortion?

FW: Because of the expansion of federal and state government-sponsored programs in the 70s and 80s, access to information and methods of contraception is widely available. As a result, women are better "contraceptors" than ever. They are avoiding the dilemma of an unintended pregnancy and having to consider options for that circumstance. The rate of unintended pregnancy, abortion and childbearing among teenagers is declining. I was programmed in my professional training as a nurse and nurse midwife not to impose my personal values on my patients. Such is unacceptable, even unethical. The experiences and value structure of healthcare providers are not the same as their patients'. Dishonesty about sexual decision-making and misinformation about contraception methods are designed to advance a particular moral code. Healthcare providers are not in the religion business.

LC: No information is a form of misinformation. The facts need to be given. Even if only one percent of women will experience post-abortion stress and 10 percent will suffer a form of depression, 10,000 and 100,000 women respectively will need help each year. Add that to the number of women unable to find help the year before and there is an enormous amount of unresolved emotional, spiritual, and sometimes even physical pain in women today. Many women are told that abortion is a minor surgical procedure after which many experience relief. What they are not told is that many of these same people proceed to struggle with their decision for 10, 20, and 30 years until finding true relief. Every year, approximately 15,000 women and men participate in post-abortion recovery classes offered at Care Net pregnancy centers.

NOW: Many states mandate that women undergo a waiting period and mandatory counseling before an abortion. What should states be telling women —if anything —during this time?

FW: Imposed waiting periods are demeaning to women. The rationale given for these laws is to cause women to reflect on their decision, which assumes they haven't done so before their request. Do we impose this on men requesting a vasectomy? This message is unmistakable: the government doesn't trust women to make responsible decisions, unless they have scaled arbitrary hurdles. Waiting periods also place an undue burden on women who have to travel to fewer available abortion providers; teenagers who must seek court protection, if they cannot turn to their parents for advice and counsel; and increase the risk of pregnancy complications.

LC: In the waiting period, women need to know that all the choices are hard. Parenting is hard, adoption is hard, and abortion is hard. Abortion is not an easy choice. There are serious potential consequences to abortion: physical, emotional and spiritual. Some women regret their abortion decision and suffer greatly. Accurate statistics on the risks need to be provided like all other pre-operative preparation. Care Net centers provide clients with current and accurate information on abortion risks in brochures reviewed by Care Net's Medical Advisory Board.

NOW: Do you believe crisis pregnancy centers —many of which are supported by federal and state tax dollars —serve a practical and/or a political purpose?

FW: What is a crisis pregnancy center? Centers purporting to offer free pregnancy tests and "counseling" have long been a front by religious organizations attempting to persuade women to continue a pregnancy. A woman's informed reproductive decisions are ambushed by misleading and fraudulent disinformation. Women who are pregnant and do not wish to be are not always in a state of crisis. Whether they are or whether they are not, they should be left alone. The true nature of any provider and the range of services should always be transparent. As president of Planned Parenthood, we brought lawsuits against so-called 'crisis pregnancy centers,' charging them with false advertising in the Yellow Pages, which are designed to defraud and mislead the public.

LC: Our country will always have unplanned pregnancies. Pregnancy centers will continue to serve a valuable and practical need in our communities. All services at pregnancy centers are free, including parenting and childbirth classes, material resources, job training, mentoring, and how to form and maintain healthy relationships. Only a small number of pregnancy centers (13% in 2005) have received a federal and state grant. Most centers are supported by individuals, churches, businesses, and community agencies that care about women in crisis.

NOW: What is the psychological impact on women if they are legally prevented from having abortions?

FW: There is disproportionate weight to psychological issues around childbearing when women choose to terminate a pregnancy. Ironically, women who continue an unwanted pregnancy are more likely to report psychological concerns than do women who choose termination. Women are often mischaracterized as lacking moral standards and skewing the state of motherhood. In more than 30 years of work in the women's rights movement, women have told me that they felt relief after terminating an unwanted pregnancy. Admittedly, this did not reflect a representative sample. My impression is that women are able to go on with their lives, become productive citizens, look forward to motherhood and believe that they've made the decision that was right for them.

LC: We do not know what the psychological impact will be, but we do know the psychological struggle of legal abortion. Women ask, "If abortion is legal and my right, why do I feel bad after one? Am I wrong for feeling bad? Is there something wrong with me or is there something wrong with abortion?" The issues of right and wrong and life and death are being brought to the post-abortion recovery room. We are seeing the psychological impact of legal abortion in each session. Coming to terms with the answers to these questions is part of the healing process.

NOW: How might a ban on abortions impact family planning clinics and crisis pregnancy centers?

FW: Family planning providers are the vehicle for women to exercise their decisions in safety. A ban on abortion would be to the harm of women. Constitutional recognition of this most private decision did not invent abortion. The question is whether women will be killed or injured. The movement to re-criminalize abortion has used derogatory graphics of fetuses to advance their goal. The focus shouldn't be on the providers; it should be on the concern for the sad tale of permanent infertility, the newspaper accounts of physicians being hauled to jail and the bodies of dead women. This should give us pause to seriously ponder the consequences of reversing four decades of liberation of such horrors. My concern is for women; wives, mothers, sisters, daughters.

LC: There would be a continued need for comprehensive pregnancy center support services providing women with options. Whether or not there is an abortion ban, we will always have women with unplanned pregnancies. They deserve to be treated with respect and dignity. We need to reach out to them with compassionate care and practical resources. And there will be a continued need to offer support to those who chose abortion prior to the ban.

NOW: Who is in the best position to make an appropriate decision regarding the termination or continuation of a woman's pregnancy?

FW: Incontrovertibly, the individual whose body is altered by the state of pregnancy is in the best position to make the appropriate decision. The fact that this question remains unsettled reveals that women have not still advanced to a status of trust about their life decisions. This, at the beginning of the 21st Century.

LC: The woman is in the best position to make the decision. She is the one most impacted and about to make a major life decision. Pregnancy center options counseling provides comprehensive information she needs to make an informed choice. If this woman is still living at home, her family is also greatly impacted, and she will need their input. The father of the child is also in an appropriate position. Pregnancy centers believe that women should have the freedom to make this decision without coercion or manipulation from others.

NOW: How can we best help women prevent unwanted pregnancies?

FW: I cannot recall a single woman who declared that terminating a pregnancy is a life-fulfilling event. Unwanted pregnancy requires a woman to access a healthcare system that is increasingly hostile if her decision is to terminate the pregnancy. It seems ironic that a movement dedicated to overturning the legal status of abortion has done so little to prevent unintended pregnancy. Adoption is one option; however, pregnancy should not be enforced for the purpose of giving others the experience of parenthood. The lack of interest in preventing unintended pregnancy leads one to question their true motives. There is a prime opportunity to join together on the common ground of assuring that unintended pregnancy becomes rare and abortion remains safe and legal.

LC: Pregnancy centers provide comprehensive education to help clients make healthy life choices. Pregnancy centers offer educational information about contraception as well the risk of pregnancy and STDs associated with using various forms of contraception. Abstinence outside of marriage and fidelity inside marriage is the best way to prevent unwanted pregnancy and STDs. Abstinence is also recommended to protect the emotional, mental, and spiritual health of our clients.