|  Post-abortion
stress syndrome" — PASS or PAS — sounds scientific,
but don't be fooled — it's a made-up term. Not
recognized as an official syndrome or diagnosis by the
American Psychiatric Association , the American Psychological
Association, or any other mainstream authority, it is
a bogus affliction invented by the religious right.
Those who claim its existence define it loosely as a
raft of emotional problems that they say women suffer
after having an abortion — nightmares, feelings
of guilt, even suicidal tendencies — and compare
it to post-traumatic stress disorder.
Using
the allure of outward compassion, dozens of anti-choice
PAS organizations have sprung up in the last ten years,
accompanied by books, pamphlets, billboards, and Web
sites. From SafeHaven and Healing Hearts Ministries
to Victims of Choice and Rachel's Vineyard — a
project of the anti-choice American Life League that
operated its varied programs on a $7 million annual
budget in 1999 — all of them insist that women
who have had abortions suffer severe psychological damage
that can be alleviated only with their assistance. Even
though they call it a "syndrome," they don't recommend
medical intervention.
It's
anti-choice dirty-play at its worst. Because the groups
believe that abortion is always a wrong choice, they
often engage women in three steps toward recovery: confession
of their mistake; reconciliation, usually through a
ritual (Project Rachel, which is affiliated with the
Catholic Church, takes women on retreats that include
a "name your baby" ceremony and a "Mass for the Unborn");
and, finally, restitution of some sort. Of course, "the
way to make recompense is usually to speak out against
abortion," says Rev. Cynthia Bumb, an activist who has
followed PAS activity closely. The groups tell PAS sufferers
to lobby for anti-choice legislation; Afterabortion.org
helps women get started with model bills, like the "Protection
from High Risk and Coerced Abortion Act." Another route
to "recovery" is to sue an abortion provider for malpractice.
At the Web site of the anti-choice Justice Foundation
— actually a malpractice firm, not a foundation
— viewers are greeted by a burst of thunder, followed
by a voice: "If you've been physically or emotionally
injured by abortion, don't suffer in silence." You can
"talk to an aggressive attorney today," the voice says.
"You don't have to be a victim for the rest of your
life." Their hope is that malpractice claims will eventually
put abortion clinics out of business, even if protesters
do not.
Claiming
that abortion causes women psychological suffering conveniently
flips the debate so that the anti-choice movement seems
less callous toward women's concerns and more focused
on women's "health." This cynical pro-woman/pro-life
scheme was honed by David C. Reardon, director of the
anti-choice Elliot Institute in Springfield, Illinois
— the organization behind Afterabortion.org —
who realized that the fetus imagery of the "pro-life"
movement was failing to sway the masses because too
much of the public believes that women will suffer if
abortion is criminalized. In fact, an October 2000 Gallup
poll found that two-thirds of Americans surveyed said
they are against a constitutional amendment that would
overturn the right to abortion established in Roe
v. Wade. In March 2001, only 18 percent of the people
polled told Gallup they want abortion to be illegal
in all circumstances. But Reardon asserts that many
people who support abortion are "uneasy pragmatists"
who "have hardened their hearts to the baby because
they think at least women are being helped." In his
book, The Jericho Plan: Breaking Down The Walls Which
Prevent Post-Abortion Healing, Reardon describes
his new strategy for making the anti-choice movement
appear pro-woman, bringing down the walls of choice
by convincing the public "about the dangers of abortion."
And since legal abortion is, in fact, a very safe surgical
procedure and is far less dangerous than childbirth,
Reardon and his allies seek to foment mental pain. "So
as we educate [the public] about how abortion hurts
women, it changes the whole equation," Reardon told
Priests for Life. "The potential of post-abortion healing
. . . can rapidly change the whole dynamic of the abortion
debate in this country. And I am really confident that
we will see an end to abortion within the decade."
His
formula calls for "stealth healers" (his term) to offer
mercy and forgiveness to women who have had abortions
— he calls them "post-aborted women" — and
then use them as "compelling advocates for the unborn."
Says Reardon: "By demanding legal protection for women
forced into unwanted abortions and greater rights for
women to sue for post-abortion trauma, we force our
opponents to side with us in defending women's rights
or [to] be exposed as defending the abortion industry
at the expense of women." He wants the message of the
antiabortion movement to be, "abortion hurts women."
And he's getting his wish. During the Republican National
Convention in Philadelphia last year, a string of anti-choice
protesters spread out on a street in a "human life chain,"
holding the same sign: abortion hurts women.
 Of
course, the overwhelming scientific evidence shows that
abortion does not hurt women — physically or mentally.
In the late 1980s, President Reagan tried a strategy
similar to Reardon's and asked his like-minded surgeon
general, C. Everett Koop, to conduct a study on the
mental pain caused by abortion. To everyone's surprise,
Koop determined that there was insufficient evidence
of trauma. Psychological problems were "minuscule from
a public health perspective," he said. The American
Psychological Association followed up by asking a group
of six experts to undertake a special review. The panel
concluded in 1989 that terminating an unwanted pregnancy
posed no hazard to women's mental health. The predominant
sensation women felt following an abortion was relief,
the group said.
And
in August 2000, a study conducted by Brenda Major at
the University of California at Santa Barbara —
the latest among many — confirmed those findings.
Severe post-abortion psychological distress is extremely
rare, affecting just one percent of patients. "Most
women were satisfied with their decision, and believed
that they had benefited more than they had been harmed,"
said Major, who, along with other researchers, tracked
women for two years after they had first-trimester abortions
(88 percent of abortions are performed in the first
trimester, and therefore represent the typical experience).
The best predictor of post-abortion mental health, it
turns out, is a woman's mental health prior to the abortion.
"Abortion
does not cure depression or bipolar disorders; nor does
it cause them," says Suzanne Poppema, a retired Seattle
abortion provider, now an international consultant on
reproductive health issues. She and many others have
little tolerance for PAS — "because it doesn't
exist," she says. The overwhelming emotion she witnessed
at her clinic, she says, was relief; PAS is merely an
attempt to scare women, and she points out that if women
do feel negative emotions, they are probably a result
of the antiabortion movement itself. After all, the
picketers who scream "murderer" at women entering clinics
are significant stress-inducers, too.
Like
Poppema, abortion rights organizations are quick to
denounce PAS as the myth that it is. "The shame here
is they look for women and seek to exploit them," says
Ron Fitzsimmons, executive director of the National
Coalition of Abortion Providers in Alexandria, Virginia,
an association of independent clinics. When Project
Rachel began its multicity anti-choice ad campaign in
the Spring of 2000, the National Abortion Federation,
the largest professional association of abortion providers,
countered with a press conference that cited scientific
studies disproving post-abortion stress. "This is an
invention of those who oppose choice," says Vicki Saporta,
NAF's executive director.
Abortion does not "hurt" women and there is no such
thing as "Post Abortion Syndrome," but it's also true
that women who feel relief after having an abortion
may also have normal feelings of sadness, grief, or
regret. An unwanted pregnancy alone can create significant
anxiety. With the clock ticking, a woman is forced to
decide between very limited options, each of them stressful.
The alternatives to abortion — carrying a pregnancy
to term and either keeping the child or making an adoption
placement — can have a serious impact on a woman's
mental health. Rosemary Candelario, a longtime abortion
rights activist and current director of the Massachusetts
Religious Coalition for Reproductive Choice, points
out that it is important for pro-choice organizations
to recognize that some women, especially those with
religious backgrounds, may have difficulty making the
decision to terminate the pregnancy: "I think the fear
in the movement is if we admit abortion is hard for
some women, then we're admitting that it's wrong, which
is totally not the case. I've heard from women who are
having problems dealing with their abortion who are
still ardently pro-choice."
Attributing
a woman's emotional problems to the simple fact that
she had an abortion can detract from a full understanding
of what is going on with her," says Nancy Russo, a professor
of psychology and women's studies at Arizona State University
and the author of multiple studies on the subject. Ava
Torre-Bueno, a psychotherapist and the author of Peace
After Abortion, says most of the women who come
to her seeking counseling say, "I'm pro-choice. I'm
still pro-choice. So why do I feel so bad?" Many are
recovering from the sheer stress of making the decision
to have an abortion. About one-quarter, she says, are
grieving-sometimes for the fetus or what they might
see as a life or potential life. Others are grieving
another kind of loss: a breakup with a boyfriend or
rupture with parents.
Women's
real-life responses to abortion are "complex," notes
Gail B. Williams, an associate professor of nursing
at the University of Texas, and are "associated with
a mixture of feelings." And the current political climate
has only made things worse. In the days of back-alley
abortions, "women felt lucky if they didn't die," says
Susan Brownmiller, author of the feminist memoir In
Our Time. Now, however, the atmosphere surrounding
abortion is saturated with anti-choice rhetoric. "Women
who sit in my clinic don't see it as a right," says
Peg Johnston, director of Southern Tier Women's Services
near Binghamton, New York. "They're scared."
What
they are scared of is stigma, according to a little-noticed
1999 study by Brenda Major, the lead researcher of the
U.C. Santa Barbara study, and psychologist Richard H.
Gramzow, who found that approximately half the women
in their study who had abortions felt a need to keep
them secret from friends and/or family for fear of social
disapproval. The effort of concealment itself was a
major source of distress for women, the study said.
"Women are hypersensitive to the sociopolitical climate
and how it affects their feelings. This is the only
medical procedure you can't talk about," says Dana Dovitch,
a psychotherapist in Los Angeles and coauthor with Candace
De Puy of The Healing Choice, a therapeutic handbook
on abortion. In interviews across the country, women
described to Dovitch the difficulty of creating a pretense
at work, lying to relatives, avoiding friends. Torre-Bueno
agrees. She noticed that emotional issues, especially
feelings of guilt, began rising along with anti-choice
efforts to restrict abortion. "More and more often,
women would say, 'I hope you won't judge me,'" she says.
 In
response to these forces, some pro-choice activists
are trying new approaches. NAF has a hot line, staffed
with trained personnel who are willing to help women
sort through their issues and give referrals to psychotherapists.
Both The Healing Choice and Peace After Abortion
provide exercises to help women review why they made
the decision to have an abortion and their feelings
about it. Many clinics, depending on the community,
offer in-house post-abortion counseling. Northland Family
Planning Centers in Michigan offer referrals for counseling
as standard service. Hope Medical Group for Women in
Shreveport, Louisiana, which attracts patients from
a wide geographic swath in the region, publishes "After
Your Abortion . . . A Natural Response" on its Web site.
It describes ways to cope with grief, anger, and sadness.
Recently in St. Louis, Rev. Cynthia Bumb set up pro-choice
counseling as an alternative to the local anti-choice
post-abortion projects. "A woman can process her decision
from a faith-based perspective without an assumption
that she was wrong," she says.
In
Binghamton, New York, Johnston offers women a polished
stone before the abortion, and describes Native American
and Buddhist rituals to help the healing process. "I
tell them, 'There is no Hallmark card for you, but it
doesn't mean you can't honor your loss,'" she says.
The touch is personal, but Johnston also sees this approach
as a political act to erase the stigma of abortion and
silence the anti-abortion thunder. "A lot of the rhetoric
of the anti-choice movement has really burdened women,"
says Johnston. "This is about listening to women-that's
what the women's movement is about."
Cynthia
L. Cooper writes about reproductive health issues.
She lives in New York City.
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