After the “Choice”

For Those Facing Post Abortion Syndrome

by Sandra Glahn, Th.M. and William Cutrer, M.D.

Having reviewed the medical and ethical aspects of abortion, we must also consider its personal impact. Statistics suggest that in a year’s time, more than one and a half million U.S. women will have abortions. Where are all these women and how do they feel after “the choice” has been made?

Despite the risk of hemorrhage, infection, and future problems with pregnancy or fertility, it’s remarkable that most women who have abortions recover with no physical problems. Yet what about the emotional and spiritual issues? Are there any long-term effects? Can a woman take the life of her own unborn child and suffer no emotional or spiritual pain?

Many women—and the men involved, too—do, in fact, suffer with what has been labeled PAS (Post Abortion Syndrome) or PASS (Post Abortion Stress Syndrome). (We will use PASS hereafter, as in future columns we will use PAS to refer to Physician-Assisted Suicide.)

The pro-life community has been quicker than the pro-choice community to acknowledge the existence of PASS and provide support for those affected by it. Many in the pro-choice community have denied its existence.

A 1997 study reported that “Despite a concerted effort to convince the public of the existence of widespread and severe postabortion trauma, there is no scientific evidence for the existence of such trauma.” The study received widespread media attention.


There are several problems with studies such as this that rely heavily on testimony from the women themselves:

The subjects are not trained to diagnose their own conditions.


Most studies are affected by reporting bias. In 1989, then-Surgeon General C. Everett Koop wrote in a government report that only about 50% of women who have had abortions will admit it when asked directly.


Poor measurement of trauma is used. In the above-cited study women were asked about their self-esteem. The method was not set up to measure trauma.


More recent research has provided evidence that contradicts the 1997 study:

A July 2002 study, the results of which were reported in the American Journal of Orthopsychiatry (written by Priscilla Coleman, Vincent Rue, David Reardon, and Jesse Cougle) demonstrates that abortion can cause mental health problems, both early and delayed. The new study, “State-Funded Abortions Versus Deliveries: A Comparison of Outpatient Mental Health Claims Over 4 Years,” avoids the problems cited for the report listed above. Using records kept by the California Medicaid program, researchers looked at rates of first-time outpatient mental health treatment following abortion or a live birth from 1989-1992. All women who had made claims prior to pregnancy were eliminated from the study. Here are some of the results:


After controlling for age, months of eligibility, and the number of pregnancies, the mental health claims of the 54,419 women in the study were analyzed for 90 days, 180 days, one year, two years, three years, and four years following the pregnancy event.


The overall rate of mental health claims was 17% higher for the abortion group in comparison with the group who delivered.


Within the first ninety days after the pregnancy, the abortion group had 63% more claims than the birth group.


The aborting women had significantly higher rates of treatment within the categories of adjustment reaction, bipolar disorder, neurotic depression, and schizophrenic disorders. Higher rates of treatment for the abortion group approached significance for the categories of anxiety states and alcohol and drug abuse.


In subsequent time periods, the abortion group also had a higher percentage of claims compared to the birth group:


42% at 180 days; 30% at one year; 16% at two years

Rates were not significantly different after three and four years.

Conclusion: The abortion group had a greater need for mental health care than the childbirth group, which persisted for two years following pregnancy outcome.

An unpublished, in-house study performed by the Virginia Department of Medical Assistance Services yielded similar results: Of 325 women who had state-funded abortions, 73% had more health claims (85% higher costs) for reproductive health problems compared with a matched sample of women who carried their babies to term. They also found that women who had state-funded abortions had 62% more mental health claims post-dating the procedures (43% higher costs) compared with a matched sample of women covered by Medicaid who had not had state-funded abortions.*


A special issue of the Journal of Social Issues dedicated to research on the psychological effects of elective abortion, the journal’s editor concluded: “There is now virtually no disagreement among researchers that some women experience negative psychological reactions post abortion. Instead the disagreement concerns the following: (1) The prevalence of women who have these experiences… (2) The severity of these negative reactions… (3) The definition of what severity of negative reactions constitutes a public health or mental health problem…and (4) The classification of severe reactions.

What are the symptoms of PASS? They include denial, depression, anger, despair, anxiety, feelings of worthlessness, mild to severe depression, guilt, isolation, and particularly in the faith community, the “murderer syndrome.” In addition, some report that these symptoms further present themselves in sleep or eating disorders. Someone with PASS may not experience all of these, and the symptoms may first present themselves at varying times in the post abortion period, including as much as a decade later. The hormonal changes involved in the sudden cessation of pregnancy may further aggravate symptoms.

Is There a Solution?

If you have had an abortion, the first place to begin is repentance. Recognizing the destruction of a life created in God’s image, begin by confessing your sin to God (1 John 1:9) and asking His forgiveness through Christ. The Bible promises that God is faithful and just to forgive such confessed sin—it is part of His character. In offering your prayers of repentance and confession, you take the most important step toward finding inner peace. You might also admit your sin to another trusted individual (James 5:16), who can encourage you that it is impossible to fall outside of God’s love.

In addition…

Meditate on scriptures that speak to your unique situation. King David committed adultery and murder. Yet David, who is called “a man after God’s own heart,” went on to pen prayers of repentance in Psalm 51 and Psalm 32. For centuries these verses have blessed those seeking reconciliation with God and encouraged souls troubled by guilt. David prayed for God’s forgiveness and indicated that if God would restore him, “…then I will teach sinners your ways.” Look for opportunities to use your past mistakes to bring glory to God by helping others avoid the same mistakes you’ve made.


Think about stories in scripture that remind you of God’s forgiveness. Consider the Prodigal Son (Luke 15), Jesus’ restoration of Peter after who denied his Lord three times (John 21), and Jesus’ words, “Neither do I condemn you—go and sin no more” (John 8:11).


If you find yourself feeling hopeless or suicidal, seek professional help immediately from someone who understands your needs.


Visit Internet sites where you can find encouragement and support for people facing PASS. Having a chance to talk and interact with others who understand what you are going through can help a lot.


Encourage other believers and churches to reach out in forgiveness and reconciliation. Work to make your faith community a “safe” place to be “imperfect.” Heather Jamison in her forthcoming book titled Reclaiming Intimacy points out that Jesus did not say to the woman caught in adultery, “Let the one who is without sexual sin cast the first stone.” He said, “Let the one who is without sin…”


Contact your local Pregnancy Resource Centers and ask about their PASS support groups.


Know that some who suffer with PASS feel better if they can be involved—such as volunteering at a Pregnancy Resource Center or donating clothing to those experiencing crisis pregnancies.


Whether or not you are touched by the tragedy of abortion, with 1.5 millions abortions performed annually in the U.S., you must know that the pain of abortion has touched many around you. So be quick to offer a word of grace and hope in a desperately hurting world. As the Lord reached out to the woman caught in adultery, we must be quick to offer the grace of, “Neither do I condemn you…go and sin no more.”

*Source: Wanda Franz, PhD. National Right to Life News, “Abortion Associated with Higher Levels of Psychiatric Problems than Carrying Pregnancy to Term,” p. 22-23.

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Abortion As Birth Control?