Abortion Counselling (Termination, Miscarriage and Sudden Infant Death)
Abortion is a controversial subject in any culture from moral, religious, personal beliefs and medical views of what is right, wrong and the rights of women. In this article I will try to show the approach taken from a psychotherapeutic point of view as to how a woman can be assisted in making decisions about her own well-being, the life of the unborn baby, the personal and social impact of that decision on abortion her life, her family and her relationships. We will also cover briefly and in context the idea of termination, of having an unplanned miscarriage and sudden infant death including infanticide of children in a further paper to be published.
The first evidence of an abortion goes back to an Egyptian Ebers Papyrus in 1550 BC that depicted the methods used for relieving the women of the unborn child. (1) Various accounts in history going back hundreds of years discussing abortion whether accepted or not and the penalties of killing an unborn child (often inflicted on the women for disobeying her husband in losing her baby) can be seen – this is not a modern medical choice but a historical phenomenon showing that abortion was an issue from the very beginning as controversial and difficult topic to discuss.
In modern days the issue across cultures still rages on with particularly polarised religious and moralistic viewpoints as to what is right, what is allowed and what is seen as wrong (an offence) it is under this pressure and social umbrella that women have to come to terms with the decision of whether once they discover they are pregnant how to decide whether they should terminate of not.
Psychotherapy itself makes no judgemental issue as to the rights and wrongs of abortion although individual therapists may have strong religious or moral views of the topic. Where the therapist does have a conflict of judgement they should clearly remove themselves from the situation of counselling a woman or couple of an abortion choice and should leave the matter to more professional therapists that stand by their non-judgemental stance in therapeutic situations. Any psychoanalyst who allows his or her personal prejudices into the therapy room should seriously consider a change of profession or at least declare that their professionalism is tainted by their own belief system. In saying this one should also declare their personal beliefs whether in the pro-life camp or the free to decide camp.
In the start of a therapy session boundaries and objectivity should be set from the beginning with the client (patient) letting her or them know the limitations of your service and the difficulty in arriving at a any decision that feels emotionally completely right. In my own practice I usually set the boundary of who makes the decision to abort of not. I make it abundantly clear that the final say is in the hands of the pregnant woman only. That her partner, medical advisers, counsellors, family members are only secondary considerations to her own well-being and decision. This sense of responsibility is very important in the emotional recovery of deciding to go ahead with an abortion. Later she cannot look to anyone else as forcing her, influencing her or otherwise persuading her to go ahead when she was not sure. She must accept it is her decision and her final responsibility to go ahead or not. The reason this is important is that after the event she needs to be emotionally clear that she made the best decision for herself.