DR THOMAS STUTTAFORD
A Lack of interest in sex after an abortion is so common that it can
almost be said to be expected. Before long your libido is likely to have
returned, but both you and your partner have to bear in mind that even now
having an abortion is a huge event in anyone's life. It is possible, but by
no means inevitable, that the changes this will have wrought in the way you
feel about a future together may have irretrievably undermined your
relationship. If this happens, neither of you should assume blame or feel
guilty.
Years of experience with patients have reinforced the teaching I received in
my early medical life that even the most ardent affair may not survive an
abortion, although both partners often remain good friends. Frequently,
there has been too much emotion around, even if there have been no spoken
recriminations. The shadow of the decision to have the termination, and any
doubts one or other may have had about this deep down in their psyche, means
that sooner or later they will be tempted to start again with, as if it
were, a clean slate.
You don't tell us how old you are, how long you have been with your partner,
or how many weeks pregnant you were when the abortion was performed. All
these factors are highly relevant. As you were pregnant, so far as your
hormonal balance is concerned, an abortion is physiologically just one of
the ways it may end. Although it is said that hormonal changes after a
pregnancy are only a relatively minor factor in the cause of any
psychological consequences following delivery or termination, they obviously
have some bearing on how the woman feels afterwards, and the timing of the
resumption of sexual desire and its intensity.
However, far more important considerations than hormonal changes determine how
soon a woman is likely to feel sexy again. This depends on the amount of the
psychological readjustment that has been necessary before she is again able
to think of her genitalia as a source of potential pleasure - rather than
the focus of interest for a detached medical team.
About 15 years ago, a large American survey of the psychological effects on a
woman of having an abortion was revealing. It showed that although nearly
all the women studied felt grief and feelings of guilt, in 90 per cent of
cases, the acute feelings of doubt, remorse, anxiety and depression passed
within a month.
When the psychological symptoms persisted for longer, the research workers
found that usually the underlying cause of the continuing grief was that
unavoidable pressure to have a termination, placed on the woman by her
family or her partner. My own opinion is that the American research workers
were unduly sanguine in expecting women to jettison guilt and overcome their
feelings of loss - the grief response - within just a month.
However, if your troubles continue, you should see your GP, discuss your
symptoms with him or her, and together decide whether you would benefit from
consulting a counsellor, or need a specific treatment for depression.
Post-puerperal depression or other psychiatric states can be induced by an
abortion, just as they can be by a spontaneous miscarriage or delivery at
term.
Dr Thomas Stuttaford, The Times doctor, spent many years working in a
genito-urinary clinic
SUZI GODSON
A Having “the right to choose” does not guarantee that the choice made
will be the right one, or that a woman will not later regret a course of
action that seemed the only sensible option at the time. Women are
programmed physically and mentally to respond to the experience of
pregnancy; abortion forces them to chose between logic and instinct, so the
decision is never easy. Afterwards, some feel so relieved that they never
give the procedure a second thought. Others, like you, feel terribly guilty
and find it hard to move on.
Women who have abortions are often reluctant to talk about the experience.
They don't want to be judged and they don't want to admit to negative
psychological consequences for fear of playing into the hands of
anti-abortion activists. Recently, the anti-abortion movement has begun
promoting the concept of post-abortion stress syndrome, a pseudo-scientific
condition that encompasses a range of emotional problems, including sexual
dysfunction.
The “pro-choice” movement sees this as a cynical attempt to exploit female
vulnerability. However, several studies, including research published in The
Journal of Child Psychology and Psychiatry, conclude that abortion in young
women might be associated with mental health problems. The Royal College of
Psychiatrists recommends updating abortion information leaflets to include
the risks of depression.
Though it's been available for 40 years, abortion remains hugely contentious.
In the 1970s arguments about abortion were simple and polarised: abortion
was either “murder” or “a woman's right to control her body”. But times have
changed. Today, technological advances have given the “foetus” a human face.
Three-dimensional ultrasounds of perfectly formed 16-week-old babies,
sucking their thumbs, make it difficult to remain emotionally detached. The
threshhold for viability also keeps shifting. In 1990, the Human
Fertilisation and Embryology Act reduced the cut-off for abortion from 28 to
24 weeks; and better neonatal medicine has decreased the age at which a baby
is viable by several more weeks. Data from the EPICure Study suggests that
20 per cent of infants born alive at 24 weeks go home to a relatively normal
life. If that figure continues to improve, it will become impossible to
justify such late abortions.
The irony, of course, is that the “choice” to have an abortion is one that no
woman wants to make. Though yours was a mutual decision, abortion often
unsettles relationships. Couples can feel subconscious hostility towards
each other, and withdrawing from sex is an obvious way of manifesting
conflict. You and your boyfriend need to unravel those feelings together.
Relate might help (www.relate.org.uk), and you would almost certainly
benefit from post-abortion counselling. Three sessions at the British
Pregnancy Advisory Service (www.bpas.org; 08457 304030) cost £65.
You also need to investigate a more reliable form of contraception. An implant
would eliminate the possibility of user failure, and help to restore your
sexual confidence. Erasing the trauma of your recent experience may take a
little longer. Be kind to yourself, and your partner, and be grateful that
you live in a country where abortion is both safe and legal.
Suzi Godson is author of The Sex Book (Cassell, £16.99) and The Body Bible
(Penguin, £16.99)
Interesting difference between Kate and Malcolm's comments.
Malcolm's cohabiting friends' relationships didn't survive an abortion. Kate's marriage did. I know two couples where the same is true.
Whatever you think about abortion, does this say something about marriage vs cohabiting?
Lizzie, London,
My husband and I are very happy, and expecting a new baby this summer. We chose to have an abortion several years ago. It was the right decision, though very sad, and our relationship has thrived since. We are not alone in this in our friendship group, either.
Kate, London, UK
Some friends of mine looked into this. They found that in every single case of cohabiting couples they investigated the cohabitation didn't survive for more than a few weeks after the abortion, even when the reason for the abortion was to protect the relationship.
Malcolm McLean, Bradford, UK
No wonder the native British population is in decline in every way (and not just in numbers).
Chris, Michigan, USA
oh my dear god, i never knew there is so much mentally pain for women when they choose the option of abortion. no wonder my mom had done it once before she pregnant me, she had totally forgot the whole abortion thing and after years until my father mentioned it again undesignedly
cty, zhejiang, china