When a woman makes a decision to have an abortion, it is undoubtedly one of the most stressful periods of her life. Often she is young. Often she is under pressure to make the decision quickly. Typically, friends and family have a highly emotional reaction to her pregnancy. Sometimes, due to her circumstances, she chooses to bear the decision alone.

Frequently she lacks information about pregnancy options, or accurate information about the physical, emotional and spiritual realities following an abortion. These factors can combine to produce profound and confusing grief about the abortion, sometimes years afterward.

Confusing nature of grief

The confusing nature of the grief arises from the circumstances surrounding the abortion procedure. Because society and medical professionals sanction abortion, an abortion is portrayed as a safe and uncomplicated procedure. Women are unprepared, then, for an emotional response. The intensity of the grief is correlated with the degree to which a woman bonded with the baby, was torn about the decision, or had to keep the abortion secret, thereby increasing the shame.

Many women immediately try to get on with their regular lives, keeping uncomfortable feelings at bay until the feelings finally erupt, sometimes years later. These feelings are often triggered by current circumstances that bring them right back to the unfinished business – the post-abortion trauma.

Trying to cope

Whenever we cannot process a loss in our lives, we cope by trying to diminish the significance of the loss, in order to move on. Post-abortive women who have an inkling of their loss but are unaware how to process it, cope in a variety of ways. Their interpretation of what abortion is can change through time. Then, when they begin to consciously recognize the losses abortion brings, they begin to feel feelings long buried. Surprised and without any safe place to process the feelings, methods are invented to keep the feelings at bay.

Symptoms of post-abortion syndrome

Post-abortion syndrome is a collection of symptoms some women experience after an abortion due to a thwarted, or delayed, ability to grieve. Since many post-abortive women use repression as a coping mechanism, grief is typically delayed; meanwhile, the unacknowledged feelings of distress surface in other areas of life.

Women may complain of sleep disturbances, vaginal and abdominal pain, stress responses out of proportion to an event, a sense of hypervigilance in general, anxiety attacks, anger outbursts, cynicism, depression or negativity. They may have flashbacks of the abortion, disturbing dreams about babies or intrusive obsessive thoughts regarding abortions or babies. Throughout the years, they may have repetitive symptoms of distress on the anniversary date of the abortion or the projected due date of the pregnancy.

Avoiding and withdrawing

Women unknowingly tend to avoid what they assume may be associated with the onset of their distress. They can increasingly avoid friends who are pregnant, baby showers or young children, or conversely, may become pre-occupied with becoming pregnant, with taking up children’s causes, or working with young children as a way to compensate.

Women may withdraw from relationships as a way to avoid feeling and a way to avoid pregnancy, or act out their shame by becoming promiscuous. They may become involved in alcohol and drug abuse and avoid happiness or positive experience as a way to punish themselves. They may refuse any relationship with God, believing He wouldn’t want anything to do with them, or that they don’t deserve to have anything to do with Him. Some women develop a deep distrust of and anger toward men and therefore experience chronic relationship problems after an abortion. Some consider and attempt suicide.

The stages of grief

Sometimes these crisis symptoms eventually prompt a woman to get help. For the woman who is ready to deal with her past abortion, who interprets it as a child-bearing loss, healing comes through the work of grieving. This is the process of accomplishing specific tasks through stages of grief. In post-abortion grief healing, women identify the ways they have been in denial of their pain, where their anger is directed, and the ways they have engaged in bargaining in order to control heartache. They also examine how depression has manifest itself in their lives, how they have acted out their shame and guilt, and how they would like to experience and express acceptance of their baby and honour the life lost.


To continue denying the significance of her abortion and her pain, a woman may employ many avoidance strategies and may become unable to sustain any level of interpersonal emotional closeness. Over time, her denial requires more and more emotional energy to keep awareness and feelings below the level of consciousness. Eventually some form of crisis presents, where she can no longer keep the lid on her feelings.


A woman begins to break through her denial when she begins to define exactly what was aborted, the relationship she had to that life, and her hopes and dreams for it. Because the numbness provided by the denial is wearing off, anger is often projected onto anyone involved in the abortion event. Her partner, parents, friends, family and the medical professionals may all become targets as she begins to deal with the loss. Anger at herself also begins to be identified, and the pain of that may nudge her to direct it onto God (for not stopping her) and/or onto the baby, for actually being conceived.  


When the numbness has gone, when the feelings are exposed and anger feels out of control, bargaining is commonly employed to manage the pain and guilt. The woman may try to restore her loss by conceiving another child. She may try to be super-mom to any children she has, or have unrealistic expectations of her relationships with any children in her friends’ lives. She may join the pro-life movement, or conversely, allow herself only a meagre existence and very little happiness as a way to atone. When a woman realizes that bargaining in any form does not work, depression sets in.


As a woman begins to identify her losses, talking about her abortion is a way to help solve the depression. In counselling, as she begins to work through the repressed and denied feelings, the sadness begins to lift and she feels less "stuck."

Guilt and shame

One snare that keeps post-abortive women stuck in depression is the logic that says, "because I did a bad thing, I am bad." Women at this point have no hope without the forgiveness of God in Christ. Until they receive forgiveness from God, they hold on to their guilt and shame and try to punish themselves and atone for their choice. When they receive God’s forgiveness, they can begin the process of forgiving themselves.


The stage of acceptance is characterized by honesty, freedom and hope. Post-abortive women have come to the place of acknowledging that abortion ended the life of their child. They have processed and are no longer engulfed in their guilt and grief feelings, and may eagerly anticipate being reunited with their lost child in heaven. They are free to move on and live without secrets, giving and receiving relationally, and refusing to let their past define their future.

© 2010 Focus on the Family (Canada) Association. All rights reserved.

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