The angst of abortion

Many people, especially those who oppose termination of pregnancy, think that those who choose abortion have a nonchalant, couldn't care less attitude in their decision-making. I have not found this to be true. In my three-plus decades of performing procedures, it is the extremely rare patient who requests a termination without much forethought and with total indifference. Yes, there are such patients, but they are the exceptions rather than the rule. Other rare individuals use abortion as a form of birth control and show up pregnant repeatedly, much to my chagrin and the befuddlement of the staff. We view these as failures on our part, for follow-up birth control is a large part of what we do.

For almost all others, terminating a pregnancy is an agonizing, gut-wrenching decision. Virtually every patient is aware of the pregnancy growing inside her, and as early as six weeks, many patients have begun to develop strong emotional bonds to their future child -- fantasizing about it, wondering what it will look like, guessing about its sex, etc. For the most part (except, for example, in cases of rape or nonconsensual sex) such thoughts are normal and even healthy. But, and this is a big but, they complicate what might have been an easy decision to abort. Guilt and shame often come into the picture, and they immediately complicate the decision. This is further compounded by the patient's religion, upbringing, and sense of morality. The decision goes from what might have been a snap to a tear-filled, often ambivalent mind-set.

This is a common picture. And it is these patients who require the utmost in emotional support, hand-holding, and reassurance. In my facility, we never try to force a patient in one direction or another; and it is not unusual, after counseling and discussion, that a patient opts to continue her pregnancy. If she chooses, we will happily refer her for prenatal care. It is our job to answer questions and offer advice and support, not to suggest a decision.

Bottom line: What to do with an unwanted pregnancy is an intensely personal matter, and it is rarely a decision that is made lightly.