By contrasting post-abortion syndrome with postnatal depression, Ellie Lee provides a fascinating and excellent interrogation of modern day abortion and motherhood within the United States and Britain. Both these countries have embraced what might be loosely called a therapeutic ethos. An increasing list of common occurrences—from bereavement and divorce to moving house and being criticised—is now liable to generate a psychiatric label such as post-traumatic stress, depression, or anxiety. Surprisingly, however, post-abortion syndrome has failed to take a place within this modern “syndrome society.”
Figure 1.
Ellie Lee
Aldine de Gruyter, $29.95/sFr48/€29.95, pp 293 ISBN 0 202 30681 X www.degruyter.com/aldine
Rating: ★★★
On both sides of the Atlantic, advocates of post-abortion syndrome have met considerable resistance from official psychiatric and psychological associations. Numerous studies are cited as failing to provide any evidence of widespread post-abortion syndrome and mental health professionals have made clear demands that transient feelings should not be confused with illness. All those concerned with women's health seem united in stating that the effects of abortion on women's minds should be set in context and not exaggerated.
This contrasts starkly with postnatal depression; for example, mental health professionals, politicians, and feminists routinely place the tragic case of the Texan mother Andrea Yates, who took the lives of her five children while experiencing extreme puerperal psychosis (BMJ 2002;324: 63411895819), on the same continuum as women suffering postnatal “baby blues.” Demands for evidence and balance have prevented the runaway diagnosis of post-abortion syndrome, limited to less than 1% of women who have aborted, whereas postnatal depression is suggested to affect at least 10% and as many as 80% of mothers.
Part of the reason for this difference is that access to abortion had to be fought for and women who currently seek abortion are consequently viewed as active subjects with regard to their pregnancy. The unusual history and politicised nature of abortion limits the influence of a culture that would otherwise view women seeking termination as being at risk of psychological damage. As long as this remains the case, it will be difficult to present women as the victims of trauma following an abortion.
No such constraints prevail for childbirth, however, and Lee notes a “discernible element in cultural, academic, and professional representations of childbirth,” perceiving the experience as “at least a psychological ordeal for women and very often a cause of mental illness.” Having children is considered traumatic and depressing; abortion is seen as benign by comparison.
In Britain, the very provision of abortion is linked directly to the psychological risks of childbirth. Currently, two doctors must state that a woman's health is threatened for abortion to be recommended and risks to mental health are used to justify over 90% of British abortions. Almost every British abortion, therefore, emphasises the mental health danger of childbirth. While it may be accepted that women seeking abortion are strong, the justification for those abortions perversely emphasises the supposed diminished ability of women to cope with childbirth.
The flipside of rejecting post-abortion syndrome is to make more and more mothers the victims of postnatal depression. Such developments should be questioned, as Lee argues, and likely condemned as being against the interests of women in particular and society in general.