Abortion as a Traumatic Experience

Theresa Burke
with David C. Reardon
Forbidden Grief: Chapter 8
Reproduced with Permission

Eleven months after her marriage, Lora thought her American dream had come true. She had a handsome husband, a home of her own, and now she was pregnant! She carefully planned how to tell her husband, John, the good news. She bought a tiny baby's bib, waited for a private moment together, and gently laid it upon his chest, offering him the gift of her child.

Instead of rejoicing, John cursed at her. He insisted they weren't ready. They couldn't afford a baby. She would have to have an abortion.

Lora was stunned. She had been raised in a traditional Catholic home. She had always believed that a child was the greatest gift a woman could give her husband. She didn't realize that her young husband, who had been abandoned by his mother and father as a child and raised by relatives, had his own unresolved fears about becoming a father. In many way he was immature and narcissistic. Many elements of their relationship suggested that he wanted Lora to fill the role of both a wife and the mother he never had. Perhaps the idea that a child, even his own child, might compete with him for her maternal affections was intolerable. In any case, no matter how much Lora pleaded with him, he would not relent. Abortion was the only option.

When Lora insisted that she would have the baby anyway, John threatened to leave her. For Lora, this was a grave threat. Divorce was unthinkable. She had been raised to believe that a couple must be willing to make any sacrifice to keep their marriage afloat. She turned to a friend, seeking support for her desire to keep her baby. But her friend encouraged the idea of abortion, telling Lora she had "had a couple of abortions and it wasn't that bad." Lacking support from any quarter, and torn between her love for her child and her duty to her husband, Lora gave in.

On June 15th, when she would otherwise have been busy planning to celebrate their first wedding anniversary three days later, Lora had an abortion. Immediately afterwards, she felt as if her life was over. Emotionally she felt as if she was falling apart. She no longer found pleasure in any of the activities she had previously enjoyed. She experienced her first major depression. She became sexually frigid. She began stealing supplies and cash from her employer.

Lora and John~s relationship was poisoned by the abortion. She resented him. He felt rebuked by every sign of her sadness, anger, and depression. They became verbally and physically abusive with each other. He taunted her with a string of extramarital affairs.

During the next three years, they were separated twice. But there was a bond between them that neither wanted to break. After making mutual promises to reform their behavior, they moved into an apartment together.

Finally, Lora hoped, they could have the "replacement" baby she so desired. But then, as had happened several times before, John invited one of his buddies to come live with them. Lora saw the writing on the wall. Once again she would be burdened with another long-term house guest with whom her husband would spend his nights partying. It was as if he were afraid to let their own relationship become too close. Having a party buddy in the house was his way of keeping her at a safe emotional distance. Lora threw down the gauntlet. If John's friend Robbie moved in, she would move out.

As the deadline approached, Lora began complaining to friends and neighbors that John had been raping and abusing her, but she refused all their offers of shelter. Still hoping to conceive her replacement pregnancy, Lora continued to have consensual intercourse with John. She wouldn't leave him yet.

The timing for this conflict could not have been worse. John's friend, Robbie, was due to arrive on Father's Day, just two days after their fourth wedding anniversary and five days after the third anniversary of her abortion. Lora spent her wedding anniversary at her doctor's office with all the symptoms of a classic post-abortion anniversary reaction. Her hands were shaking and she was hyperventilating. She had cramping in her abdomen, feelings of anxiety, and difficulty concentrating.

Two days later, Robbie arrived. Lora moved many of her belongings out of the apartment but continued to sleep with John and declined another girlfriend's offer of shelter. On the third night after Robbie moved in, John came to bed at three in the morning after being out drinking with his friend. Shortly after that, Lora found herself in the kitchen experiencing flashbacks to her abortion. All the loss and anger she felt about the abortion and her chaotic relationship with John came to a head. She picked up a knife, walked into the bedroom and cut off her husband's penis. Before he or Robbie could react, she fled the house with it, pausing only long enough to grab up Robbie's portable Game Boy.

By this point, you almost certainly will have realized that Lora's real name is Lorena. She and her husband, John Wayne Bobbitt, were at the center of one of the world's most spectacular trials of the late twentieth century.

As you may recall, Lorena Bobbitt was acquitted of the crime of malicious wounding on the grounds that she suffered from temporary insanity arising from post-traumatic stress disorder (PTSD). The psychiatrists who offered expert testimony for both the defense and the prosecution agreed that Lorena had PTSD and was experiencing major depression at the time of the cutting incident. There was even substantial testimony in the trial regarding the coerced abortion, Lorena's subsequent psychological problems, and her flashbacks to the abortion prior to the cutting. But this connection was never fully explored in the trial, much less in the media coverage of the case. As a result, few people in the general public understand the underlying cause of Lorena's mental breakdown.

But post-abortion specialists, and many women who have suffered from abortion-related PTSD, immediately suspected a connection to a traumatic abortion as soon as the first stories about the attack were released. (These suspicions were later confirmed by subsequent reports.1) Indeed, Jane, one of my own post-abortion clients, came into my office shortly after this incident proclaiming, "Someone finally did it . . . I wish I had the nerve!"

Jane's comment reflected the experience of many women who have had their own fertility stolen from them by men who coerced them into unwanted abortions. It is not unusual for women to describe themselves as feeling "castrated" by an abortion. This experience was first reported by psychiatrist Theodor Reik in 1953.2 In less severe cases, a woman may feel that her partner's support for abortion is a rejection of her sexuality.3

I have frequently seen this dynamic present in my own counseling practice. For example, Megan had become excessively preoccupied with thoughts of the man who had impregnated her. She experienced detailed fantasies and dreams of revenge, castration, and events that would heap misfortune and chaos upon his life. She wanted him to hurt in the same way she had been hurt. Her intense anger and fixation on him was a way to avoid her grief. It served as a means by which she desperately kept her relationship with her aborted child alive. Rage became a tool she used to survive endless moments of intolerable pain.

Megan did not act on her fantasy. But it takes no great leap of the imagination to see how a woman like Lorena Bobbitt, who felt sexually mutilated by her abortion, at least on a subconscious level, would in a moment of bitter passion focus her attack on an attempt to castrate her husband in return.

I am not suggesting that Lorena consciously made a decision to sexually mutilate her husband that night. But the known facts of the case, and the powerful symbols involved in the attack, lead directly to the conclusion that Lorena's abortion shaped not only the form of the attack (on John's sexuality) but also the timing of it (on approximately the third anniversary of the abortion.)

The fact that Lorena ran off with the penis still in her hand clearly supports the argument that she was not acting rationally that night. Her deranged behavior is further evident in the fact that she also grabbed up a child's toy when fleeing the house. On a rational level, the theft of a Game Boy after mutilating her husband is extremely odd. But highly symbolic acts are often disturbing. Indeed, the irrationality of this act underscores its symbolic importance.

One possible explanation is that she stole the video game as a means of punishing John (and his intrusive friend) for his preoccupation with toys and adolescent escapades. John's cherished toys and partying friend reflected his inability to assume the responsibilities of fatherhood and a mature marital relationship. He had deprived her of their child in order to protect his adolescent lifestyle from the responsibilities of fatherhood. Now, she was depriving him of his immature games and his sexual license.

Alternatively, as Lorena was fleeing the house and their doomed relationship, she may also have been reflexively grabbing up symbols of her aborted, wanted child whom she did not want to leave behind. In one hand she clutched a phallic symbol, the source of her aborted child's life. In the other hand she held a Game Boy, which even by its very name symbolized the missing little boy she so desperately wanted to take with her. On that night, perhaps, Lorena was not just running from the scene of horrible domestic violence; she was reclaiming and fleeing with her symbolic replacement child. But it was only that, symbolic.

John Wayne Bobbitt's reproductive organ was stitched back into place. As subsequent headlines revealed, John's sexual function and adolescent lifestyle were renewed. But there is no miraculous surgery to repair Lorena's loss.

In choosing to begin this chapter with the Bobbitts' story, I've taken a calculated risk. Though it was a highly publicized, dramatic story, most people did not recognize that Lorena's abortion was the underlying cause of her post-traumatic stress disorder (PTSD), which preceded her violent act. On the other hand, the Bobbitt case is also an extreme example. Most women who suffer from PTSD following abortion do not "snap" and become violent. Still, the Bobbitt story, along with many of the other women's stories recorded in this book, does illustrate that PTSD following abortion can result in bizarre behaviors. As we will see in the next few chapters, these irrational behaviors can only be understood in the context of reenacting the trauma of a past abortion.


In the previous two chapters we discussed how defense mechanisms are used to avoid unwanted thoughts, memories, emotions, or truths. These defense mechanisms are waging a battle against all those forces -- one's unconscious mind, daily experiences, or the admonitions of one's friends or family -- that seek to draw the conscious mind to face these unpleasant thoughts, memories, emotions, or truths.

Post-traumatic stress disorder is simply a special variation of this common mental conflict. Not everyone who uses defense mechanisms suffers from PTSD. Not everyone who has an abortion suffers from PTSD. Nor does everyone who has been exposed to a traumatic experience necessarily suffer from PTSD.

Fundamentally, PTSD is not a tangible thing, like a virus or a brain tumor. It is simply a label therapists use to describe a specific grouping of psychological symptoms. By classifying and grouping these symptoms, therapists are better able to communicate with each other about the types of emotional problems they are treating and about the types of treatment that are most effective. Knowing that symptom B is often found when symptom A is present also helps therapists explore underlying issues that a patient or client might not initially volunteer.

The American Psychiatric Association's definition of PTSD represents some of the most modern theory on the nature and effects of trauma. As described in Appendix A, however, the study of trauma has historically been marked by controversy and political maneuvering. Trauma victims and their advocates have been dismissed as exaggerators by those who either support social structures that perpetuate the causes of trauma or are simply embarrassed to confront the causes of trauma. This same pattern of denial continues to be played out with regard to abortion trauma. (See Appendix A for more on the controversy regarding abortion-related PTSD and chapters 2 and 3 regarding other examples of social and professional denial.)

As it is currently defined, PTSD can be described as a psychological disorder that results from a traumatic experience that overwhelms a person's normal defense mechanisms. The shock of this experience is so great that the person's defense mechanisms become disorganized and disconnected from reality, either temporarily or for a prolonged and indefinite period of time.

More precisely, the formal definition of PTSD involves two major elements and three types of symptoms. The first element, a traumatic event, can be any event in which one either witnesses or experiences "actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others." If a person has "experienced, witnessed, or been confronted with" such a traumatic event and "the person's response involved intense fear, helplessness, or horror," he or she is considered eligible for a diagnosis of PTSD.4

Following this initial evaluation of circumstances, a clinical diagnosis of PTSD requires identification of symptoms in all three of the following broad categories: hyperarousal, intrusion, and constriction.

Hyperarousal is a characteristic of inappropriately and chronically aroused "fight or flight" defense mechanisms. In some way, the person is almost always on the alert for threats of danger. Symptoms of hyperarousal include exaggerated startle responses, anxiety attacks, difficulty falling or staying asleep, irritability, outbursts of anger or rage, aggressive behavior, difficulty concentrating, hyper-vigilance, or physiological reactions upon exposure to situations that symbolize or resemble an aspect of the traumatic experience. Connectors, such as those described in chapter seven, may often trigger symptoms of hyperarousal. For instance, when a post-abortive woman experiences anxiety, an elevated pulse, or sweating during a routine pelvic exam, this is an example of hyperarousal.

Intrusion is the reexperience or reliving of the traumatic event in one of many ways. In the case of abortion-related PTSD, intrusion can include recurrent and intrusive thoughts about the abortion or the aborted child, flashbacks in which the woman momentarily reexperiences an aspect of the abortion experience, nightmares about the abortion or child, or anniversary reactions of intense grief or depression on the due date of the aborted pregnancy or the anniversary date of the abortion. Repeat abortions and replacement pregnancies are two common ways in which women reenact elements of their abortion trauma. In many cases, some aspect of the trauma is recreated in disguised or symbolic ways. Risk-taking behavior, suicidal impulses, and obsessive-compulsive behaviors may arise from unconscious reenactment of elements related to the unresolved trauma.

Constriction is the numbing of one's emotions or the development of behavior patterns designed to avoid any sights, sounds, smells, or feelings associated with the trauma. It is often marked by feeling helpless or powerless to control or direct one's life. It involves an attempt to deny and avoid negative feelings and/or people, places, or things that aggravate the feelings associated with the trauma. In post-abortion trauma cases, constriction may include: an inability to recall the abortion experience or important parts of it; efforts to avoid activities or situations that may arouse recollections of the abortion; withdrawal from relationships, especially estrangement from those involved in the abortion decision; avoidance of children; efforts to avoid or deny thoughts or feelings about the abortion; a restricted range of loving or tender feelings; a sense of a foreshortened future (e.g., does not expect a career, marriage, or children, or a long life); diminished interest in previously enjoyed activities; drug or alcohol abuse; suicidal thoughts or acts; and other self-destructive tendencies.

It is common in cases of PTSD for the symptoms of hyperarousal, marked by high levels of emotion, to alternate with periods of pronounced constriction, the numbing of one's emotions. This alternating between states reflects a form of the approach-avoidance conflict discussed in chapter six. Through constriction one seeks to avoid thoughts and memories related to the trauma. By means of intrusion, the subconscious draws attention to some aspect of the traumatic experience, resulting in a period of hyperarousal. As a woman (or man) who suffers from PTSD oscillates through this approach-avoidance cycle, she may observe that she is constantly alternating between feeling emotionally numb and feeling emotionally overtaxed. It is very likely that the emotionally overtaxing periods will be triggered by thoughts or events that symbolically force her to relive aspects of the traumatic event.5

The three categories of PTSD symptoms are themselves symbolic of different aspects of the traumatic experience: "Hyperarousal reflects the persistent expectation of danger; intrusion reflects the indelible imprint of the traumatic moment; constriction reflects the numbing response of surrender."6

Victims of PTSD typically experience an initial state of numbness while psychologically trying to integrate the traumatic experience. Later symptoms, which may not appear for months or even years, include irritability, depression, an unreasoned sense of guilt for having survived while others did not, memory impairment or trouble concentrating, and difficulties relating emotionally to other people. Nightmares, flashbacks to the traumatic scene, and overreaction to noises or situations that remind one of the trauma are also common.7


As Molly lay on the abortion clinic operating table, she fought a grave fear that something bad would happen to her. In part, this was due to the natural nervousness she felt at undergoing her first surgery of any kind. But she also feared that God would punish her for having an abortion, and this punishment might come in the form of an immediate injury or long-term reproductive damage.

My abortion was a horrifying experience. I remember Iying back on the table . . . unable to lay my head back because I wanted to see what was happening. My legs were shaking and I kept trying to close them together. The doctor appeared irritated and told me that he could not work if I did not keep my legs spread apart. I was terrified that something would go wrong. What if the doctor's instrument slipped? What if he cut my uterus and I ended up in the hospital? What if I could never have children? I tried to do as instructed, but I was terrified. I could not control my tears, shaking, and crying. For a few moments during the procedure, I wished for death. What if I died during the operation? I had fantasies about them taking my body out of the clinic to the morgue and my mother having to come identify me.

When it was all over, I felt a horrible guilt. I was certain that God would punish me for what I had done. I felt I did not deserve to have a baby because I had killed one. I was tormented by this fear for years, along with a disturbing fear that when and if I had kids, they would be retarded, handicapped, or would die from some terrible disease.

In Molly's case, the intense fear she felt at the time of the abortion was focused on the idea that she might die or be seriously injured herself. Later that anxiety was focused into fears of appalling things happening to any children she might have in the future. In Katrina's case, on the other hand, the same event -- abortion -- produced an emotional reaction focused on her horror at seeing her aborted child.

My doctor promised me that the procedure would be safe and private right in her office. The sooner it was done, the better, since the baby had no shape at this point . . . just a bunch of growing tissue. I wanted to believe that, in spite of knowing better myself. I posed no questions and neither did my fiance. The date was set for a Saturday.

That morning we drove there together in silence. I was taken in and prepared for the surgery. The doctor came in, but it wasn't my regular doctor. It was a man I'd never seen before. He was not introduced but went right to work. It hurt terribly; he was very rough and spoke harshly to me when I cried. The nurse held my hand and told me to just relax. The machine went off and I thought the procedure was over. They went over to the sink and were doing something. Then they came back and on went the machine again. It seemed to go on forever. Finally it was over.

They left the room, telling me to get dressed. In my curiosity, I went over to the sink to see what they were looking at. There were all the reassembled parts of my baby: arms, legs, torso and what must have been the head. They were tiny and perfect. In that instant I felt an incredible horror. This was my baby! Torn apart, in bloody pieces. The terror and agony of that moment is etched deeply into my soul. My doctor, the abortionist, the staff -- all liars! Surely they could see what I could see. I hated them. But at the same time, I knew I was part of that lie because I knew I could never tell anyone. I left the office in a state of numb repulsion. I began to despise myself even more than them.

In many cases, especially when the woman feels she has no choice but to abort because of pressure from others or her circumstances, her overriding emotional response at the time may be a sense of helplessness. She feels unable to alter the course of events that are driving her inexorably toward an unwanted abortion. A particularly dramatic case is Jennifer, who had been incestuously raped by her father.

The doctor informed me that I was pregnant and asked me what I wanted. I had seen the "Silent Scream" in high school religion class and knew that abortion was murder. In spite of the pain and guilt I felt, knowing who the father of the baby was, it was far better to have a baby than the alternative -- to kill it. I refused to have an abortion.

My father flew into an uncontrollable rage and demanded that I consent to the abortion, or that the doctor do it with or without my permission. The doctor refused because of my wishes. My father demanded that an abortionist be found -- regardless of the cost.

Within one hour, this man arrived at the hospital, talked with my parents and decided to do the abortion, without speaking to me. I refused and tried to get off the examining table. He then asked three nurses to hold me while he strapped me to the bed and injected me with a muscle relaxant to keep me from struggling while he prepared to kill my baby. I continued to scream that I didn't want an abortion. He told me, "Shut up and quit that yelling!" Eventually, I was placed under general anesthesia and my child was brutally killed....

I grieve every day for my daughter. I have struggled to forget the abuse and the abortion. I can do neither. All I think of is, "I should have done more, fought more, struggled more for the life of my child.'8

Frequently, women report that shortly after their abortion began, they suddenly changed their minds and told the abortionist to stop. In many cases, the doctor told them it was too late to stop and continued despite their protests. Such experiences can reinforce a woman's sense of helplessness during an abortion. This can contribute, as in the case of Alexa, to subsequent survivor guilt.

I had convinced myself that having an abortion would be for the best. I was in a no-win situation and I had to take this route. In the waiting room, I was shaking but confident. I wouldn't allow any negative thoughts to enter my head.

When they called my name, I got up. As I went with them, I began trembling even harder. I knew I was going to have to be strong. I got up on the table as directed, and a feeling of disbelief came over me. Was I really doing this? When the doctor came in, I asked him some questions. I don't even remember what I asked, just that he ignored me and the nurse answered me, sort of covering for him. I began to feel that I didn't want to be there. I told them I wanted to leave, but again, I was ignored. A fear rose in my chest. I was truly frightened . . . what was I doing there? I grabbed the nurse's hand and held tightly as the procedure began. There was no way out. I was there and I didn't want to be. I wanted to leave but couldn't. My life was being sucked out of me. I was helpless. I began to beg them to let me leave. The nurse just held my hand more securely. Then the fear in me surged and I tried to throw myself off the table. I had to get out of that place. They held me down. I couldn't go, I couldn't breathe, I felt I was being suffocated. I screamed and they held me with reinforcements. I thought I was dying. Nothing mattered but to get off the table. I was becoming weaker, and then I don't remember anything. I don't know what happened . . . they just finished with me. When I woke up, I cried. I feel like I've been crying ever since.

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