Substance abuse and relationship problems

ALCOHOL / DRUG ABUSE

The use of drugs and alcohol by women following an abortion is not uncommon. They are usually used as a means of ignoring or forgetting unsettled psychological issues resulting from the abortion. Some post-abortion researchers see substance abuse as part of the woman's attempt to cope with her decision to abort.

The Brende study describes this coping strategy as follows: "...victims develop repetitive symptoms with splitting and dissociation as mental defenses, often using alcohol, tranquilizers and other substances." (72)

In her Ph.D. thesis, Anne Catherine Speckhard (73) interviewed 30 post-abortive women and found that 60% developed an increased intake of alcohol while 58% reported drug use. A majority of the women believed their first heavy use of drugs or alcohol to be associated with stress induced by the abortion.

Only 10% reported any substance abuse before the abortion. The findings of this research are based on the assumption that substance abuse is a response to distress, lack of personal control or a lack of positive self-esteem.

Speckhard's findings indicate that, among women who have suffered from negative post-abortion reactions, most of those who engaged in substance abuse believed they did so in an attempt to cope with abortion related stress.

The South African Medical Journal found that 11% of the post-abortive women they interviewed developed an increase in the use of alcohol and tobacco while 16% had increased their use of tranquilizers. (74)

David C Reardon also examined the link between abortion and subsequent substance abuse. (74a) He notes that

"Women who aborted a first pregnancy were 3.9 times more likely to report substance abuse than women who carried to term."

These findings were based on a national randomised sample of 700 women participating in a reproductive history survey.

Excluded were women who had engaged in substance abuse prior to their first pregnancy. This study found that for the women surveyed who were pregnant prior to a history of substance abuse, the rate of post-pregnancy substance abuse rose from 3.8% for women who did not abort to 14.6% for women who did abort their first pregnancy.

It is also likely that the risk of post-abortion substance abuse among women who undergo multiple abortions is even higher than the risk for women who experience only a single abortion. It is also reasonable to assume that post-abortion stress may further aggravate these problems among women with a prior history of substance abuse.

SMOKING

There have been numerous studies done in relation to smoking and pregnancy in general. J Lydon (75) interviewed 57 women, some of whom had undergone an abortion and some of whom had carried to term. Lydon and colleagues found that those women continuing the pregnancy smoked fewer cigarettes, while those who had abortions reported no change or an increase in their smoking behaviour.

The Journal of the American Medical Association studied women patients of Boston Hospital and found smoking rates of 31.7% for women with no prior induced abortion, 40.3% with one prior abortion and 51.7% with two or more prior abortions. (76) Thomas and Tori found similar results in that women who aborted were more likely to have a history of substance abuse. (77)

EATING DISORDERS

There is a need for more research to be conducted on the connection between abortion and subsequent eating disorders. Abortion has, however, been linked to eating disorders such as bingeing and starvation. A report in a 2000 edition of the International Journal of Eating Disorders found that there was an elevated incidence of eating disorders among women who had had abortions which was not found among women with live births or miscarriages. (78)

RELATIONSHIP PROBLEMS

Abortion can have a major impact on the relationship a woman has with the father of the aborted baby and also with family members and other children. The incidence of marital breakdown and relationship dissolution after an abortion is between 40-75%. (79) Often, when if a young girl is forced into having an abortion by her parents, there is a similar breakdown in the parent-child relationship.

Abortion can also have a negative effect on relationships with future children. Some women report being emotionally frozen and find it difficult to bond maternally with their children. In fact, the Canadian Journal of Psychiatry (79a) reported a condition known as ‘Post-Abortion Survivors Syndrome' which can manifest itself in the future children of a post-abortion woman, negatively affecting the parent-child relationship.

In the report entitled Post-abortion Trauma, (80) Dr. Vincent Rue remarks; "Abortion never occurs within a relationship vacuum. Whether the abortion is shared or not, many significant others can be impacted." There is a general tendency to assume that the only inter-personal relations affected are those of the woman and the father of her child. Though these may seem the most likely, other relationships can be severely strained as well.

MARITAL BREAKUP

As detailed below, reports find that between 40- 50% of relationships are negatively affected by abortion. These relationship dissolutions can be attributed to several factors. Some arise from the abortion experience itself, while others arise from the reactions of the man in the relationship. Both of these factors, and indeed many others, can produce a breakdown of intimacy in the relationship and cause it to fail.

In Sherman's study, the author found that 48% of his sample reported that their relationship with their spouse had been changed dramatically following the abortion. (81)

Barnett et al (82) studied women from steady relationships who had abortions and subsequently separated. The authors found that in 80% of the relationships the separation was initiated by the woman. Also 60% reported a connection between the abortion and subsequent separation. None of these couples were married at the time of the abortion nor did any marry each other after the event.

In 1993, Teichman (83) found that there was a positive link between depression in women who had had abortions and their relationship with their partners. Interestingly, the author suggested that the nature of a woman's relationship can affect the level of depression she experiences. Women who were involved in committed relationships found it easier to cope, whereas unmarried women reported significantly higher levels of anxiety and depression.

RELATIONSHIP BETWEEN ABORTING MOTHER AND LIVING CHILDREN

In Raphael's book, The Anatomy of Bereavement, (84) the author maintains that "the pattern of grief and mourning [for induced abortion] is not dissimilar to that for spontaneous abortion, except that suppression and inhibition of grief and mourning are much more likely."

After an abortion some women find it difficult to react in a compassionate, loving way to their living children and to those who are born following the abortion. Some researchers believe that this can be the result of ongoing depression or the fact that children are a constant reminder of the aborted child.

One such case is discussed by Janet Mattinson (85) in her report The Effects of Abortion on a Marriage. In this report the author refers to a couple (who had a previous abortion) whose baby gave them great pleasure for eight months after it was born, but who returned to therapy when the wife turned against the child and had a nervous breakdown.

Similarly Brown et al studied letters from women who said they had experienced negative post-abortion reactions and in 13.3% of the cases they reported what the authors call "phobic responses to infants." (86)

References

Alcohol / Drug Abuse

72. Brende et al, "Fragmentation of the personality associated with post-abortion trauma," Newsletter of the Association for Interdisciplinary Research in Values and Social Change, July/August 1995, 8 (3):1-8, p 6
73. Speckhard A, "The Psycho-Social Aspects of Stress Following Abortion," Kansas City MO; Sheed & Ward, 1987, p 51
74. Drower et al, "Therapeutic Abortion on Psychiatric Grounds, Part I, A local study," South African Medical Journal 1978 October, 54 (15): 604-8
74a. Reardon D, "Substance abuse subsequent to abortion, American Journal of Drug & Alcohol Abuse, 26(1):61-75, p 61, February 2000
75. Lydon et al, "Pregnancy decision making as a significant life event: a commitment approach," Journal of Personality and Social Psychology, 1996, 71(1):141-51
76. Levin A, "Association of Induced Abortion with Subsequent Pregnancy Loss," Journal of the American Medical Association, 243:2495-2499, June 27, 1980
77. Thomas, Tori, "Sequelae of Abortion and relinquishment of child custody among women with major psychiatric disorders," Psychological Reports, 1999 June, 84 (3 pt 1); 773-90
78. MA Blais et al, "Pregnancy: Outcome and Impact on Sympomatology in a Cohort of Eating-Disordered Women," International Journal of Eating Disorders 27:140-149, 2000

Relationship Problems
79. De Veber Institute for Bioethics and Social Research, Toronto, Canada, "Women's Health after Abortion", p 217, 2002
79a. Ney P G, "Post-abortion Survivors Syndrome," Canadian Journal of Psychiatry, 38 (8) : 577-578, Oct 1993
80. Rue V, "Post-Abortion Trauma," Lewisville, Texas, Life Dynamics, 1994, p 28
81. Sherman et al, "Women and Loss: Psychological Perspectives," New York, Praeger, 1985:98-107
82. Barnett et al, "Partnership after induced abortion: a prospective controlled study," Archives of Sexual Behaviour, 1992 October, 21 (5):443-55
83. Teichman et al, "Emotional distress in Israeli women before and after abortion," American Journal of Orthopsychiatry, 1993 April, 63 (2):277-88
84. Raphael B, "The Anatomy of Bereavement," New York, Basic Books, 1983
85. Mattinson J, "The effects of abortion on a marriage," Ciba Foundation Symposium, 1985, 115:165-77
86. Brown et al, "Prolonged grieving after abortion; a descriptive study," Journal of Clinical Ethics, 1993, 4 (2), 118-23 p 120