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Men and Abortion
Address given in Santiago, Chile at the International Congress on Post-Abortion Support

Dr. Martha Shuping

 For decades, abortion has been viewed primarily as a women’s issue, so the focus of research has been primarily on the effects of abortion on women, with fewer studies considering the effects of abortion on men. 
 
But research shows that in 95% of abortions, men are involved in the abortion decision (1). So it is important to understand the ways in which men are being affected by abortion. Current research confirms that men are impacted by abortion, and that abortion also affects the relationships of couples.
 
In the book Changed, a man named Brad tells of his experience with abortion (2).
 
Brad’s girlfriend told him, “I’m going to get an abortion. I know how you feel about abortion, but I don’t care. I’m having one no matter what you say or do.”

Brad says, “I realized in an instant I was powerless. I didn’t argue with her…I stayed calm and tried to support her decision.” Secretly, he hoped he could change her mind through his compassion and through prayer, but she had the abortion. Now, years later, he says, “I often think back and wonder if there was something I could have done to help her…It took me a long time to come to terms with what happened. When I see little children, sometimes tears spring up in my eyes as I envision Trevor--my son who never got a chance.”
      
Examples of similar experiences are reported in the book Men and Abortion, by Dr. Catherine Coyle (3). In one example, Bill says that after going to the doctor with his pregnant girlfriend, they talked with a priest.  Bill says, “I will never forget his words, ‘It’s her decision—you have nothing to say about it—she has to live with that decision, not you.’” 
 
The relationship ended about one month after the abortion. Now, years later, Bill says, “I wish every day of my life that it would not have happened.”
 
Both Brad and Bill and many others describe experiences of being helpless and powerless, an experience that is rooted in societal expectations that this is a woman’s decision, an expectation so strongly enforced in modern society that even a priest could tell Bill, “you have nothing to say about it.”
 
Not surprisingly, several studies document experiences of helplessness and powerlessness among males after abortion, along with various other emotions (4, 5, 6, 7).
 
Dr. Coyle, in Men and Abortion, cites research indicating that only 11% of men opposed the abortion decision (8), but points out that due to the large numbers of abortions that take place, that 11% represents millions of men. And she reports that these men experienced intense suffering because of the abortion.  She says, “The men I have interviewed, who were opposed to their partners’ decision to abort, were truly devastated. They found themselves absolutely powerless to protect their unborn children…Each of these men lost a relationship with a woman he loved, a child he desperately wanted to protect, and the hopes and dreams he held for the future.” (9)
 
Just as Brad described suppressing his own feelings about the abortion and trying to support his partner, Gordon and Kilpatrick reported that men at an abortion clinic “did not express their feelings to their partners and instead felt the need to be a source of support by maintaining a strong front” (10). Shostak and McLouth also reported on men repressing their own emotions as they attempted to provide emotional support for their partners (11). In another study, 77% of men believed they could help their partner by controlling their own emotions (12.).   
 
Dr. Coyle reported that men she interviewed “were confused about the role they were expected to play.” These men believed they should support whatever decision the woman made and they attempted to do so. (13) But Dr. Coyle points out that “by repressing their emotions” men may “prevent others from appreciating their suffering” (14).
 
Because men often process pregnancy loss internally, not discussing their feelings, they may have greater difficulty in recovering from this loss (15).  
 
Dr. Arthur Shostak, Professor Emeritus at Drexel University, has spoken publicly and has written extensively about his own personal abortion experience in the early 1970’s. His own experience prompted him to conduct research regarding men and abortion. 
 
Regarding his own experience (16), he says that his former girlfriend had phoned him about a month after they had ended their relationship. She told him that she intended to have an abortion, a decision he fully supported. At the same time, she insisted that Shostak promise that he would never, ever tell anyone about the abortion. He agreed, but he now believes this promise was a mistake. He also reports interviewing men about their abortions and seeing them cry with relief when telling him about the abortion—the first time they ever told anyone about the abortion. Although I have not seen data on this point, it may be that the woman’s request for complete privacy concerning the abortion has been a factor in the silence of men.
 
As we said earlier, some research indicates that 11% of male partners opposed the abortion, but the majority did not oppose the abortion. In my own experience, a very high percentage of abortions occur because of pressure from the man or because the man withholds emotional support in regard to continuing the pregnancy. So, the finding that only 11% of men oppose the abortion is realistic, in my experience. But whether the man opposed or supported the abortion, studies show that many men experience significant distress that is often very long lasting.
 
One study of abortion during adolescence showed that abortion was associated with psychological distress in adult life (17). In this study men whose partners had abortions had higher scores for psychological distress compared to men who became fathers.  In regard to men who became fathers, the results were the same whether they married the mother of their child or whether they were single fathers. In either case, the men whose partners chose abortion had greater psychological distress compared to men who became fathers during adolescence. The sample size for this study was 2,522 males, 15.4% of whom had experience adolescent pregnancy. 
 
A range of emotions has been repeatedly observed in multiple studies, including grief (18, 19, 20, 21, 22), guilt (23, 24, 25, 26, 27, 28) depression (29, 30) anxiety (31, 32, 33, 34), regret, (35, 36) and anger (37, 38).  There are published reports of intense anger in men who disagree with the decision to abort (39, 40), and a 2010 study that included 198 men showed that lack of agreement on the abortion decision predicted abortion-related anger in men (41). Dr. Coyle discusses that anger may be associated with the helplessness of not being able to protect one’s child (42).
 
There is published literature showing that some men may experience abortion as trauma and some men meet diagnostic criteria for posttraumatic stress disorder  
 
In order to develop posttraumatic stress disorder, the pre-condition for development is first of all to experience a situation in which you come very close to death yourself, or you experience the death of another person in a situation in which you experience intense fear or helplessness (43). Experiencing the death of your child in a situation in which you are helpless to prevent it can meet the pre-condition for development of this disorder.
 
In one study of 1,000 men who accompanied their partners to the abortion clinic, one in four of the men considered the abortion to be participation in the death of their child (44). In another study (45), 21.3% of men who stayed with partners during the abortion believed it was a traumatizing experience.   
 
And we have already discussed the experience of helplessness that has been described in the published literature.
 
Following the initial experience of trauma, the diagnosis of posttraumatic stress disorder requires symptoms of three types (46). One type of symptom is “reexperiencing” or “intrusion” in which you may have recurrent, intrusive, distressing thoughts that remind you of the trauma, or you may have bad dreams or flashbacks of the trauma.
 
Dr. Coyle tells the story Ted, whose partner had two abortions (47). Both times, he offered to support his partner and the baby, but abortion was chosen by the partner. He experienced profound helplessness. Because of persistent, negative thoughts about the abortion, he lost his job. Then he went to school but had to drop out; he could not concentrate due to the thoughts about the abortion.  
 
In one study by Shostak, 44% reported dreams or thoughts about the “infant they might have fathered” (48). In another study by Shostak 1,000 men were interviewed at the clinic the day of the abortion, and another 75 were interviewed at a much later time after the abortion (49). Forty-seven percent of the men at the clinic and 63% of the men interviewed later said that men involved in abortion have disturbing thoughts about it afterwards.
 
Other types of symptoms required for the diagnosis of posttraumatic stress disorder include avoidance symptoms, such as avoidance of people or places that remind you of the trauma, and also hyperarousal symptoms such as anger, irritability, sleep disturbance, or concentration problems (50).  
 
As we saw in the example of Ted, some post-abortive men may have significant concentration problems, and anger and irritability have been identified by some authors. In addition, a single case study reported by Holmes reported sleep disturbance in a man six months after the abortion (51).
 
More recently, a 2010 study (52) examined 374 women and 198 men for specific symptoms of posttraumatic stress disorder. In this study, 54.9% of the women and 43.4% of the men met DSM-IV diagnostic criteria for posttraumatic stress disorder. 
 
For the men, lack of agreement between man and woman in regard to the abortion decision was predictive of intrusion symptoms, hyperarousal symptoms, meeting diagnostic criteria for posttraumatic stress disorder, and relationships. Additionally, for men, a perception of inadequate counseling predicted avoidance symptoms, intrusion symptoms and relationship problems.
 
This study controlled for numerous variables including prior mental health, and also for physical and sexual abuse in childhood and adulthood.
 
The study participants were self-selected, not randomly selected. The authors suggest that “this highly traumatized sample may represent those who drop out of other studies. In some studies, a very high dropout rate has led to the conclusion that those who do not participate in follow up may be the most stressed by the abortion. But in this study, because of the anonymity of the internet-based protocol, it may have been facilitated participation by those who were more severely affected by the abortion.
 
This study was not designed to prove that some specific percentage of men develop posttraumatic stress disorder after abortion. But it does demonstrate that some men do experience trauma related symptoms, and in clinical work with individual men, it may be necessary to evaluate for possible posttraumatic stress disorder in men who have been involved in an abortion depending on the types of symptoms they report.
 
In addition to the problems that men experience as an individual, recent research has shown that men and women experience relationship problems after abortion (53).
 
In regard to the sexual relationship, studies indicate that there are sexual problems in both men and women after abortion and there are more problems in post-abortive couples than in the general population (54). More of the published studies examine women’s sexuality after abortion, without considering the men; studies of post-abortive women show loss of sexual desire, decreased enjoyment, and decreased frequency of sexual relations (55, 56, 57, 58, 59, 60, 61). Even one year after the abortion, 5 – 20% of the women are still having problems (62). Clearly, if women are having sexual problems including decreased frequency of sexual relations, this certainly impacts their husbands and would potentially cause problems in the marriage relationship. More limited research indicates that some men have problems of their own after abortion (63).   
 
In an interview with ZENIT International News Agency in 2007 (64), Kevin Burke of Rachel’s Vineyard Ministries said, “Tragically, a person will abort with the hope of salvaging their relationship, but the toxic after effects of abortion are like a radioactive seed planted in the heart of the relationship that will, at varying speeds, kill the relationship.”
 
This statement is confirmed by several published studies (65, 66, 67, 68, 69) that show an increased risk for separation or divorce following an abortion.
 
Because of this serious risk to the marriage, it is essential that both men and women have access to treatment for abortion related problems, individually and as a couple.
 
An important feature of the Rachel’s Vineyard weekend retreat program is that men are included. Single men who are no longer in a relationship with the mother of their child are welcome to participate on their own. Married men may come alone, for example when a man has been involved in an abortion with a previous partner. But frequently married men participate together with their wife, and this is frequently the best. In my own experience, I have had some men on most retreats that I have conducted, and the men have always experienced the retreat as helpful. Their presence with their wife has helped to heal the marriage, and the participation of men has been experienced as very helpful to the other women on the retreat. Although men may be more reluctant to disclose their feelings, they have the freedom to choose whether they wish to listen or to speak. They are free to choose their level of participation, and they do find the retreat exercises helpful.
 
In addition, the retreat concludes with a Memorial Service for the children who are now in the care of the Lord. Even if the man does not attend the entire weekend, his wife can include him in the Memorial Service if they both desire this, so that he also is provided with an opportunity to grieve this loss. By including men in the Memorial Service, Rachel’s Vineyard provides an opportunity for the marriage to begin to heal, and the man can attend an entire weekend later if desired.
 
In conclusion, I encourage you in all efforts to provide opportunities for healing for men and women. We have talked about many problems after abortion, but through Rachel’s Vineyard weekends, I have seen lives transformed. I hope you will have the opportunity to see this transformation through abortion recovery programs in your own country.

 
REFERENCES:
 
1.  Zimmerman M.K., Passage through Abortion (New York: Praeger, 1977).
 
2.  Fredenburg M. Changed: Making Sense of Your Own or a Loved One’s Abortion Experience, 82-85. (San Diego: Perspectives, 2008).
 
3.  Coyle C.T. Men and Abortion (Lewiston: Life Cycle Books, 1999).
 
4.  Myburgh M., Gmeiner A., van Wyk S. The experience of biological fathers of their partners' termination of pregnancy. Health SA Gesondheid 2001; 6(1): 28-37.
 
5.  Poggenpoel M., Myburgh C.P.H. The developmental implications of a termination of pregnancy on adolescents with reference to the girl and her partner. Education 2002; 122 (4): 731-741.
 
6.  Gordon R.A., Kilpatrick C. A program for group counseling for men who accompany women seeking legal abortions. Community Mental Health Journal 1977; 13 (4): 291-295.  
 
7.  Coyle C.T.  Men and abortion: a review of empirical reports concerning the impact of abortion on men. Internet Journal of Mental Health 2007: 4(2). URL:
http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijmh/vol3n2/abortion.xml
 
8.  Shostak A., McLouth G. Men & Abortion: Lessons, Losses and Love (New York: Praeger, 1984).
 
9.  Coyle C.T. Men and Abortion (Lewiston: Life Cycle Books, 1999), 27-28.    
 
10.  Gordon R.A., Kilpatrick C., op. cit.
 
11.  Shostak A., McLouth G., op. cit.
 
12.  Patterson J.  Whose freedom of choice? Sometimes it takes two to untangle. The Progressive 1982; 46 (1): 41-45. 
 
13.  Coyle C.T. Men and Abortion (Lewiston: Life Cycle Books, 1999), 93.
 
14.  Coyle C.T. Men and abortion: a review of empirical reports concerning the impact of abortion on men. Internet Journal of Mental Health 2007: 4(2).
URL: http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijmh/vol3n2/abortion.xml
 
15.  Wagner T. Perinatal death: how fathers grieve. Journal of Perinatal Education 1992; 6:1058-1243.
 
16.  Shostak A. No, I am not a “rock”: on abortion and waiting room men. 
URL: http://menandabortion.com/art_personal.html
 
17.  Buchanan M., Robbins C. Early adult psychological consequences for males of adolescent pregnancy and its resolution Journal of Youth and Adolescence 1990; 19 (4), 413-424.   
 
18.  Kero A., Lalos A. Ambivalence - a logical response to legal abortion: a prospective study among women and men. J Psychosom Obstet Gynaecol 2000; 21(2): 81-91.
 
19.  Robson F.M. "Yes!-A chance to tell my side of the story': a case study of a male partner of a woman undergoing termination of pregnancy for foetal abnormality. J Health Psychol 2002; 7(2): 183-193.
20.  Speckhard A., Rue V. Complicated mourning: Dynamics of impacted post abortion grief. J Prenatal Perinatal Psychol Health 1993; 8(1): 5-32.
21.  Coyle C.T., Enright R.D. Forgiveness intervention with postabortion men. J Consult Clin Psychol 1997; 65(6): 1042-1046.
22.  Poggenpoel M., Myburgh C.P.H., op. cit.  
 
23.  Coyle C.T. An online pilot study to investigate the effects of abortion on men. The Association of Interdisciplinary Research in Values and Social Change 2006; 19(1).
 
24.  Speckhard A., Rue V. Complicated mourning: Dynamics of impacted post abortion grief. J Prenatal Perinatal Psychol Health 1993; 8(1): 5-32.
 
25  Poggenpoel M., Myburgh C.P.H., op. cit.                                
                                               
26.  White-van Mourik M.C., Cooper J.M., Ferguson-Smith M.A. The psychological sequelae of a second-trimester termination of pregnancy for fetal abnormality. Prenat Diagn 1992; 12(3): 189-204.  
 
27  Gordon R.A, Kilpatrick C., op. cit.
 
28. Rothstein A. Male experience of elective abortion: psychoanalytic perspectives. In N. L. Stotland, editor. Psychiatric aspects of abortion Washington, D.C.: American Psychiatric Association; 1991. p. 145-158.
29. Blumberg B.D., Golbus M.S., Hanson K.H. The psychological sequelae of abortion performed for a genetic indication. Am J Obstet Gynecol 1975; 122(7): 799-808.
30. White-van Mourik M.C., Cooper J.M., Ferguson-Smith M.A. The psychological sequelae of a second-trimester termination of pregnancy for fetal abnormality. Prenat Diagn 1992; 12(3): 189-204.
 
31.  Coyle CT, Enright RD. Forgiveness intervention with postabortion men. J Consult Clin Psychol 1997; 65(6): 1042-1046.
               
32.  Coyle C.T. An online pilot study to investigate the effects of abortion on men. The Association of Interdisciplinary Research in Values and Social Change 2006; 19(1).
 
33.  Gordon R.A., Kilpatrick C., op. cit.
 
34.  Rothstein A., op. cit.
 
35.  Coleman P.K., Nelson E.S. The quality of abortion decisions and college students' reports of post-abortion emotional sequelae and abortion attitudes. J Soc Clin Psychol 1998; 17(4): 425-442.
 
36.  Gordon R.A., Kilpatrick C., op. cit.
 
37.  Coyle CT. Men and Abortion (Lewiston: Life Cycle Books, 1999), 93.
 
38.  Coyle CT, Enright RD. Forgiveness intervention with postabortion men. J Consult Clin Psychol 1997; 65(6): 1042-1046.
 
39.  Naziri D. Man’s involvement in the experience of abortion and the dynamics of the couple’s relationship: A clinical study. European Journal of Contraception and Reproductive Health Care 2007; 12: 168-174.
 
40.  Reich J.A., Brindis C.D.  Conceiving risk and responsibility: a qualitative examination of men’s experiences of unintended pregnancy and abortion. International Journal of Men’s Health 2006; 5: 133-152.
 
41.  Coyle C.T., Coleman P.K., Rue V.M. Inadequate Preabortion Counseling and Decision Conflict as Predictors of Subsequent Relationship Difficulties and Psychological Stress in Men and Women.
 
42.  Coyle CT. Men and Abortion (Lewiston: Life Cycle Books, 1999), 93.
 
42.  Shostak A, McLouth G. Men & Abortion: Lessons, Losses and Love (New York: Praeger, 1984).
 
43   American Psychiatric Association. Diagnostic and statistical manual of mental disorders. (Revised 4th ed.). (Washington, DC: American Psychiatric Association, 2000).
 
44.  Shostak A., McLouth G. Men & Abortion: Lessons, Losses and Love (New York: Praeger, 1984).
 
45.  Lauzon P, Roger-Achim D, Achim A, Boyer R. Emotional distress among couples involved in first-trimester induced abortions. Can Fam Physician, 2000; (46): 2033-2040.
 
46.  American Psychiatric Association. Diagnostic and statistical manual of mental disorders. (Revised 4th ed.). (Washington, DC: American Psychiatric Association, 2000).
 
47.  Coyle C.T. Men and Abortion (Lewiston: Life Cycle Books, 1999), 87-88.
  
48.  Shostak A. Men and abortion: three neglected ethical aspects. Humanity Soc 1983; 7(1): 66-85.
 
49.  Shostak A, McLouth G. Men & Abortion: Lessons, Losses and Love (New York: Praeger, 1984).
 
50.  American Psychiatric Association. Diagnostic and statistical manual of mental disorders. (Revised 4th ed.). (Washington, DC: American Psychiatric Association, 2000).
 
51.  Holmes M.C. Reconsidering a "woman's issue:" psychotherapy and one man's postabortion experiences. Am J Psychother 2004; 58(1): 103-115.
 
52.  Coyle C.T., Coleman P.K., Rue V.M. Inadequate Preabortion Counseling and Decision Conflict as Predictors of Subsequent Relationship Difficulties and Psychological Stress in Men and Women.
 
53.  Coleman. K., Rue V., Spence M. Intrapersonal Processes and Post-Abortion Relationship Challenges: A Review and Consolidation of Relevant Literature. The Internet Journal of Mental Health 2007; 4 (2). 
 
54.  Ibid.
55.  Rue V.M., Coleman P.K., Rue J.J., Reardon D.C. Induced abortion and traumatic stress: a preliminary comparison of American and Russian women. Med Sci Monit 2004;10: SR5-S16.
56.  Miller W.B. An empirical study of the psychological antecedents and consequences of induced abortion. J Soc Issues 1992; 48:67-93.
57.  Tornboen M, Ingelhammar E, Lilja H, Moller A, Svanberg B. Evaluation of stated motives for legal abortion. J Psychosom Obstet Gynaecol 1994;15:27-33.
58.  Fok WY, Siu SSN, Lau TK. Sexual dysfunction after a first trimester induced abortion in a Chinese population. Eur J Obstet Gynecol 2006; 126:255-258.
59.  Bianchi-Demicelli F, Perrin E, Ludicke F, Bianchi PG, Chatton D, Campana A. Termination of pregnancy and women's sexuality. Gynecol Obstet Invest 2002; 53:48-53.
60.  Boesen H.C., Rorbye C., Norgaard M., Nilas L. Sexual behavior during the first eight weeks after legal termination of pregnancy. Acta Obstet Gynecol Scand 2004; 83:1189-1192.
 
61. Bradshaw Z., Slade P. The effects of induced abortion on emotional experiences and relationships: A critical review of the literature. Clin Psychol Rev 2003; 23:929-958.
 
62.  Ibid.
63.  Lauzon P., Roger-Achim D., Achim A., Boyer R., op. cit.
64.  ZENIT International News Agency, Men and the Abortion Aftermath, Interview With Kevin Burke of Rachel’s Vineyard, King of Prussia, Pennsylvania, 29 August, 2007. URL:  
http://www.ewtn.com/library/FATHERS/zmenabort.HTM .
65.  Freeman E. Emotional distress patterns among women having first or repeat abortions. Obstet Gynecol 1980; 55:630-636.
66.  Barnett W., Freudenberg N., Wille R. Partnership after induced abortion: a prospective controlled study. Arch Sex Behav 1992; 2:443-455.
67.  Bracken M.B., Kasi S. First and repeat abortions: a study of decision-making and delay. J Biosoc Sci 1975; 7:473-491.
68.  Lauzon P., Roger-Achim D., Achim A., Boyer R. Emotional distress among couples involved in first trimester abortions. Can Fam Physician 2000; 46:2033-2040.
69.  Rue V.M., Coleman P.K., Rue J.J., Reardon D.C. Induced abortion and traumatic stress: a preliminary comparison of American and Russian women. Med Sci Monit 2004;10: SR5-S16.

 

 

 

 

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