BY THE early 1970’s we had seen a profound social change in Australian society. The sexual revolution had promulgated sexual liberation, unrestricted sexual activity and an increase in unplanned pregnancies, and sexually transmitted diseases. Campaigns for abortion on demand followed and the catch cry of the day was that abortion was a woman’s choice and right – it was the answer to an unplanned or crisis pregnancy.
However, there were many caring, concerned people in the community who realised that the women and girls faced with an unplanned pregnancy needed support, help, information and counselling to work through their problem so that they could make a decision knowing the implications of such a decision. There were pregnancy support agencies such as the Caroline Chisholm Society which had been in existence for years before the 70’s, but now the need was becoming greater and more urgent.
Pro-life supporters, who were deeply concerned about the lives of the unborn babies and the physical and mental health of the mothers, felt there was a need to be more than anti-abortion – there must be an organisation which provided support, help, care and counselling for the women or girl who is faced with an unplanned pregnancy.
In September, 1972, a pregnancy help centre called “Birthline” was formed in Adelaide. Brisbane opened their Pregnancy Help Centre in 1973, Newcastle in 1974, Hobart and Canberra in 1975. In the next few years more centres opened in cities and towns throughout the length and breadth of Australia – Cairns to Hobart, Perth to Darwin.
In 1979, the Directors of Birthline in Adelaide decided to organise a conference so that all the pregnancy help centres throughout Australia could meet together. At the instigation of Rev Dr Daniel Overduin and Mr (now Father) David Cappo, a letter was sent in January 1979 to all pro-life pregnancy support agencies in Australia, which read in part:
It is with great pleasure that I inform you of the 1979 First Australasian Conference of Pro-Life Pregnancy Service Centres to be held at Aquinas College, North Adelaide on June 1-3, 1979. The objects of the Conference as endorsed by Birthline’s Committee of Management are as follows:
(i) To create a venue for all Pro-Life Pregnancy Support Service Centres in Australia and New Zealand, to come together and share their common concern for mothers and their unborn children.
(ii) To share with others the value, tasks, variety of service and specified problems of the Pro-Life Pregnancy Support Services.
(iii) To provide to service personnel, the opportunity for learning and growth in vision, commitment and skills.
(iv) To organise an Australian Federation of Pro-Life Pregnancy Support Services so that continued representation to the Federal Government can be pursued re. legislation and financial matters.
There was obviously a lot of interest in forming a Federation, for there were 78 people who registered for the Conference and they represented 14 pregnancy support or help centres.
At the end of the Conference, on Sunday 3 June 1979, the Federation of Pro-Life Pregnancy Support Service Centres of Australia was formed. Delegates returned home full of enthusiasm, inspiration and a warm feeling of camaraderie, confident that we were doing something worthwhile and also with new ideas on how we could improve our services. After all, we had spent three days listening to keynote speakers from the USA and Australia who were experts in the field of counselling and helping those faced with a problem because of a pregnancy.
Every second year the Federation holds a conference in a capital or large city in Australia.
Nineteen-ninety-three finds us fourteen years old, going stronger than ever, still with the same ideals but with improved counselling skills, 35 agencies, more education in the schools about pro-life philosophy and a greater understanding of problems faced by women and girls who find themselves unexpectedly or unwillingly pregnant.
The women and men who founded pregnancy support groups throughout all Australia, did their founding from a pro-life stance. Some were already members of [a] Right to Life Association, some were mothers who had had difficult and unexpected pregnancies themselves, and some because of their calling or professions, were attracted by the positive principles of such a caring agency. When these founders drafted their constitution they were precise in what they intended to do. Their objects included:
‘to offer an initial crisis contact counselling service to women distressed by unplanned pregnancy’
‘to provide a variety of support and referral services to these women and their families.’(1)
The main aim of the pregnancy support/help agencies is:
To provide the woman with the opportunity to move from her present state of emotional and mental turmoil, to a state where she is able to think rationally, so as to examine her situation and her options systematically. She then needs information on these options, to weigh each one up in the light of her priorities, values, needs and resources, not forgetting the reality of the pregnancy. To conclude, we help her decide on the next steps in the way of action or gathering more information. The whole interview should leave her feeling more confident that she can handle this situation and that she is not alone.(2)
Our counsellors are trained to be understanding, listening, non-judgmental and caring and they respect the girl’s confidentiality. They listen and establish a relationship with the client. We get calls from married women, single adult women, career women – the variety of problems is endless.
When a woman or girl calls us she either knows she is pregnant or thinks she could be pregnant. If the pregnancy is confirmed the girl/woman is usually very upset, she needs someone to listen to her problems, she needs help in verbalising her concerns and she needs a shoulder to cry on. Our counsellors are warm, understanding women who will listen to and help her work out a way of handling the problem. If the pregnancy is confirmed, the life of another person is at stake – the life of her baby.
If the pregnancy is confirmed she has three options: continuing the pregnancy and keeping her baby, continuing the pregnancy and offering the baby for adoption, or abortion.
Should she decide to continue the pregnancy and keep her baby we offer her support throughout the pregnancy and if she so desires, the counsellor can be present during the birth of her baby. We discuss with her what support she will receive from the father of the baby and her family, we tell her of the financial assistance available through the Department of Social Security. If she feels she cannot stay at home during the pregnancy, we arrange for accommodation while she awaits the birth of her baby. We invite her to keep in touch after her baby is born if she needs continuing help and support. Some centres have young mothers’ groups for mutual support.
The Federation and its affiliated agencies subscribe to the following principles:
(a) to propose and offer through counselling, education, action and creative services, alternatives to abortion, and thereby provide more positive choices for the women distressed by pregnancy;
(b) not to discriminate regarding race, creed, colour, national origin, age or marital status;
(c) to render personal and confidential services;
(d) not to be judgmental and not to use emotional, manipulative or shock tactics whether by way of speech, pictures or videos in counselling;
(e) not to advise, provide or refer, directly or indirectly for abortion or abortifacients;
(f) not to take a position with regard to political, religious or family planning issues.
In order to explain and clarify our pro-life counselling stance that we will not refer directly or indirectly for abortion, I will quote from a paper delivered by Dr Monica Allen of Brisbane at our Sydney conference in 1985.
The problem lies in the reality of counselling the abortion call. Firstly, counsellors by their very nature are loving, caring people, they really and truly want to help the distressed client regain her peace of mind and feel good inside. The last thing they want to do is hurt the client in any way. Secondly, through their clients they have been made aware of life-styles and attitudes far beyond anything they had ever read about, and yet they have been trained to accept the client exactly where she is at. Thirdly, over the years they have realised how accepting the community has become with regard to abortion and that doctors and social workers who never refer for abortion under any circumstances are no longer in the majority, in fact they are becoming scarce. Fourthly, counsellors have been trained to accept that the client, in spite of good counselling and supportive offers may opt for an abortion.
Counsellors hear some very persuasive arguments from desperate women who seek abortion as the only way out of their dilemma, and have made up their minds that all they want is to have an abortion. The counsellor may have spent up to an hour on the phone with such a woman, listening to the woman pouring out her trouble, and in that time build up a bond of caring and feeling. The counsellor does not want this woman to feel rejected and she doesn’t want the woman or the people she is going to next to think that this agency has left her floundering. I believe that this is the point of the dilemma for some counsellors – wanting to be pro-life, being concerned about the harm that will befall that woman’s unborn child, but at the same time having all the feelings of tenderness and acceptance towards this woman and her situation, wanting to help her, or at least to refer her on to someone else with the hand of friendship.
I believe that if we send an abortion-seeking client to another professional or government or non-government agency or hospital for abortion counselling, and we do not know whether or not that person at the other end is going to be 100% pro-life, then I would regard that as a soft abortion referral. I believe that if we say to a client we don’t refer for abortion, but we refer the client to the telephone book or some other neutral collection of information, then I would believe that that would be an indirect abortion referral. If we are a pro-life organisation, and we do believe that unborn life is precious, we have to be very careful along what path we steer our clients. The fact that they have already chosen that path anyhow doesn’t make our steering any the less against what we are all about. You would be in exactly the same position if you were counselling someone contemplating suicide. If that someone reached a decision that life just wasn’t worth living, you would accept that that was how that person really felt, but you would never steer them towards the means to do so.
Having set our limits, we do nevertheless genuinely care about what happens to our clients, and we don’t want them to feel rejected. As agencies we have to be prepared to put a great deal of time and effort into learning how to handle these clients in a caring way, so that they know that abortion referral either directly or indirectly is not one of our services, but that we are concerned about them and that our doors are always open to them.(3)
Lynn Fisher has also highlighted the difficulty for many counsellors in how to balance their pro-life stance with genuine care for the woman with a crisis pregnancy who seeks an abortion.
The client seems to be saying, ‘if this person cares about me as much as she makes out, why won’t she help me with the information I now want?’ There is no easy way out. At this point in time we really have to rely on our honesty to back us up. No blunt terms like ‘abortion kills’ and so on … but simply saying that on this issue our values differ. Gently talk about our pro-life stance and how the unborn child is also precious in our eyes. Honestly say that to give out such information would really be contradicting our own beliefs. Our tone of voice, our body posture and other non-verbals do much to say that we are not here to condemn their actions, only by showing our concern and our support until the end will the client be assured that we will still be there when she needs us, and that our door will always be open to her.(4)
In our society, abortion continues to be presented as the most sensible, responsible, affordable and socially acceptable ‘solution’ to the problem of unplanned pregnancies. Based on current figures it is estimated that 45% of Australian women will have an abortion at some time of their lives. In other countries, notably China and Russia, the percentage is much higher – over 90%. In the United States alone, there have been 20 million legal abortions since 1973 so the number of women and men who are affected by this experience is staggering.
Those in favour of abortion claim that the decision to terminate an unplanned pregnancy is not a major life crisis and that women in this situation simply require reassurance of their decision and perhaps some help with “the arrangements”. While recognising that some women may feel a sense of loss or sadness, they claim that the overwhelming reaction is one of relief, with no-long term negative effects. They insist that the few who do suffer guilt and depression do so largely because of conditioning by society; they are said to be the victims of parental or religious indoctrination. Alternatively, it is suggested that those women who react negatively to an abortion are emotionally flawed or damaged by past traumas so would probably have had difficulty coping even if they had kept the baby, perhaps by developing post-natal depression. Numerous studies are quoted supporting the claim that abortion causes no ill-effects in women who make this decision freely and that more distress is experienced by women who are forced to continue with a pregnancy that they do not want.
However, the reality which we encounter every day in our work in pro-life pregnancy support centres suggests that abortion can have devastating effects on the physical, emotional, psychological and spiritual lives of those involved. Pregnancy Help in Brisbane recently altered their intake sheets to take account of how many clients have previously experienced a pregnancy loss through abortion or miscarriage because it is becoming so common and they are recognising its significance in the health and well-being of their clients.
In the past, post-abortion counselling was seen as best left to the more experienced counsellors or to the social workers. It was felt that this type of counselling was beyond the scope of most telephone counsellors and that we didn’t want to do any “damage” by saying or doing the wrong thing. Unfortunately, the growing need for post-abortion counselling means that all pregnancy support centres must become competent in this area. Counsellors already have the experience and the skills from working in pregnancy support centres to assist women with post-abortion grief. These include the listening and interpersonal skills of crisis counselling, a commitment to be self-aware with regard to their own feelings about abortion so that they can offer genuine acceptance and empathy, and a belief that an abortion actually involves the loss of a child.
Because we are committed to providing ongoing support for our clients irrespective of the decision they make regarding pregnancy, by offering post-abortion counselling we are affirming that we are truly accepting the client’s ability to make her own decision.
Addressing post-abortion trauma is one of the greatest keys to the prevention of unplanned pregnancy and the prevention of further abortions. It is not the medical complications that will convince people against abortion, but the emotional, psychological and spiritual effects. On an individual level, a woman who has had one abortion is more likely to have another one if she becomes pregnant again, if she did not have counselling or address the real issues that perhaps led to the first unplanned pregnancy. An American study found that 30% of teenagers who have an abortion become pregnant again within two years. A doctor who runs an abortion clinic has been widely quoted in the media deploring the number of women who come back again and again for abortions – obviously stuck in the same self-destructive behaviour pattern.
Only pro-life people are going to be tuned into the needs of a woman who is overcome by grief following an abortion. If family and friends as well as health professionals deny the ill-effects of abortion and suggest that there is nothing to worry about or grieve about, then a “conspiracy of silence” isolates women and denies the reality of their feelings.
Who also may need post abortion counselling? Most commonly, women who have had abortions or who were planning on abortion when they miscarried; their male partner, the father of the child, who has no legal right to intervene even if the couple are married; men who discover that their partner had an abortion in a previous relationship; the parents, siblings, grandparents or other relatives or friends of a woman who has had an abortion; the surviving or future children of a woman who has had an abortion; health workers, nurses, doctors, counsellors.
Partners are often the most influential figures in the decision to have an abortion by what they say and what they do not say. The role they played, the support they offered and the pressure they applied may need to be explored. Perhaps they were never even told of the pregnancy.
Others who may be involved in the abortion process can be other children who it was felt could be disadvantaged if the family had to cope with the financial and emotional drain of another baby; also relatives – parents, siblings, grandparents, aunts and uncles, cousins who may or may not have known about the pregnancy but their anticipated reaction was judged to be a significant pressure towards abortion; friends who gave advice or reacted negatively to the pregnancy; doctors, counsellors, nurses or other staff at the abortion clinic; and society as a whole because of the myths that abound denying the negative effects of abortion.
When do people seek post-abortion counselling? It may be immediately after the abortion – some women wake up after the operation screaming. They may even identify whilst seeing you for pre-abortion counselling that an abortion will be devastating and yet they still go ahead with this decision. In some ways women who face the reality of the trauma and loss straight away are more fortunate because it is those who repress their feelings of grief and pain who are more likely to develop the serious emotional, psychological and physical malfunctions we now identify as Post-Abortion Syndrome.
Talking about the journey they have taken to reach this point is very important: where was she when she discovered she was pregnant, who she told, how they reacted, where she went, how she felt, where she went next, how she was treated, where the abortion was performed, where she went afterwards and how she came to be contacting us. By remembering the journey – the places, the people, the pressures, the reasons for her decision to terminate the pregnancy, she has the opportunity to reconnect with her feelings about it.
Women who are experiencing negative feelings about an abortion are unlikely to seek further contact with anyone who was involved with the abortion and hence these organisations report that they have few requests for post-abortion counselling.
A person who comes for post-abortion counselling exhibits such symptoms as guilt, depression, grief, anxiety, sadness, shame, helplessness, hopelessness, lowered self-esteem, distrust, hostility towards self and others, regret, insomnia, recurring dreams, nightmares, anger, psychophysiological symptoms, suicidal ideation and attempts, alcohol and/or other dependencies, sexual dysfunction, insecurity, emotional numbness, flashbacks of the abortion, relationship disruption, communication impairment and/or restriction, isolation, foetal fantasies, self condemnation, uncontrollable weeping, eating disorders, preoccupation with the abortion, and confused and/or distorted thinking.
A person experiencing post-abortion trauma needs someone who is willing to listen to her story – to let her tell all the gory details; to let her get it out of herself and share it with someone who is not going to condemn or judge her. She needs to feel safe in talking about feelings that have been buried and denied, sometimes for years. She needs to face her pain, not to be protected from it. She needs to be able to grieve, to mourn for the child she has lost and the potential within herself which she has denied. And she needs to eventually be able to let go and move on with her life.
A counsellor can help a person experiencing post-abortion trauma by listening, accepting her unconditionally, encouraging her to tell her story as fully as possible, acknowledging reasons for the decision and pressures that existed. Focus on and acknowledge feelings, take time, acknowledge the loss, give her permission to grieve, personify the loss – make it real to her – name the baby, visualise it. Gently confront about responsibility for decision. Challenge them to own the decision and accept that it was not the right decision for them, look at their feelings towards others who were involved. Ask for forgiveness (of God, baby, community, other people and self). Create a ritual to say goodbye. Look to the future.
A client who seeks post-abortion counselling may also need to look at other issues connected with why they become pregnant in the first place or why they chose abortion. Perhaps they are in a destructive or exploitative relationship, perhaps they were victims of incest or other childhood abuse, perhaps they have poor self-esteem or have no sense of direction in their life. Whatever the issue, the opportunity exists for the counsellor to assist the woman in her search for meaning, in the process of transforming the woman’s personal pain and despair into a new understanding of her own self-worth and to a rediscovery of hope for the future and a will to live.(5)
In July 1990, the Australian Institute of Family Studies provided a Research Support Grant to meet the major costs associated with conducting an exploratory survey of pregnancy and parent support services in Australia. The Australian Catholic Social Welfare Commission which had been interested for some years in studying the availability of support services in Australia for women who are pregnant, particularly those who decide to continue with an unplanned pregnancy, conducted this survey.
The ACSWC report has an excellent coverage of pregnancy support issues. Notably, the ACSWC found that Pregnancy Support Agencies see possibly more clients than the Family Planning Associations, especially if the comparison is restricted to pregnancy counselling. However, unlike FPAs, Pregnancy Support Agencies do not receive any Commonwealth Government funding.(6)
Pregnancy Support Agencies provide an extremely valuable service to the Australian community. Although not widely or publically recognised, those thousands of people who have had cause to seek help and counselling have found acceptance, comfort and support to help them face the problems accompanying a crisis pregnancy.
* Heather Sertori has been involved in the Australian Federation of Pregnancy Support Services Inc since its inception in 1979, has served two terms as president of the Federation and is currently senior vice-president of the Federation.
1. Dr Monica Allen, paper delivered at the Australian Federation of Pro-Life Pregnancy Support Services Conference, Sydney, 1985.
2. Mrs Pat Gartlan, paper delivered at the Australian Federation of Pregnancy Support Services Conference, Hobart, 1993.
3. Dr Monica Allen, paper delivered at the Australian Federation of Pro-Life Pregnancy Support Services Conference, Sydney, 1985.
4. Lynn Fisher at the Queensland State Conference of Pro-Life Pregnancy Support Services, 1984.
5. Mrs Kris Saunders, paper delivered at the Australian Federation of Pregnancy Support Services Conference, Hobart, 1993.
6. Australian Catholic Social Welfare Commission, (1991) Review of Pregnancy and Parent Support Services. Australian Catholic Social Welfare Commission, Canberra.