Wednesday, June 08, 2005

Where's the "need" for abortion?

Among the prochoice it's a given: there is a real "need" for abortion, as measured by the reality of women seeking abortions. But is the request for abortion proof that abortion is necessary, or does it demonstrate some other principle?

It's long been documented that ambivalence is normal in early pregnancy:
"Surprise or shock is often the initial reaction to the validation of pregnancy. Caplan (1959) indicated that initial rejection of pregnancy is common, but that it is generally followed by acceptance at the end of the first trimester." (Lederman, Psychosocial Adaptation in Pregnancy, 1984)

"Those who plead for an extensive relaxation of the law [against abortion] have no idea of the very many cases where a woman who, during the first three months, makes a most impassioned appeal for her pregnancy to be 'finished,' later, when the baby is born, is thankful indeed that it was not killed while still an embryo. During my long years in practice I have had many a letter of the deepest gratitude for refusing to accede to an early appeal." (A. Bourne, A Doctor's Creed: The Memoirs of a Gynecologist, 1963)

"[Members of the 1955 Planned Parenthood conference on abortion] agreed, and this was backed up by evidence from the Scandinavians, that when a woman seeking an abortion is given the chance of talking over her problem with a properly trained and oriented person, she will in the process very often resolve many of her qualms and will spontaneously decide to see the pregnancy through, particularly if she is assured that supportive help will continue to be available to her." (Calderone, "Illegal Abortion as a Public Health Problem," American Journal of Public Health, July 1960)

"M.J. Daly has noted that the legitimately pregnant woman, and often those illegitimately pregnant too, are ambivalent to the pregnancy. This ambivalence is so universal that it may be considered normal in the first trimester. ("The Unwanted Pregnancy," Clinical Obstetrics and Gynecology, 1970." Cited in Gardner, Abortion: The Personal Dilemma, 1972)

"Ambivalence is another emotional response observed in many pregnant women. .... Surprise or shock may be the initial reaction, followed by very mixed feelings. .... Rubin believes that few women who become pregnant feel ready 'now.' .... Initial rejection of the pregnancy is common, Caplan states, but it is usually replaced by acceptance by the end of the first trimester." (Nichols and Humenick, Childbirth Education: Practice, Research, and Theory, 1988)

To summarize: It's normal during the first trimester to be ambivalent, or even to reject the pregnancy. The fact that the woman rejects the pregnancy during the first trimester does not mean that she will continue to reject the pregnancy, or that she will reject the baby once it is born. It simply means that she is normal.

To "treat" this ambivalence with abortion is as irresponsible as to "treat" the bleeding of menstruation with a hysterectomy. Normal, self-limiting phenomena do not need to be "treated." The conscientious doctor will instead provide support to help the patient understand and deal with her symptoms.

No comments: