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Symptoms and Frequently Asked Questions About Post Abortion Stress Syndrome

As I have researched further into women's experiences after abortion, many similar symptoms and patterns have emerged. We have discussed quite a few of these on the Women's Support Board. I have decided to list the major ones here. This is a general listing of feelings, emotions, and physical problems that women with PASS may have. This section also lists the stages of PASS.


What is PASS? Why is it a real syndrome?

There's a lot of controversy about Post Abortion Stress Syndrome. Prolife activists claim PASS is real, and affects every woman who has an abortion. Prochoice activists claim it does not exist, and is a myth made up by prolifers to help in their "fight to make abortion illegal". Prochoice activists claim that PASS is a 'scare tactic' to try and pressure women into not choosing an abortion, and to pressure congress into making abortion illegal."

So what's the 'truth'? To date, there have been conflicting "official" studies on whether PASS exists or not. I believe that PASS does exist as a real syndrome. I am neutral on the issue, yet I have experienced PASS, and I know through my own experiences and the experiences of other women that PASS is real. I feel we need to provide information and support for women before and after an abortion, and if a woman experiences PASS after an abortion, we need to reach out to her and help her through any problems she might have. Of course any woman who's experienced Post Abortion Stress Syndrome doesn't need me or anyone else to convince her it's real. We know, from what we have felt! It's real, and we are now learning by ourselves how to deal with it. When the rest of the world eventually catches up, and recognizes PASS for the serious issue it is, we'll be waiting! In the meantime this site and it's resources will help other women to feel less alone in their struggle with this problem.

Officially, here's the "Webster's Dictionary" definition of a 'syndrome':
1 : a group of signs and symptoms that occur together and characterize a particular abnormality

2 : a set of concurrent things (as emotions or actions) that usually form an identifiable pattern

That's the definition of a "Syndrome", and PASS fits that definition. Much of the mainstream world still does not acknowledge its existence. However, let's remember that abortion has only been legal and widely practiced for twenty-some years. There is no long history of how women react to legal abortion, for people to really know. As recently as fifty years ago, intelligent, educated and experienced professional mental health clinicians were teaching that schizophrenia was caused by poor parenting. Usually they blamed mothers! Today, we know that schizophrenia is caused by a brain chemical disorder, and we have also discovered that some of the other mental health problems that have been blamed on "bad parenting" are also caused by aberrant brain chemical reactions or other physiological problems. At one time, people with clinical depression were only said to have "poor coping skills"! Now today depression as well as other mental illnesses are treated successfully with medication. Note that I am NOT equating Post Abortion Stress Syndrome with these illnesses, or saying that it is caused by a brain chemical disorder. It may have some hormonal components to it, related to the interruption of pregnancy, but we don't know yet. I am just pointing out that one day researchers and doctors tell you that a certain illness is "just in people's mind's", or "Not proven", or a "myth" then later they change their tune, and say "Well, we were wrong, it is an illness, after all". Scientists are people who make judgements based on what they see and can measure, and as a result of tests conducted. If you can't test it and prove it statistically, then to scientists it is 'not real'. If they drop a glass of milk 100 times and it spills out to the left every time, then they are convinced that when you spill a glass of milk, it will "always" spill to the left. That is, until someone spills one to the right. Then all kinds of controversy breaks out, chaos rules, what they "know" to be real has been changed, and some change their mind about the way milk spills. Still others will not believe the findings of the "Right Spill" experiment. And on and on the scientists will go. Scientists at one time said that:

  • It was impossible to break the sound barrier.
  • They also said it was impossible for a man to walk on the moon.
  • They also said cloning of complex animals was impossible.
  • They laughed at the idea that mold could somehow kill bacteria - until Penicillin.
  • Louis Pasteur was told his theory of 'germs' was 'ridiculous fiction'.

Science is nothing more than people making assumptions based on the information they have at the time. When that information changes, then so does the opinion of the scientific community.
What do Scientists Like to Study?
Most scientists and researchers are men, and most of them are interested in 'cool' science, spending lots of time, money and effort on abstract things like "measuring the age of the universe". They want to study interesting, high tech, ground-breaking issues. So the issue of 'abortion', and 'how women feel afterwards' is not that type of topic. No matter what type of issue they discover surrounding abortion, either the prolife or Prochoice side will bash them publicly, in an intense media circus. They will be vilified by either side, depending on what they research and report on. Scientists don't want to deal with that, or with politics - so they avoid subjects like abortion, or abortion research. They prefer to stick to the cool, neutral, 'real science' stuff. For example, check out this daily news feed, that discusses what scientists are currently reporting and researching on. You'll find very little about abortion or birth control, but plenty about giant icebergs in Antarctica, fruit fly genetics breeding, cloning, nuclear/radioactive experiments, ect.

Hormonal Trigger?
My personal theory is that PASS within the first few months following an abortion may have a hormonal trigger as part of the reason for the woman's suffering. It's common knowledge that some women experience PMS in such a severe way that they are driven to extreme reactions, and can even be given medication for treatment of PMS. Other women don't have a single symptom of PMS at all. Some women have postpartum depression after the birth of the baby, that can become so severe she must be hospitalized, and/or treated with medication. Other women remain blissfully full of joy from delivery date onward, and don't have one minute of depression after her baby's birth. Some women become extremely sick and nauseated in the first few months of pregnancy, occasionally so severely ill that they must be hospitalized and rehydrated with IV fluids, ect. Other women "glow" in the early months of pregnancy and never even feel queasy. Some women have a severe reaction to hormonal methods of birth control, such as the Pill, Depo-Provera and Norplant. These reactions can be so severe that the women are unable to use hormonal methods of birth control. Other women use hormonal methods with no side effects. What do all these examples have in common? They are triggered by hormones, sensitivities to hormones and fluctuation in hormone levels. So I theorize that women who are sensitive to hormonal fluctuations or hormonal level changes are also very susceptible to PASS. I believe the reason why some women feel suicidal, or severely depressed, or unable to function or cope after an abortion might be hormonal. There is also the emotional aspect, if the woman felt coerced, pressured, or like she had 'no other choice' - these are also definitely contributing factors. I think the hormonal factor is also very important, and has been overlooked by researchers so far. No studies have been done to date (by my knowledge) about the possible hormonal connection with PASS.

For more details on this, and about how the medical community ignores PASS because of the politics involved, see this article PMDD real and PASS Not?? (PMDD - Pre Menstrual Dysphoric Disorder is the new medically approved name for PMS)

The Woman's "Fault"?
Women are usually afraid or embarrassed to even admit to having an abortion, let alone talk to anyone else about problems she might be having. Women are encouraged to think it is 'their fault' if they have trouble after an abortion, and that the abortion itself had nothing to do with how she feels, and that PASS is just some 'anti-choice myth'. It's interesting how if a man goes off to a war, and comes back with "PTSD" (Post Traumatic Stress Disorder), we don't 'blame the man', and 'protect' the war, we admit it was the war that caused his PTSD. We don't refuse to help the man, and belittle him or invalidate his pain by saying he had 'previous psychological problems', or other issues in his life that caused the PTSD - we admit it was the whole stress and experience of war, and we help him, support him, allow him a name for his experience and treat him. Yet when a woman has an abortion, and is traumatized by the whole experience, and develops "PASS" (Post Abortion Stress Syndrome), people are quick to 'blame the woman', and "protect abortion", and claim there's no way the abortion could have caused this, the woman must have had pre-existing problems, and it's 'her fault' she is suffering. And the woman is left alone to suffer, with no help, treatment, support or a name for her experience. The fierce war between people who have differing views on the legality of abortion has turned into a war that is hurting women, as people go out of their way to minimize women's problems after an abortion, and "blame the woman" for any trouble she is having. I am in the middle with my views, as I believe that abortion should remain legal and safe, and that every woman has the right to make her own choices concerning her body and her life. However, women and their families need to know that Post Abortion Stress Syndrome is a real problem, and can be a serious complication after an abortion.


Consider this:

Majority of doctors and researchers = Men
Post Traumatic Stress Disorder = main sufferers almost exclusively men
Men's Diagnosis for Men? = A real and serious problem for men, that needs a name, a listing in medical books, and real treatment and help.

Post Abortion Stress Syndrome = main sufferers exclusively women
Men's diagnosis for Women? = Well, just like PMS used to be thought of, these silly women just exaggerate something - it's all in their heads. No such thing as Post Abortion Stress Syndrome.
Male Doctors and Researchers say "it's not real - after all it's 'their choice', how could they be upset about it? How could a woman who chooses to go have an abortion feel upset about it afterwards? Why would women regret or have problems after a surgical/medical procedure they chose to have? This is not 'logical' to male doctors/researchers, and they don't have any 'scientific evidence' to say otherwise, so they assume PASS must be something made up by prolifers, or 'antichoicers', or the women must have had 'previous psychological problems' to be upset by an abortion." Again, let's blame the victim, let's blame the woman, and discourage any help or treatment for them. Even if the women DID have "previous psychological problems", shouldn't they be doing everything they could to help these women? Shouldn't clinics be screening for them before an abortion, and providing extra support and help for these women after an abortion? Yes, they should! But they don't. I have also found this attitude to be rampant in women who have not had abortions themselves, yet are perfectly sure about how women feel after an abortion, and list reasons why an abortion would never affect women in the manner we claim. I tell them of the multitude of women I have spoken with, who before they ever had an abortion, felt the same way. Yet after their abortion, they understood PASS completely, and were just amazed at how little press is being given to this real and serious syndrome. I have told many of these women that after they have personally experienced an abortion, they may change their mind. They assure me "They would never have any problems of any type after an abortion". It still doesn't get through to the others. They refuse to believe that a woman who chooses an abortion could have problems afterwards.

Male doctors and researchers don't understand PASS or even believe in it's existence, and I think it is difficult for them. It took years to convince them that PMS was real, and I think that only came about after there were enough women doctors to convince them! This quote from Criss provides a good explanation of why men don't understand PASS.
"Men and women experience the world in such totally different ways. Men tend to intellectualize things, and women, although we too will intellectualize things, tend to experience things in a more emotional and spiritual way. I think that this is due to the fact that women's identities and experience are very rooted in their physical bodies, whereas men's identities tend to be tied up in their accomplishments. I think that this is both natural and cultural. Women experience menstruation, hormones, ovulation, pregnancy, birth, breast feeding, menopause, etc.., etc.. Outside of career, success, providing, protecting, etc.., men do not really experience life through their bodies. Even though women have many of the same life experiences that men have, we have the added element of physical influence. I guess it is for this reason that I do not think that men can truly understand, nor have a basis for understanding PASS." I think that a woman who has not had an abortion at least has some basis to relate on some level, but then again I do not think that even they can understand PASS fully. It is a unique experience, and so far I have found that only PASS women can read a post from another PASS woman and say "YES!! I know exactly how that feels!!"

Let me tell you a little more on my opinion on 'studies and research' in general. As you probably know, the way they are conducted is that subjects get a phone call or postcard, and if they CHOOSE to respond, they can give their input and their opinion on how well they assimilated the experience. And when I was called for one such study about abortion a few years ago, I said "NO!!!" and immediately hung up the phone, because it was an upsetting topic to me. I did not want to think about it or discuss it at all. I became paranoid wondering how they had got my name to even call and ask me such a thing! Just getting that phone call gave me stomachaches for a week afterwards! I was in no way ready to deal with my feelings surrounding abortion yet. Also women who are in hospitals because of complications surrounding their abortion, or ones who have left their partner, or quit their job and moved, you won't find those women either to participate in the surveys. On the same subject, you wouldn't believe how many women (who had elective abortions not for medical reasons) tell me they lie to their doctors, their families, and their psychiatrists, simply never even mentioning they've had an abortion, or saying 'they had a miscarriage' or they 'lost the baby', or implied there was a medical problem or something else that they had no control over. The actual amount of women who tell the truth about their abortions is apparently very small. Shoot, I had five abortions, and I never told any of my doctors until after the fifth one! So you only get the responses of women who are "doing good" and "feel good with their decision". Again, I am not saying that everyone gets PASS from an abortion. There are some women who have an abortion, and for them it works exactly as it's 'supposed' to, and they never have regrets, or complications, or any other problems, and for them it was a good thing. They feel nothing but relief, and go on to have a happy, wonderful life, and never have one moment of regret, and have absolutely no complications. That's fine! I am very happy for these women. But for many more, their abortion was a coerced experience, forced by parents, forced by partners, forced by circumstances or finances, and these women usually have many more problems with PASS afterwards. We should not discriminate against women who do get PASS, just because some women DON'T get it. The real studies are not being done, the real numbers are not known. That's why I started my site, because I couldn't believe that I was the only one feeling the way I did - and all that research and the APA (American Psychiatric Association) proclamations sounded so directly contrary to what I had experienced in my own life. Once the site was up and running, I found my suspicions were correct - there were thousands of other women out there like me, suffering and silent, because they were afraid to speak up. Now with the anonymity of cyberspace, women are becoming free to talk about this issue, and find help and healing for it.

People have asked me "Why are you trying to make a disease out of something that is just normal feelings of guilt and/or grief? My answer is that PASS is NOT just normal feelings of guilt and grief, it is a group of signs and symptoms that occur together and characterize this particular illness, and there is a set of concurrent emotions or actions that usually form an identifiable pattern for these women. This meets the criteria for calling something a "Syndrome". What I ask is why are people so prejudiced against women who've had abortions, and why are they so eager to discount a problem associated with abortion? PMS only affects 3-5% of women of child-bearing age - yet it is currently recognized as a 'syndrome'. It bothers me that male doctors and researchers, women who've never had abortions themselves, and prochoice majority in general can belittle us and brush PASS off as "women making it up" or just women having "previous psychological problems". Blame the woman, protect abortion. It's the 'holy grail' of women's reproductive rights, and any attempts to discuss PASS is not being studied or investigated, because of the highly controversial nature of this illness. Most research is funded by companies that can have a dollar return on the bottom line study, and no company wants to touch the political suicide that this topic is. Women suffer in silence, afraid to talk about what they are feeling, and what is happening, and they don't tell anyone about what is going on with them, so doctors, researchers and the public at large thinks there is no such thing as PASS.

I can say Post Abortion Stress Syndrome is a 'real' illness, because of my own experiences, and from all the input I have had from other women. A regular, identifiable pattern of feelings, emotions and stages for PASS has emerged. Back to the Top

Stages

Here are the stages that I have identified for Post Abortion Stress Syndrome. They are listed in the order that I consider 'normal'. However, women can start with different stages, can skip stages, can start with one stage, progress, and then go back to another stage! There is no set 'time' that a woman spends in these stages. Some stages may last a few days, or weeks, and some may last years! There is also varying levels of 'intensity' that women will experience with these stages. While stage 3 might be mildly upsetting for one woman, another woman may become seriously suicidal in that part. As more studies are done, we will be able to refine this better. I recommend that any woman experiencing PASS, in ANY stage, should seek professional help to help her deal with this. For help on finding a counselor or depression therapy, see the Counseling Help Page

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  1. Stage 1 - denial, numbness, apathy
    This stage can start before the abortion has even taken place! Many women, after coming to the extremely difficult choice to terminate a pregnancy, may enter Stage 1. Women have reported feeling a sense of 'disassociation' with the abortion plans, things like 'calling the clinic', or making other arrangements seem to have been done 'in a fog', like it was 'someone else' doing it. One woman reported that she told herself over and over again that she was NOT having an abortion, she was just having a 'procedure' done, and thought this way the whole time. She had a difficult time on the procedure table, but once it was over, went right back to the chant in her head "I did not have an abortion, I did not have an abortion." She never told anyone in her life that she had an abortion, she lied about it to doctors on medical histories, and basically 'forced' her mind to accept the thought that she had not had an abortion. This worked for 11 years for her, until something broke her wall of denial down, and she ended up having a nervous breakdown, and needing care at an inpatient facility, to deal with the immense amount of feelings that had been 'stuffed' for so long. Denial and numbness can go on for weeks or even years. Women can be having problems in their lives, and having problems with their health, but discount their abortion as the cause. Women can experience a wide range of emotional and physical problems after abortion such as: sexual dysfunction, eating disorders, alcohol abuse, drug (prescription and street) abuse, depression, relationship problems, low self esteem.

  2. Stage 2 - beginning awareness (feeling a bit sad or uncomfortable when thinking of the abortion)
    This stage is characterized by avoidance of babies, women who are pregnant, baby related sections in stores, and avoidance of discussions of prolife/choice issues. The reason is not fully there in the woman's mind yet, but she knows that these things are bothering her, triggering her somehow, and she just stays away from them at every chance. Women can be edgy, irritable, easily startled, easily upset by triggering things and sounds (vacuum cleaners, or smells or other things that remind her of the abortion)

  3. Stage 3 - full awareness (being very upset about the abortion, but possibly still not "consciously" acknowledging the abortion as the cause of the problems)
    This stage begins with awareness of the reality of the abortion, followed by extreme sadness, depression and grief - also includes a desire to 'punish' oneself by viewing pictures of aborted fetuses, thinking of pain the fetus may have felt, obsessing over what happened, thinking of yourself as a 'murderer', punishing yourself with abuse of drugs or alcohol, not eating or eating too much. This is a very intense, very frightening stage. Women can be haunted or obsessed night and day, and can have recurring frightening nightmares. Women can sleep poorly, wakening often during the night, have trouble falling asleep, and can also be easily startled. This can also be where the 'replacement baby' symptom shows, and the woman will start attempting to become pregnant again, almost desperately so, in order to replace the 'lost' baby - thinking if she gets pregnant again, that all her pain from the abortion will go away. Clinical depression is a common part of this stage, as well as major difficulty dealing with existing children, and any relationships. "Intrusion" is also a part of this stage, which means the woman can involuntarily re-experience the abortion or events surrounding it - flashbacks to the clinic, to protestors, to the actual abortion procedure, and the hours afterwards. When they are not suffering these 'reminders', PASS sufferers are subject to another set of symptoms, described as "emotional constriction" or "numbing" - a need to avoid feelings, thoughts and situations reminiscent of the trauma, a loss of normal emotional responses or both. Their feelings can seem "unreal" to them, and the ordinary day to day business of life no longer matters. They feel cut off from the concerns of others, and are unable to trust them. It seems like the future holds nothing, and there's really no purpose for living. At the same time they may feel hidden anger towards those responsible for their abortion, and may be experiencing shame at their own helplessness to 'get over this', and feel guilty about having the abortion. They become demoralized and isolated, and withdraw themselves from activities they used to enjoy, and isolate themselves from friendships, and social situations. They may have feelings that they would like to go back and 'not have' the abortion, but the abortion cannot be 'undone' and there is anger and depression associated with that thought

  4. Stage 4 - beginning anger (towards the man or the people involved)
    In this stage, women are still suffering from the symptoms and behaviors in Stage 3, but are now becoming more aware of anger. If certain people forced or coerced her abortion, or if she perceives certain people to be responsible for her abortion, anger at these people can begin to break through her numbness, and can cause her to have problems with her temper, explosiveness at little situations, yelling frequently, even throwing things - a sensitivity that is easily triggered, especially when in conflict with the people she perceives as 'responsible' for her abortion decision. This can make her life difficult, because her episodes of anger can now isolate the people who can recognize her actions, and who can help her seek treatment. The woman herself is not always capable of realizing why she is having this problem, and so does not always seek out treatment at this stage. Anger at 'herself' can also emerge at this stage, and she can begin or worsen self-destructive behaviors. Anger can emerge at seeing pregnant women, or hearing about pregnant women. Clinical depression can emerge in this stage as well. The feeling can surface that they would like to go back and 'not have' the abortion, but the abortion cannot be 'undone' and there is anger and depression associated with that thought

  5. Stage 5 - 2 versions, anger or severe depression
    Anger
    Lots of self destructive behaviors can emerge in the anger stage. Drinking, illegal drugs, casual relationships, carelessness in activities of all sorts, disassociation emotionally from existing children and family, overeating, anorexia, bulimia and other self-harming practices like 'cutting'. The woman can seem completely out of control temper-wise, emotions-wise, actions-wise. Again the feeling can surface that they would like to go back and 'not have' the abortion, but the abortion cannot be 'undone' and there is anger and depression associated with that thought, People may look at her actions, and label her as uncaring, or selfish, or just plain 'sick', without ever realizing what is driving her to act this way. At this point, the woman is usually becoming 'tired' of whatever is pushing her underneath, but is unable to help herself stop - she still may not realize it is the abortion that is causing her to have these problems, and even if she does, she most likely doesn't know where to get help. Intrusion may also be present in this stage. Clinical depression can also emerge here. This can also be the stage where women who are 'online' will go to 'Abortion Debate' message boards, and will express extreme anger towards other people, depending on their view. For example if the woman now feels prolife, she will express inappropriate anger and hatred towards any woman or man who is prochoice. Likewise if she is prochoice, she may express inappropriate anger and hatred towards women or men who are prolife. Depression aspect
    Some women have a "depression Stage 5, where instead of feeling anger, and having self-destructive behaviors, they fall into complete and very deep depression, have difficulty getting out of bed, have difficulty performing normal daily self care, feel completely hopeless, express a wish to 'die' and 'join the baby', don't eat, or eat too much. They can see no point in the future, no hope in the future, and no reason to go on. They can't see a light at the end of the tunnel, they can't even see the tunnel! They can't function in their normal lives, and can even quit or get fired from their job, or school, and don't really care. The black cloud of despair comes down on women in reverse 5 so strongly, that nothing matters anymore. It is important that women with these symptoms seek professional help immediately, to help avoid suicidal ideations.

  6. Stage 6 - beginning resolution stage( which deal with dealing with what happened, dealing with your choices)
    At this stage, the woman has realized that she needs help resolving her feelings about the abortion, and has realized that her abortion has been causing problems for her. She now seeks out either a professional counselor, a psychiatrist or a woman's post-abortion support program. Sadness, fear, panic, and many of her PASS symptoms will still be with her, but hope may be dawning that she can finally find a way to deal with all this.

  7. Stage 7 - forgiveness stage (finding out how to forgive yourself, how to forgive the people you are angry at, naming and asking your baby for forgiveness)
    As the woman begins therapy, or begins a post-abortion support group, she begins to deal with all her feelings and issues about the abortion. She examines what happened to her, how it affected her life, and works on finding forgiveness for herself and the others involved. Anxiety may return at this stage. PASS symptoms may still be occurring. The longer she has waited from procedure date to officially seeking help, the harder recovery can be. There can be a period of wanting to 'withdraw' from all of it, and just try to go back to the way things were, and try to forget everything about the abortion. Healing, and all the things we must do and examine can be overwhelming, and retreat seems the better choice. Sometimes women do take 'escape breaks' from healing. But usually Intrusion and PASS symptoms start again, and then they will return to the emotionally difficult task of healing.

  8. Stage 8 - beginning peace (starting to feel resolved with your personal feelings and losses, getting through the majority of the grief stage)
    As woman continue with their healing efforts, a light begins to break through the clouds. She starts to actually feel better, some of the grief, guilt and depression starts to lift. She begins to feel better about herself, and her role in the abortion. She begins to feel peace with the situation. The loss of the potential baby is still painful, and upsetting, but it is not as devastating as it was before. Seeing pregnant women does not evoke the same anger and jealousy that it did before. Her anger towards others starts to lessen. She can begin to see a future, and reasons for living, and she can see a definite lessening of her PASS symptoms and triggers.

  9. Stage 9 - full peace
    At this stage, women have totally forgiven themselves, the man involved and anyone else who they felt contributed to their abortion. They feel at peace with the loss of their potential child. They are able to listen to and discuss abortion issues without emotion taking over. Their PASS symptoms are gone, or are very mild. Their response to triggers is mild. They feel at peace with themselves, at peace about the abortion in general, and are functioning normally in their lives again. In any of the 9 stages, women can have a strengthening of their views about abortion, and can become strongly prochoice, or strongly prolife. Some women switch their view about abortion, after they have one themselves. I have talked with women who were prolife before their abortion, and became prochoice after, and vice versa. It's not really important how you feel about this for healing, it's just an interesting part of the whole experience, so I am mentioning it. During the more difficult stages, women can become very vocal about their particular preference in this area. Once a woman gets to Stage 9, however, if she has strong views about abortion, she discusses them in more gentle and subtle ways.

Back to the Top

Main Symptoms

They don't all occur to every woman, and they occur at different 'times' in the post abortion period. Some women become distraught immediately, others are in a numbness period for a while, some are just vaguely uncomfortable until a friend or neighbor becomes pregnant, or until they marry 10 years in the future, and go to start their 'planned' family. So a woman who feels 'just fine' after her abortion at 17 may have a whole different view on it at 27, when she begins trying to conceive. Also the 'intenseness' of each symptom varies from woman to woman. Here are some, and they have been confirmed over and over again by visitors at the site:
  1. Fear and avoidance of doctor's & dentist's offices, any type of medical building or situation. Fear of doctor's offices in general and any invasive medical procedure - they can cause extreme anxiety, nausea, sweating, panic attacks, and other problems. Things that trigger this are: gyn exams, having blood drawn, dental or oral procedures, and tests involving hands or tubes or needles or anything put into your body. Feeling very 'protective' of your body, and not wanting anyone to touch you or come into your personal space for any reason.

  2. Feelings of sadness and crying when seeing babies or children or pregnant women

  3. Feelings of jealousy when seeing babies or children or pregnant women

  4. "Anniversary Date" problems:
    The Anniversary is usually one of three, or all three;
    1. The date the woman got pregnant
    2. The date of the abortion procedure
    3. The would be 'due date' of the baby, had the pregnancy not been interrupted.
      Anniversary Date problems can be: an unexplained lapse back into severe depression in the days before and after an Anniversary Date, illness on or around Anniversary Dates, Accidents and Injuries around Anniversary Dates, reoccurrence of any other regular PASS symptoms. Sometimes this can be unconscious - the woman doesn't think 'consciously' about an upcoming date being an "Anniversary", it's all subconscious, and just finds herself getting any of the above mentioned problems around an Anniversary Date year after year, with no other explanation for them. Even when women recover, Anniversary Dates can still be problematic.

    4. Sleep Problems:
      Having difficulty falling asleep, having difficulty staying asleep, sleep problems in general.

    5. Dreams and Nightmares, featuring:
      either a baby in danger that you can't help, or yourself in danger; common 'threateners' are people with knives, or medical people. Picturing yourself having a baby, or being with a baby or small child - various problems happen in these dreams, people try to take the baby away from you, or the baby or child is upset and won't look at you, or other people are telling you what you have to 'do' with the baby, commonly like it needs surgery that you don't want it to have, ect. These occur frequently, nightly for some women, weekly for others, monthly or only on 'anniversaries' for others. These dreams can be quite upsetting, and can contribute to the sleep problems.

    6. 'Replacement Baby' feelings:
      - the strong urge to go out and get pregnant again, preferably with the same man, but in this urge, any man will do, and 'keep' it this time. This urge is present, even when all the reasons or situations that influenced women to choose an abortion the first time are still in place. Many of the women at my site have done that, and then were surprised to find that they actually felt 'worse' about the abortion because of it! And that's because 'replacing' a baby is impossible - you still miss the one you 'lost' regardless of how many additional you have. But when that desperate urge hits, you can't realize that - it seems like if you just 'get pregnant again' and keep it, everything will be fine. The 'replacement baby' feeling can be very strong. Women can even go as far as to sneak behind their partner's back, and stop using birth control, or even get artificially inseminated, if the partner has had a vasectomy. Even if a woman does go and get immediately pregnant with a replacement baby, once the new baby is born, they have reported a return of the replacement baby urge right after birth!

    7. Intrusion or 'Flashbacks':
      "Intrusion" means the woman can involuntarily re-experience the abortion or events surrounding it - flashbacks to the clinic, to protestors, to the actual abortion procedure, and the hours afterwards.

    8. Numbing Out:
      "emotional constriction" or "numbing" - a need to avoid feelings, thoughts and situations reminiscent of the trauma, a loss of normal emotional responses or both. Their feelings can seem "unreal" to them, and the ordinary day to day business of life no longer matters. They feel cut off from the concerns of others, and are unable to trust them. It seems like the future holds nothing, and there's really no purpose for living. They numb themselves out, to protect themselves from possible future trauma. Alcohol, food and drugs can also be used as part of the 'numbing'.

    9. Anger:
      Depending on the stage, the anger may be weak and hidden, or it may be extremely intense and full blown. The anger may be towards themselves, or the people they perceive as responsible for their abortion, or both.

    10. Guilt and Shame:
      Women tend to feel guilt and shame about their abortion and they do not tell anyone about it, or talk to anyone about it, and will go to great lengths to prevent anyone from finding out about it, including lying to doctors, family and friends about having one.

    11. Isolating Themselves:
      They may be experiencing shame at their own helplessness to 'get over this', and then become demoralized and isolated, and withdraw themselves from activities they used to enjoy, and isolate themselves from friendships, and social situations. Isolating is very common, and also seems to come with depression.

    12. Sensitivity to pre-existing phobias:
      If a woman had certain phobias before, such as fear of heights, fear of thunderstorms, or fear of bugs, those fears and phobias can become more severe, with the woman being much more sensitive to these phobias than she was before.

    13. Eating disorders:
      Anorexia and compulsive overeating both have been noted by me(via website and surveys) to start after an abortion, where there was no history before. It seems that women are upset about what has transpired, and wish to 'punish' themselves subconsciously , for what they have done. Also there is a lot of stress associated with the whole idea of sex and pregnancy and abortion, and women have reported to me a need to feel 'unattractive', to avoid the possibility of a relationship, because in their traumatized state of mind, they think "Oh god, I'll get into a relationship, then my birth control will fail again, then I'll have to face another abortion, and this would just kill me", and so women find themselves either eating compulsively to swell themselves up and protect themselves from this problem, or to not eating at all.

    14. Easily startled and upset by:
      loud noises that resemble the suction machine, such as vacuum cleaners, and blenders. one woman reported to me that the first time she went to 'Starbucks" after her abortion, to get her favorite blended coffee drink, that the sound of their blender made her sick to her stomach, and shaky and sweaty, and she ran out without even getting it!

    15. Obsession with pictures of fetuses:
      I call this the 'drive-by' part - it's like slowing down to look at a car wreck - you know it's going to horrify you, but you 'have' to see. At this stage, women become obsessed with what their fetus looked like, and search out pictures of a fetus that matches the age that theirs was, and stare at it, and imagine what it felt like when it was alive, and try to imagine if it heard or felt anything. Woman have reported to me over and over again, that they feel compelled to look, to know, yet feel even worse afterwards! I have placed some links on my site to Medical Schools that have pictures like this online, so they can AVOID the prolife sites that show unnecessarily graphic pictures, as well as misrepresentations of what fetuses look like at different ages.

    16. Relationship problems:
      Having problems with relationships with your partner, lots of anger or other emotions interfering in your daily life and relationship, being unable to discuss and resolve these problems, and relationship problems with anyone else who was around or influenced your decision to have an abortion.

    17. Difficulty Making Decisions:
      Women have reported difficulty making decisions, being unwilling to make any decisions, being very upset by any changes such as moving, changing jobs. There is a panic that a 'wrong' decision might be made, and this can be a big problem. It can affect all kinds of daily small decisions, like what to have for dinner, what movie to get from the video store. A sense of panic sets in, and the woman feels frozen and paralyzed. One woman told me about breaking down with her b/f and crying in Blockbuster, because she couldn't handle even choosing a movie for the weekend.

    18. Emotional numbness with regards to current children:
      being unable to relate and bond properly with the ones that are here. Feeling like a 'bad mother', and feeling like the children would be better off without her interaction and influence.

    19. Overprotectiveness of current children:
      an almost hysterical worry about current children, constant fears that something will happen to them, as 'punishment' for having the abortion. This can lead to parents not being willing to leave the child with any babysitters, being overprotective about their physical health, and the activities they do.

    20. Fears and overprotectiveness when pregnant again:
      When a woman becomes pregnant after an abortion with a planned pregnancy, there can be a reoccurrence of nightmares, as well as constant fear and worry that something will 'go wrong' with this pregnancy, as punishment for the abortion. Fear of the baby dying, or having something wrong with it are common.

    21. Comparison of pregnancies and/or children:
      Looking at pregnant women, babies or children (depending on 'when' you had your abortion), and comparing yourself to where you would be in the pregnancy, had you kept it, or also comparing the baby or child to where 'your child' would be, if you had kept it. Looking at other children and thinking they look like what your child would have looked like.

    22. Viewing miscarriage or infertility as 'punishment':
      Feeling that future problems with infertility or miscarriages are 'punishment' for having had an abortion.

    23. Suicidal feelings:
      many women have problems for weeks, even months or years of struggling with suicidal feelings, feeling like they 'don't deserve' to be alive, and some report the urge to want to go 'find' the baby in 'wherever' and apologize to it, hold it, ect.. And just general suicidal feelings with the thoughts of being unable to cope with what has occurred.

    24. Triggers of smells and food:
      women have reported being unable to eat or having a panic/nausea/anxiety attack at the smell of food they ate on the morning of the ab, or from what they gave them in the recovery room afterwards. One woman told me she wants to vomit at the smell and site of graham crackers now, because that was what her clinic gave afterwards.

    25. Sex problems:
      this seems to go either way - fear of sex, and a terror of getting pregnant again, no desire for sex, and no ability to enjoy it, or else careless casual sex (which had not been the person's 'way of operating' before) having sex with anybody, not caring about birth control, and not caring if another pregnancy occurs.

    26. Being distressed at having your period - it's a reminder of the abortion, lots of blood and cramps again, and no baby. Women with PASS seem to be very upset the first few times they have their period after an abortion. One woman who had had no problems before was terrified by the sight of blood, and had to keep getting in the shower 5 or 6 times a day to wash herself clean - she couldn't stand seeing or smelling and blood on herself.

    27. Anxiety problems:
      Having problems with anxiety, worry and nervousness, with no visible cause. Anxiety can be treated with medication. To assess your level of anxiety, you can try the screening test in the Counseling Help Page

    28. Clinical Depression:
      This is very common for women with PASS - the trauma of the whole experience, and the problem of not having readily available public support for her feelings and issues after an abortion can lead to clinical depression. Clinical depression should be treated with anti-depressant medication! To assess your own depression level, you can try the screening tests in the Counseling Help Page

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    How do you Heal?

    Okay, if you have PASS, what do you do? How do you heal? The best ways to heal are this:
    1. If you have insurance, or if you can afford to pay yourself, finding a professional counselor that understands PASS is a good way to start. For more info on how to find a counselor visit the Counseling Info. Page
    2. Visit the message boards at the site, and come to the chats. Having a chance to talk and interact with women who understand what you are going through is very helpful.
    3. Visit the Structured Recovery Group Information Page. Doing the online healing group has helped many women recover.
    4. There's more general information in the healing room, so look there too!
    5. If you find yourself feeling upset as you consider your past experiences, and especially if you feel hopeless, or are considering suicide, seek professional help immediately. To speak with a crisis counselor right away, go to the Crisis Intervention Help Page

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