A PSYCHIATRIST'S VIEW OF GRIEF AND ABORTION
By Colman McCarthy
Since 1973 when the Supreme Court legalized abortion, 20
million have been performed. About 20,000 have been done by Dr.
Julius Fogel, 75, a Washington obstetrician-gynecologist. I've
known him for more than 20 years.
I spoke to him the other day when C. Everett Koop, the
surgeon general, announced that no government report would be
issued on the emotional effects of women following abortion. Not
enough is known. Koop said that almost 250 studies "do not
support the premise that abortion does or does not cause or
contribute to psychological problems."
The reason I talked with Julius Fogel is that in addition to
being an obstetrician-gynecologist, he is also psychiatrist, one
of the few U.S. physicians to practice both crafts. If anyone
has an opinion worth listening to -- one based on something more
than ideology or anecdotes -- it is Fogel. Well-credentialed,
and well-regarded in the medical community, he is a dispassionate
observer.
"There is no question," he said, "about the emotional grief
and mourning following an abortion. It shows up in various
forms. I've had patients who had abortions a year or two ago --
women who did the best thing at the time for themselves -- but it
still bothers them. Many come in -- some are just mute, some
hostile. Some burst out crying... There isn't no question in my
mind that we are disturbing a life process."
Fogel's thoughts last week were identical with those he
expressed in 1971 when I interviewed him on the same subject.
That was two years before Roe v. Wade, and Fogel and others were
doing what were then called "therapeutic abortions." He did not
claim then, or now, that mental illness automatically follows an
abortion. "Often," he said in 1971, "the trauma may sink into
the unconscious and never surface in the woman's lifetime...
(But) a psychological price is paid. I can't say exactly what.
It may be alienation, it may be a pushing away from human warmth,
perhaps a hardening of the maternal instinct. Something happens
on the deeper levels of a woman's consciousness when she destroys
a pregnancy. I know that as a psychiatrist."
Fogel, unfortunately, wasn't one of those consulted by Koop.
The surgeon general says that he sought the views of 27 scientif-
ic, medical, psychological, and public-health experts. The
impression left now is that the data aren't there to lead to any
conclusion that he or anyone else should be acting on. It's
close to unbelievability that a major medical procedure performed
20 million times in 16 years has somehow been left either insuf-
ficiently studied or studied in a way that the results end in a
draw.
Variables and uncertainties surely exist in the studies of
abortion aftereffects, depending on everything from the woman's
age and income to her religion and education. And it may be
true, as Koop claims, that "scientifically you can't prove a
thing." But since when is scientific certainty the credibility
standard for deciding, as Julius Fogel had done, that people are
hurting?
In "Aborted Women: Silent No More," David Ctionardon says
in a chapter on the psychological impact of abortion that studies
of the aftereffects are common. He cites seven, ranging from an
American Journal of Psychiatry report on 500 women to a survey of
available studies by the Royal College of Obstetricians and
Gynecologists in England. The latter found, "The incidence of
serious, permanent psychiatric aftermath (from abortion) is
variously reported as between 9 and 59 percent."
Reardon states, "Even the most biased pro-abortion surveys
admit that severe post-abortion psychological trauma does
occur.... One researcher even claims that 'disabilitating'
psychiatric problems occur in 'only' 1 percent of aborted women.
But dismissing even a 1 percent rate of disabling sequelae with
an 'only' is obviously unjustifiable when the number of women
undergoing abortions each year has reached such large propor-
tions.If 'only' 1 percent of 1.5 million women suffer severe
disabling psychic trauma from abortion, that means that each year
15,000 women are so severely scarred from post-abortion trauma
that they become unable to function normally."
Whatever the numbers and percentages, the pending Supreme
Court decision on a Missouri anti-abortion law has become a
bonfire heating the already inflammatory rhetoric on both sides.
The National Abortion Rights Action League needs to lay off its
preachments about "reproductive freedom," as if destroying fetal
life is the problem-free pinnacle of feminist principle. On the
other side, George Bush opposes abortion and calls for adoption.
Is he calling also for federal money to help couples who would
adopt children but who ar in debt paying for the ones they al-
ready have?
One effort worth honoring is a new project begun this month
by Archbishop Roger Mahoney of Los Angeles -- a diocesan counsel-
ing program to help women deal with post-abortion stress. In
Washington, Julius Fogel has long worked to counsel women. The
two men have opposing views on the morality of abortion, but they
come together in easing the anguish, whether or not it's scien-
tifically proven.
(c) 1989 Washington Post Writers Group
