Termination of pregnancy

_{Note: In this article we refer to women, but this is for brevity and is inclusive of all people and non-birthing partners.}

Termination of pregnancy, or abortion, is the medical process of ending a pregnancy. In their lifetime, up to one in three Australian women will choose to have a termination. Women may terminate an unwanted pregnancy or terminate a wanted pregnancy upon discovering a maternal or foetal health complication (often referred to as a medical termination).

Any decision to terminate a pregnancy can be complex and distressing, and women must be supported in their decision, regardless of the reason.

There are several reasons why a woman might make the decision to terminate, and the woman’s emotions are directly influenced by the level of support provided, the circumstances of the pregnancy, and how the decision was made. Having support and being able to spend time talking through the decision with a trusted person can significantly help in processing the experience.

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Feelings experienced after a termination of pregnancy

Studies have shown that the most commonly reported emotion after the termination of a pregnancy, is relief.¹ Although some women experience a sense of relief, others can experience a whole range of feelings and thoughts, ranging from happiness and empowerment; to guilt, sadness, anger, overwhelm, loss and shame. It is critical to realise that there is no right or wrong emotion when it comes to the experience of a pregnancy termination, and all emotions are okay.

The ability to cope after a termination can be impacted by the following:

Values and beliefs, often influenced by religion, society, culture and laws and policies
Future pregnancies, which can bring up emotions and feelings of loss from a previous terminated pregnancy
The level of support received from family or friends and whether or not the decision was wholly their own
A partner's strong or opposing views on whether or not to terminate a pregnancy
Whether or not they felt like they had to keep the termination a secret or acted against their own values or beliefs

Even if the decision to terminate a pregnancy is well considered, significant loss and anxiety can still be experienced.

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Medical termination of pregnancy

Due to improved technology and advances in clinical testing, there has been an increase in detection rates of congenital anomalies during pregnancy. However, there are still very few in-utero treatments available for major anomalies, which leaves parents with very few options following a diagnosis. These circumstances of medical termination of pregnancy are traumatic for families²and women who make the decision to terminate a wanted pregnancy upon discovering maternal or foetal health complications can experience a complex range of emotions.

Even before a pregnancy, many parents fantasise about their future with a child, such as a baby's first words and steps, or starting school. Letting go of this imagined future is extremely difficult, even when there is evidence of medical or developmental problems.

Cultural and religious beliefs around termination can be hard for parents to reconcile, and they should seek additional support for complex grief. View others’ experiences.

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Physical implications after a termination of pregnancy

When a pregnancy ends, hormone levels drop, which can take three or more weeks. This is a significant period of physical adjustment for the woman. Pregnancy hormones are at their greatest levels between nine to 13 weeks' gestation. If the termination is later in the pregnancy, milk can come in and the body can still feel and look pregnant, triggering further grief.

The non-birthing partner may not be aware of the impact of the physiology of pregnancy, and the woman herself may be surprised by the effect of these physical influences.

Ongoing emotional triggers

Events, dates and milestones such as the due date and birthdays can trigger sadness, anger or loss for women and their families. It is helpful to mark this day or time with a ceremony, gift, or a charity donation for example.
If friends or family are pregnant it can bring up mixed emotions, including jealousy, sadness or confusion. Taking a break from social media can be helpful, to avoid being bombarded with other people’s baby journeys. It is common to want to withdraw from others but then feel guilty about it.
Being emotionally available for other children in the family
Future pregnancies could be anxiety provoking, so seek counselling support before getting pregnant again

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Support

Everyone has a different physical and emotional response to a pregnancy termination, depending on their current health, decision making, personal situation, and beliefs. Insomnia, the inability to focus, anxiety, withdrawal, regret, and feelings of hopelessness are all common.

For some, the support of family and friends is sufficient to navigate through this time. For others who need more support, a therapist or counsellor can be helpful.

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