What women should know about taking care of their mental health pre and post abortion

In a big win for healthcare in India, the Supreme Court ruled in favour of abortion for all women — married or single — making it a constitutional right, months after the apex court in the US overturned ‘Roe v. Wade‘ — a 50-year-old legislation that allowed women’s access to abortion a federal right in the country.

India’s Supreme Court ruled in a significant judgment on Thursday stating that it is unconstitutional to distinguish between married and unmarried women for allowing termination of pregnancy on certain exceptional grounds when the foetus is between 20-24 weeks.

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While it is a massive victory with emphasis on female autonomy in accessing abortion, it is also true that just like other medical procedures, an abortion can also take a toll on a woman’s mind and body, especially given that there is a certain social stigma attached to it. We reached out to some experts to understand just how crucial it is to take care of emotional health before and after undergoing an abortion.

According to Dr Thejaswini J, consultant – obstetrician and gynaecologist, Motherhood Hospitals, Electronic City, Bangalore, while abortions performed by qualified doctors are safe and carry very few risks, physically, the mental and emotional impact depends on a “case-to-case basis”.

“Some women experience strong emotions and mood swings after an abortion, mainly due to the hormonal shifts. The hormone levels stabilise as the menstrual cycle returns. Choosing to undergo an abortion can be an emotionally-challenging experience. Women may feel extreme relief and sadness at the same time. They can also experience anxiety, grief, a sense of loss, and sleep disorders. This is natural, but if the negative feelings prolong, they should not be ignored, and help should be sought,” she told this outlet.

Adding to this, Dr Prerna Kohli, clinical psychologist and founder of MindTribe.in told indianexpress.com that these emotions may occur immediately after the procedure or over a period of time. “It is important to watch out for signs of prolonged grief, which may happen when feelings of normal grief are avoided and remain unprocessed. The cultural perception of abortion, as well as feelings of guilt, may also make the process a traumatising one,” she said.

What should women keep in mind before undergoing an abortion?

Dr Kohli said it is important to prepare yourself mentally — and in any other aspect that you might think is important — before the procedure. “Some amount of anxiousness and fear is normal; try to understand what thoughts and beliefs might be making you feel this way. Letting go of expectations about how you ‘should’ be feeling is crucial. Whatever the emotional outcome, know that it is okay to feel those emotions and to take some time to not only heal physically, but also mentally,” she said, adding that one needs to be kind to themselves throughout the process.

Dr Thejaswini explained that women should educate themselves about the different types of abortions. “Pregnancies can be terminated medically through pills or surgical procedures. Your doctor will recommend the appropriate method based on your needs and stage of pregnancy,” she said.

The doctor said one can discuss their doubts with the expert, ask them about the risks, what they should do to prepare, and the financial costs. etc., besides confiding in and seeking the support of people they trust — spouse, partner, friends and family.

“Remember, deciding to have an abortion does not mean you do not want or love children. People get abortions done for various reasons. Consult a gynaecologist and only choose safe ways to terminate your pregnancy — do not fall for any quick fixes or home remedies, or anything else that may risk your health,” explained Arouba Kabir, a mental health counselor and founder of Enso Wellness.

Pregnancies can be terminated medically through pills or surgical procedures. (Photo: Getty/Thinkstock)

Dr Thejaswini stated that it is also neccessary to have a post-abortion plan. “Ask your doctor what items you will need to stock up at home post the procedure. It could be pain medications, heating pads for cramps, pads to manage bleeding, etc. Take time off work to allow your body to recover.”

Things to keep in mind after the procedure

Dr Kohli said that various studies have proven that abortions do not cause mental health problems, but they do cause a certain amount of stress owing to the stigma, lack of knowledge, and lack of access. “Have some form of social support before, during, and after the process. Talking to this person can bring about a feeling of relief. They can also practise journaling or maintain a thought diary on a regular basis.”

Arouba concurred and said, “Try to imagine that you have already had the abortion. It can also help to imagine that you have gone ahead with the pregnancy. Often imagining how life would’ve been makes you find solace in the decision you made. Since abortion is an emotionally-taxing procedure, indulging in habits which help you heal physically, mentally, and spiritually is a great way to reconnect with yourself. Start taking light walks, do things that bring you joy, meditate, etc.”

Dealing with the social stigma of abortion

Dr Thejaswini explained that though every woman has the right to a safe and legal abortion in the country, many still face the stigma associated with it. “Women seeking abortions are shamed, bullied and marginalised. This in turn can have disastrous consequences both on their physical and mental health.”

She added that the stigma often forces women to hide their pregnancies; it prevents them from seeking safe healthcare services for abortions, especially unmarried women.

Dr Kohli said the common question that pops up is, ‘What would people say when they get to know about this?’. “The decision to go ahead with the procedure itself takes a toll on the woman’s mental health; the stigma just adds to it, giving rise to feelings of stress, anxiety, and even depression.”

“This is why some people feel forced to go ahead with the unwanted pregnancy or get risky abortions, which can be damaging to the mother and her child,” Arouba said.

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