While forces on either side of the abortion debate may never agree, they do sometimes share ideas on the services that should be available to a woman after she terminates a pregnancy.
To be sure, the debate over what happens to women after an abortion has at times been a second front in the battle over reproductive choice. In recent years, pro-life groups have begun referring to "post-abortion syndrome," a loosely-defined set of maladies which, they say, will sooner or later plague almost any woman who has an abortion. The syndrome, says Margie Becker, executive director of the pro-life Lifeline of Southwestern Pennsylvania, "can lead to alcohol or drugs, deep depression [women] don't seem to be able to deal with. It can lead to family problems -- a lot of the time they don't even know what it was that started it.
"Some of them become very promiscuous after having an abortion or two or three," she adds. "They abort and then go through that whole cycle again."
Pro-choice advocates, on the other hand, say post-abortion syndrome is a myth -- a position shared by the American Psychological Association and the American Psychiatric Association. The most common emotional response to an abortion, say choice advocates, is relief.
"The anti-choice extremists have invented this post-abortion syndrome epidemic to convince the public that women can't be trusted to make decisions for themselves," says Erika Fricke, vice president for public affairs of Planned Parenthood of Western Pennsylvania. "This is part of a whole rhetoric that they've used to say that women aren't qualified to make decisions."
Still, even staunch choice advocates acknowledge that ending a pregnancy can be fraught with conflicting emotions, and that a person facing any major life decision can use support. An abortion, both sides agree, can have uncomfortable consequences.
Planned Parenthood itself, in fact, is now offering counseling alongside its reproductive-health services, and it plans to include a new post-abortion support group in the near future. While the group's goals and methods will be much different from the outreach being done by pro-life groups, both camps offer counseling for women hoping to find peace after abortion -- and some of the counseling techniques they use are surprisingly similar.
Since becoming PPWA's counseling director in May, Casey Sill has been expanding the counseling options offered by the agency. Clients have been coming in since mid-June for one-on-one counseling on a variety of issues, from anxiety and mild depression to self-esteem and GLBT issues.
"We're already offering all these other services to women and we understand that whether a woman's coming in for an abortion or a pelvic exam, there are other things going on in her life," Sill says. "It only makes sense to put a counseling center with it." One-on-one appointments are priced on an income-based sliding scale. The new post-abortion support group, however, will be free.
Planned Parenthood has always done screenings prior to providing an abortion, says Sill, to ensure that a woman isn't being coerced into having an abortion against her will. Planned Parenthood has also always offered "options counseling," during which a woman learns about three possible outcomes for a pregnancy: parenting, abortion or adoption. Post-abortion counseling has always been offered one-on-one for a fee as well, after an initial single free session. But once a woman has had an abortion, Sill says, she may still want to compare notes with others who've been through the same experience -- even if she's sure it was the right choice.
"We wanted to develop a group where a person has a safe space to talk," Sill says. "We are there for a woman in a difficult situation to empower her in anything that she's going through."
The post-abortion group, which Sill hopes will have between six and nine participants and run for six weeks, is being billed as specifically pro-choice. The participants will determine how the discussion goes. Initially, the group will be open only to women, but Sill says that if there is a demand from men, she'd be happy to start up a group for partners affected by abortion. (Partners and family members have long been invited to be part of options counseling, or to take advantage of individual post-abortion counseling.)
While post-abortion counseling in a group setting is new for Planned Parenthood, it's not a new idea. Similar techniques are used by an organization with a different position on abortion entirely: the Catholic Church.
Catholics, of course, oppose abortion. Yet since the mid-1990s, a program called Rachel's Vineyard has been offered worldwide and locally through the Diocese of Pittsburgh. That program, based on a book by Theresa Burke, takes place during a weekend retreat and includes group counseling.
Participants in the program are often referred by faith-based charities who encounter women struggling with their decision to abort, says Ann Depner, director of family services for Allegheny County's Catholic Charities.
"One of the things that people are often leery about is that they're afraid they're going to be condemned," Depner says. "We bend over backwards not to do that. That is not the Catholic Christian perspective -- it's about healing and the good news of God's love. It gives them an opportunity to share the grief in setting where they will be protected."
Unlike Planned Parenthood's approach, though, the church relies on guided scriptural meditations. It also offers the option to symbolically give the aborted fetus a "funeral."
Depner says that women are asked to consider the factors in their lives that led them to have an abortion. "Not that we condone abortion, but we realize that everybody makes mistakes." She cites the Biblical story of a woman about to be stoned for committing adultery when Jesus chides, "Let he who is without sin cast the first stone." The sin of abortion, like any other, can be forgiven and moved forward from, she says: "The desired outcome is a sense of resolution and healing and peace."
Other pro-life organizations see the need to offer a woman solace from the psychic and moral turmoil they say she'll inevitably face after abortion.
Lifeline also offers post-abortion counseling and referrals as part of its pro-life mission. The post-abortion counseling the group offers comes mostly in the form of a sympathetic ear on the phone or a referral to a professional counselor or clergy member.
"Our purpose is to help the woman before she makes that fatal decision," says Margie Becker. But if she should call after an abortion, the group can help her move on and, ideally, never have another abortion.
"Our hope is that she's at peace with her decision -- not the decision to abort, but the decision to deal with it and move on," says Becker. Because otherwise, she says, the malady of post-abortion syndrome "is a problem that never goes away."
The three groups agree that women and men affected by abortion can benefit from counseling -- be it from peers, clergy or a sympathetic ear. Depner and Fricke, while coming from opposite sides of the abortion debate, each see value in the treatment models offered by Planned Parenthood and Rachel's Vineyard.
But while women participating in these programs may be spared moral condemnation during the sessions, it doesn't take long for the sponsors to start passing judgment on each other.
Becker, for example, questions Planned Parenthood's motives in offering post-abortion counseling -- if they believe abortion is simply an individual choice, she argues, their offer of help dealing with the aftermath of an abortion seems contradictory. "I can't understand why they would do it if they promote abortion as a woman's right to choose. I think they're just trying to counter the programs that the pro-life people put in place."
Fricke calls that assertion "like saying because we offer relationship counseling, we're saying all relationships are bad. It's not to imply that all terminations are damaging to a woman's psyche."
For more information on post-abortion counseling sessions, contact Planned Parenthood of Western Pennsylvania at 412-562-1900 or e-mail: firstname.lastname@example.org; Lifeline of Southwestern Pennsylvania at 412-572-5099; the Catholic Diocese of Pittsburgh, Catholic Charities at 412-456-6999; and Project Rachel at 412-456-3161.