Abortion: social context, psychodynamic implications

Am J Psychiatry. 1998 Jul;155(7):964-7. doi: 10.1176/ajp.155.7.964.


PIP: A case report presented by a US psychoanalyst suggests that the trauma of reproductive loss, such as miscarriage of a wanted pregnancy, can trigger suppressed feelings associated with an earlier induced abortion. The patient entered psychoanalysis when she was a 24-year-old graduate student to address relationship problems. As a 19-year-old college student, she became pregnant and chose to have an induced abortion because she was not ready to make a permanent commitment to her boyfriend or to provide properly for a child. She reported feeling grateful at the time that motherhood was not imposed on women as punishment for being sexually active and that childbearing was a free choice. The patient married during psychoanalytic treatment and decided she wanted to have a child. She experienced a hydatiform molar pregnancy, following which memories of the abortion 10 years earlier began to surface in the analysis for the first time. Her grief about the recent pregnancy loss melded with emotions about the earlier abortion. Through the analytic relationship, the patient was able to experience and express this sadness. This case underscores the need for psychotherapists to ensure that the political importance of protecting women's right to reproductive choice does not obstruct the exploration of complex emotions that may be associated with a voluntary induced abortion.

Publication types

  • Case Reports
  • Clinical Conference

MeSH terms

  • Abortion, Habitual / psychology
  • Abortion, Legal / psychology*
  • Adult
  • Female
  • Grief
  • Humans
  • Memory
  • Pregnancy
  • Pregnancy Outcome / psychology*
  • Psychoanalytic Therapy*