Mental health, Counselling and Abortion: A Crucial Conversation.

1. Mental health, Counselling and Abortion: A Crucial Conversation. The termination of a pregnancy can unleash a variety of feelings. Not everyone experiences it the same way. Antagonistic feelings can occupy the same place at the same time. Although it is common to see narratives that relate only negative feelings about the decision to end a pregnancy, there is no evidence to confirm this. According to the World Health Organization, every year there are an estimated 40-50 million abortions globally. If critical mental health outcomes were common, we would experience an outbreak of people with severe mental health struggles caused by having an abortion. Researchers have investigated how women feel after an abortion procedure. A study indicated that after five years, 99% of women felt that having an abortion was the right choice. The research took place in the United States and considered the experience of 667 women across 21 states. More than half of the women struggled to decide to terminate a pregnancy. However, after a week, 97.5% of the participants affirmed that it was the right decision. The evidence available today, or even what has been observed from 48 years of legal abortion in the United States, does not support the idea that abortion is more damaging to long-term mental health than carrying on with an unwanted pregnancy. To preserve people’s mental health, we need to have a serious conversation about abortion and feelings, including the impact of external factors on how one feels when making a personal decision. Mental health and bodily autonomy Not everyone can smoothly navigate access to an abortion. Legislation, religion, social norms in general, and lack of support are some of the obstacles faced by people around the world when trying to exercise bodily autonomy. And having your right to bodily autonomy diminished or denied is a mental health matter. Not being able to govern what happens to your body without external influence or coercion might trigger many emotions. Where you live should not define how hard it is to access a human right, or even how guilty you may feel by doing it. Our society imposes many harmful social norms that affect people’s mental health, especially when it comes to abortion. Feeling that members of your community will be judgemental about your decision to seek an abortion increases the chances of negative feelings, such as sadness, guilt, and anger. “Because of the stigma around abortion, many people don’t talk about it and patients can feel isolated,” stated Dr. Amir G. Nasseri in his interview for Healthline. “I show them the numbers of how many people have abortions and the reasons for getting them. She often falls into one of those categories and can feel less alone in that decision.” The Guttmacher Institute's May 2006 report, Abortion in Women's Lives, states: "Women who are terminating pregnancies that are wanted or who lack support from their partner or parents for the abortion may feel a greater sense of loss, anxiety, and distress. For

2. most women, however, the time of greatest distress is likely to be before an abortion; after an abortion, women frequently report feeling 'relief and happiness.” Being able to decide on your body and your future is crucial for mental health. Mental health and restrictive scenarios Only 36% of the world’s population of reproductive age live in countries that allow abortion on request, meaning that the biggest share still live under legislation that criminalizes those who decide to terminate a pregnancy. Legislation that restricts access to safe abortion adds more weight to the mental-health load of those who choose it. Society tends to stigmatize the subject even more, and those who terminate a pregnancy are often in danger of being imprisoned and face criminal charges. Criminalizing those who decide to terminate a pregnancy is not only a way to perpetuate unsafe abortions but also places a heavy burden on the mental health of those who make that decision. There are also many cases where the continuation of the pregnancy would endanger the pregnant person’s present and future mental health. Currently, 90 million women of reproductive age are living in countries that prohibit abortion altogether. Under such legislation, survivors of sexual violence have very few means to access safe abortion procedures. There is no need to justify the termination of a pregnancy, apart from wanting to do it. However, those under strict legislation are more vulnerable to external factors. Moreover, for those who have struggled with mental health and are on medication, facing an unwanted pregnancy is a very delicate situation. The interruption of the treatment can not be done suddenly and some medications are not safe to use during pregnancy. In cases of unwanted pregnancies aligned with medical treatment, the restrictive legislation is a concrete threat to mental, and physical, health. There are many cases of people seeking an abortion because they cannot adapt their treatments to a pregnancy. Nevertheless, in restrictive scenarios, their wish for a medical procedure might become a harder journey than it should be. Abortion bans should be lifted to preserve people’s mental health. Safe Abortion Counselling Abortion Counselling also plays a very important role in giving you accurate information and help you think through your options with a trained, non-judgemental and pro-choice counsellor. At safe2choose.org, the abortion counsellors will help you without judgement and will help work you through how you feeel. Counselling before an abortion is important because it will help reduce your anxiety, give you accurate information for going through the next steps with ease and also the comfort of knowing what to expect. Counselling after an abortion or post abortion care is equally as important. Some women experience a range of feelings including shame and guilt. If this has been your experience, it could be helpful to speak with a trained professional about the emotions and challenges that you are facing. Various abortion counselling options exist on the internet that are cost free. In addition to abortion counselling via email, safe2choose provides accurate downloadable information that you refer to before,

3. during and after your abortion, in case you have limited or zero access to an abortion counselor. If you need assistance, there are many organizations and individuals that can provide respectful support to help you make your decision. The Exhale Project has compiled a number of useful resources that are worth checking out if you, or someone you know, are struggling with mental health after an abortion. The most important thing here is to seek service providers that will respect your decision and support you in any choice that you make. Support is all we need Behind the statistics and research, we are dealing with real people. And real people want to be heard. For that reason, we share the story of a privileged woman from a country that criminalizes abortion. She was dating an amazing person when they found out about the pregnancy. They felt compelled to carry it on. They had enough resources and support. Society, and the law, would not accept any other way. However, after a couple of weeks, she questioned how her life would change. She wanted to have children at some point, but by doing it now, she was not honoring her feelings and decisions. She knew it was not the right moment. Amidst a pandemic, she found a safe way to terminate her pregnancy. She did not feel guilty or sad at all. She felt relieved, like the weight of the world was officially off her shoulders. A range of contradictory emotions might appear after having an abortion. It is common to have intense feelings; happiness, sadness, empowerment, anxiety, grief, relief, and guilt are the most common. All feelings are valid. The same experience is very often related to unintended pregnancies carried to term as well. Whether you are going through the process of terminating a pregnancy, have been through it, or know someone who is, remember to be kind, rely on people you trust, and seek professional advice, if needed, as part of the process toward emotional well-being. External factors cannot dictate how you feel, and there is no right or wrong when it comes to such a personal decision.