an After abortion

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Tuesday, March 1, 2005

We've been talking about whether women get adequate pre-abortion counseling, looking at blogs written by abortion clinic workers, and praying for Charmaine, whose abortion clinic counselor, seeing her tears, despair and sorrow a month after her abortion, responded with a healthy dose of reality (as seen through the eyes of someone who works full-time in an abortion clinic).

I believe that abortion providers fail to meet a duty of care to those considering abortion. The areas where failures occur most noticeably are---

(a) Failing to screen for known risk factors for post-abortion emotional distress. At a minimum, abortion providers should make themselves familiar with the health history of those considering abortion, including their psychiatric history. Women with a history of psychiatric events have an elevated risk for an adverse psychiatric reaction to abortion. (Or, as those who scoff at women who suffer in various ways after abortion sometimes say, "Women who suffer after abortion already had problems to begin with".) This would suggest that abortion providers should pay careful attention to the psychiatric history of their patients, no?

(b) Failing to develop effective ways to determine whether the abortion is the woman's idea or someone else's idea. This includes a lack of skill at helping the woman step back from psychological enmeshments with boyfriends or parents who are pushing her toward the abortion.

Compare what happens in "pre-abortion counseling" to the thinking of those who provide vasectomies.

Vasectomies may not be right for the following:

Men in couples in which one partner is unsure about his or her desire to have children in the future. (Couples in which the woman is working when they make the decision are at particular risk for regretting the decision later on.)

Men whose current relationships are unstable, going through a stressful phase, or are marked by substantial conflict.

Men who are considering the operation just to please their partners.

Men who are counting on having children later by storing sperm or by surgical reversal of the vasectomy.

Young men, who still have many life changes ahead.

Men who are single (including those divorced or separated) at the time of vasectomy.

Men who are having the operation primarily for the sake of their partners and not wholly for their own reasons.

Vasectomy providers understand that they have a duty of care to search out and thoroughly evaluate those factors with those considering vasectomy. As you can readily see, women considering abortion typically have most of the same factors that alert a vasectomy provider to believe one of his patients would not be a good candidate for a vasectomy.

The Influence of Short-Term Stress

Vasectomy should not be undertaken in response to temporary stressful situations that might block the desire for children. Such conditions may include illness, temporary financial crisis, death in the family, or birth of a child. Couples should wait through such short-term stresses or seek counseling or psychotherapy to be sure that they are not making a decision they will later regret.
How vastly different the attitude of the typical abortion provider, who thinks that the best way to solve the short-term stress is to evacuate the baby.

All Future Scenarios. Before deciding on a vasectomy, the couple should consider all future scenarios for their life together, such as the following examples:

If a couple already has children, how would they feel about a vasectomy if one of their children died?
If financial stress is triggering the decision for a vasectomy, would improved affluence increase their desire for children?
How would the man consider the vasectomy if his current relationship ended, either by divorce or the woman's death?
I have never heard of an abortion provider asking similar questions to women who seek their counsel about a prospective abortion.

Emotional Implications for the Man and Woman

The word "sterilization" has a deep emotional connotation for many people. Even though a couple may rationally accept the idea of a vasectomy, it is extremely important for each partner to be as open as possible about any negative feelings they might associate with the procedure. Such feelings on the part of either partner can have devastating consequences on a relationship if they surface only after the procedure has been performed. Openness with each other is imperative in order to make a decision that is clear of any hidden apprehensions. Neither partner should be too embarrassed to request counseling if the emotional aspects involved in making the decision are too difficult to solve between themselves.
Compare this to the attitude of one of the online abortion clinic workers, who thinks that by referring a patient to I'm Not Sorry, she has more than done her job.

We've made great strides in the last two decades at equalizing the quality of medical care that women typically receive, versus the quality of medical care that men typically receive.

Here's an area where the gap in care is astonishing and outrageous. Let's hope that Democratic party activists who want to seek a new rapprochment around abortion take up the cause of demanding that women who are considering an abortion are treated at least as well as men who are considering a vasectomy.

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