Processing Abortion Through a Pregnancy Loss, Grief Counseling Lens

Image from Unsplash by Jonatan Becerra 3/31/25

Since the dawn of time, birthing people have been getting abortions. Abortions will continue to be a reality far into the future. The piece that changes is the level of support, respect, and care the wider culture gives to birthing people.There are many types of abortions and each person’s experience with it is unique. In modern times, in the US, abortion has a heavy stigma, although it is very common. Abortion is healthcare.

Kinds of Abortions

·      Medication Abortion: Commonly use Mifepristone and Misoprostol. Usually up to ten weeks gestation.

·      Self-managed Abortion: For centuries, different cultures and populations of birthing people have created ways of utilizing self-managed abortions using the resources local to them. There continues to exist a strong network of herbal abortion remedies as a grassroots access effort.

·      Surgical/Procedural Abortion: Entails a procedure to remove pregnancy tissue. Dilation and curettage (D and C) or Dilation and Evacuation (D and E) are used.

·      Spontaneous Abortion: More commonly referred to as a miscarriage. It could also be a non-viable pregnancy such as an ectopic pregnancy.

Reproductive Justice and Choice

Coined by SisterSong in the 90’s, reproductive justice acknowledges the social and cultural factors that impact a birthing person’s experience and access to care. People don’t have full choice if they don’t have full access to care. Access to resources such as medical care, food security, housing security, childcare, and social support all contribute to reproductive justice. Access free of racist, sexist, violent interference is a human right. True reproductive justice lets people choose to have or not have children and parent in safe communities.

Read more about SisterSong here: https://www.sistersong.net/reproductive-justice/

Mental Health Impacts of Abortion

Abortion is safe. When done in a humane and safe environment abortion is safer than getting your appendix out. Research shows there is no evidence to support that abortion causes significant mental harm. When people get proper care, they usually experience positive emotions. What does cause harm is misogyny, stigma, racism, poverty, and poor access. Other factors such as pre-pregnancy mental health, pregnancy discovery, decision making, reactions, stigma, and distress at the time of the abortion are more likely to impact how someone is coping post abortion.

Image from Pexels by Brett Sayles 3/31/25

Grief Counseling for Abortion

Having complex emotions around your abortion doesn’t mean you regret it. It means you exist within a complicated world full of people who have their own opinions about your body and your life. Birthing people who lose a wanted pregnancy commonly experience negative mental health impacts. Factors impacting this experience include relationship satisfaction, level of support, use of assisted reproductive technologies, length of gestation, past psychiatric history, and history of abuse. Birthing people who’ve experienced multiple losses are at higher risk for depression, anxiety, and PTSD. People who’ve experienced termination for medical reasons (TFMR) can experience complicated grief or PTSD.

As a Marriage and Family Therapist, I work with my clients from a non-pathological, contextual lens in which I try to understand their experiences. This is a helpful lens for clients experiencing loss. As I said earlier, the kind of losses as well as experiences are widely varied and deeply individual within each person’s context. How people story their lives deeply impacts the ability to cope. The decision to end a pregnancy is impacted by a wide variety of factors. For many people, it might not feel like a choice. Reproductive justice helps us understand this point. Pregnancies and the ending of them don’t happen in isolation, but instead in a complicated context.

Disenfranchised Grief and Abortion

Disenfranchised grief relates to loss that isn’t socially acknowledged. There tends to be a lack of ‘cultural script’ for these kinds of losses. Abortion falls within this category. It’s layered with stigma, misogyny, and racism. You may not feel like you can discuss your abortion with anyone or internalize that you did something wrong. These are all features of disenfranchised grief.

Abortion As Pregnancy Loss

If you are experiencing a variety of emotions after your abortion, you are normal. If you are experiencing grief and loss related to your abortion, you are also totally normal. Feeling grief doesn’t mean you regret the decision you made about getting the healthcare you needed at the time. It’s important to understand you are part of a historical community of birthing people that have been denied visual, open forms of mourning. There are other parts of grief related to abortions that you may experience, such as disappointment related to a lack of support, stigma (direct or indirect), lack of trust, loss of dreams, loss of a perceived future, or more.

No abortion is better or worse than another. There are all sorts of reasons you may have received an abortion. You may have experienced an abortion due to a missed miscarriage, or maybe it wasn’t the right time for you to become a parent, maybe you don’t want to be a parent at all. Maybe you desperately want a child but discovered a fetal abnormality that didn’t give your baby a chance to live with a high quality of life. Whether you desperately want a child or not, or are somewhere in between, it’s okay and normal to experience emotions after an abortion. This doesn’t mean anything about you other than you are human.

Regardless of the events leading up to your pregnancy or the circumstances in which it ended, your experience needs to be witnessed, validated, and honored.

Grief Counseling in Seattle for Abortion Support

Therapy is a great resource in navigating emotions after loss. Ideally, you find a provider who is trained in reproductive health care including abortion, perinatal loss, fertility issues and whatever needs are specific to you. Therapy can help you navigate disenfranchised grief, complex emotions, trauma, your relationships and connection to your body. There are safe, non-judgmental places providers who care. Schedule a free consultation today, I’d love to meet you.

Image from Pexels by N Voitkevich 3/31/25

Resources to find inclusive therapists:

Prochoicetherapists.org

Tfmrpsychologist.com

Endingawantedpregnancy.com

About the Author: Seattle Washington Therapist, Chelsea Kramer LMFT PMH-C

Chelsea Kramer is a Seattle Therapist who works with individual and families facing grief, anxiety, reproductive and medical mental health concerns.

Learn more about Chelsea’s specialties: grief, anxiety, infertility, pregnancy loss, chronic illness, menopause, medical trauma

Learn more about Chelsea

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Blog post informed by: The Mental Health Clinician’s Handbook for Abortion Care