Having an abortion is a life-changing decision: First and foremost for the unborn child; and it has been proven to have significant, lasting emotional and physical consequences for the would-be mother. As such, we welcome the move made by the Ministry of Health (MOH) to consider extending pre-abortion counselling to all women, and even members of her immediate family.
The psychological effects on a woman include depression, anxiety disorders, suicidal behaviours and substance abuse. A pattern of psychological problems has been identified as Post-Abortion Syndrome, which has been found to be a subset of Post Traumatic Stress Disorder. Pre-Abortion Counselling prepares the woman mentally and emotionally to help circumvent such effects.
Some unforeseen effects may include strained relations with the woman's partner, both sexual and emotional, and physical impact on the woman herself. The consequences of an abortion on a woman’s health and body should be clearly communicated to her, so that she is well-informed that the abortion could potentially affect her ability to conceive in the future or lead to other complications.
It should also be made known that abortion has contributed to population decline and demographic changes, resulting in an 'ageing population' that Singapore is no stranger to. It would be in our society's interest that the cumulative criteria for mandatory pre-abortion counselling be altogether removed so that all women get equal opportunity to make an informed decision.
More importantly is the need for comprehensive Pre-Abortion counselling. We believe that the current framework fails to address the reasons why women seek an abortion in the first place and it should certainly not be overlooked. Including the woman's partner or any involved immediate family can also provide the woman with a much stronger support system than if she were to make the decision alone.
In addition to ensuring that the psychological, relational, physical and societal impact of abortion is emphasised during pre-abortion counselling, we propose to factor in multiple channels of support for the woman and to clearly present alternatives to abortion. Post-Abortion Counselling is also highly recommended as a preventive measure against Post-Abortion Syndrome.
Provide Support and Comfort for all Contemplating Abortion
We welcome the move made by the Ministry of Health (MOH) to consider extending pre-abortion counseling to all women.
Pre-abortion counselling is presently mandatory for women, regardless of marital status. We support the opinion that pre-abortion counselling should be mandatory for all, regardless of citizenship, level of education or number of children born to the woman. The consequences of abortion are not limited to only certain groups of women, but affect all women, and they can even extend to other members of the immediate family.
Abortion is a life-altering experience that can have significant ongoing emotional and physical consequences for a woman, so those considering ending their pregnancy deserve to receive solid information – not only about the process by which their baby's life will be ended, but also regarding the potential impact it will have on them – before making their decision.
Abortion can cause both short-term and long-term physical complications, including significantly affecting a woman's ability to have healthy pregnancies in the future.
Substantial research has found that going through an abortion has long-term psychological effects on a woman. A comprehensive, long-term study by a research team in New Zealand in the Journal of Child Psychology and Psychiatry found that abortion in young women is associated with increased risks of major depression, anxiety disorder, suicidal behaviours and substance dependence. Post-Abortion Syndrome has been identified in research as a subset of Post Traumatic Stress Disorder.
Pre-abortion counselling needs to address relational issues to prevent emotional traumatisation, especially if the woman's abortion decision seems circumstantially inevitable. Abortion can pose challenges to the significant relationships in the woman’s life, not just with her partner, but also her future children, possibly due to post-abortion depression and guilt. Abortion is not only a medical issue. Thus, pre-abortion counselling must encompass more than an explanation of medical procedures, potential risks and after-effects of an abortion. Every woman contemplating abortion needs to be fully provided with all the necessary information and clear explanations of the risks and consequences involved, channels of support including social services, as well as other options she has. This will empower her to make truly informed decisions regarding her unplanned and/or unwanted pregnancy that will affect her own life as well as that of her current and future family.
Editor's note: This letter was sent to the Straits Times Forum on Dec 4 in response to the changes Ministry of Health is proposing on the criteria for pre-abortion counselling. And an adapted version was sent to TODAY Voices.