Post-Abortion Syndrome: Emotions After Abortion and Getting Support

Where the term comes from

"Post-abortion syndrome" was proposed in the 1980s, modeled on post-traumatic stress disorder, to describe a pattern of guilt, depression, anxiety and trauma symptoms thought to follow abortion. It has been used mainly in advocacy and some counseling settings. It has not been accepted by major medical organizations because research has not shown a distinct syndrome caused by abortion.

What the research shows

• The APA Task Force on Mental Health and Abortion concluded that the risk of mental health problems after a single first-trimester abortion of an unwanted pregnancy is no greater than if the pregnancy is carried to term.
• The Turnaway Study, which followed nearly 1,000 people in the US for 5 years, found that those who had an abortion did not have worse mental health than those denied an abortion. Those denied an abortion had more anxiety and lower self-esteem in the short term. Over 95% of those who had an abortion said it was the right decision 5 years later.
• The National Academies of Sciences found that abortion does not increase the risk of depression, anxiety or PTSD.
• The strongest predictor of mental health after abortion is mental health before the pregnancy.

Studies suggesting a link have often failed to account for prior mental health, unwanted pregnancy itself, abuse and other life circumstances.

Emotions after abortion are real

Not being a diagnosis does not mean feelings are not real. People commonly feel:

• relief, the most frequently reported emotion
• sadness or grief, especially if the pregnancy was wanted or the decision was hard
• guilt or regret, sometimes linked to religious or family beliefs
• anger, for example at a partner or at circumstances
• mixed emotions that change over time

Hormone changes after pregnancy ends can also cause temporary mood swings, tearfulness and tiredness for a few days to weeks.

For most people, difficult feelings lessen over weeks to months. When they do not, it may be depression, an anxiety disorder, PTSD or an adjustment disorder, all of which are treatable regardless of their cause.

Factors linked to more distress

• a history of depression, anxiety or other mental health conditions
• feeling pressured or coerced into the decision, or into continuing the pregnancy
• strong ambivalence or a wanted pregnancy ended for medical reasons
• stigma, secrecy and fear of judgment
• lack of support from a partner, family or friends
• intimate partner violence
• abortion later in pregnancy for fetal anomalies, which often brings grief similar to pregnancy loss

Getting support

• Talk to someone you trust without judgment.
• Peer support lines: in the US, organizations such as All-Options and Exhale offer free, non-judgmental talk lines for any feelings after abortion.
• Counseling: a licensed therapist, ideally one who will respect your values and decision, can help with grief, guilt or trauma. Cognitive behavioral therapy is effective for depression and anxiety.
• Medical care: a primary care doctor or gynecologist can screen for depression and discuss treatment.
• Support groups for pregnancy loss, especially after abortion for fetal anomalies.

Be cautious of services that present post-abortion syndrome as an established diagnosis or use shame as part of counseling.

Physical recovery to watch for

Physical and emotional recovery overlap. After an abortion, cramping and bleeding for up to 2 weeks are normal. Seek care for:

• very heavy bleeding or large clots
• fever, chills or foul-smelling discharge (possible infection)
• severe belly pain
• continuing pregnancy symptoms, which can mean an incomplete abortion

Frequently asked questions

Is post-abortion syndrome real?

Post-abortion syndrome is not a recognized medical or psychiatric diagnosis. Major organizations and large studies have found that abortion does not cause mental illness. However, some people do experience sadness, grief or distress afterward, and those feelings are real and deserve support.

Is it normal to feel sad after an abortion?

Yes. Many people feel relief, but sadness, grief, guilt or a mix of emotions are also normal, especially if the decision was difficult or the pregnancy was wanted. Hormone changes can add to mood swings for a few weeks. Feelings usually ease with time.

Can abortion cause depression?

Research does not show that abortion causes depression. The strongest predictor of depression afterward is a history of depression before the pregnancy. If low mood lasts more than 2 weeks or affects daily life, see a doctor, because depression is treatable.

Where can I get support after an abortion?

You can talk to trusted friends or family, call free non-judgmental peer support lines such as All-Options or Exhale in the US, see a licensed therapist, or talk to your doctor. If you have thoughts of self-harm, call or text 988 in the US.

How long do emotions after an abortion last?

For most people, difficult emotions are strongest in the first days to weeks and fade over a few months. If feelings are intense, last longer, or include nightmares, flashbacks or hopelessness, a counselor or doctor can help.