Our concepts of health in the history of nursing have greatlycted the way we practice nursing. Nursing is holistic and will always be about promoting health. Nurses, in promoting patient care, do not only address the physiological health of patients, but their psychological, emotional and spiritual health as well. This story is a reminder for us to assess for unresolved grief in our patients more readily.
Hidden Losses, Hidden Grief
I was once assessing a client who was being admitted to a 28-day drug rehabilitation program. Along with the lengthy physical assessment, I was concerned that she might have a difficult withdrawal period. Emotionally and psychologically, the client had suffered a history of abuses and had recently lost custody of her children. I also discovered that she had unresolved grief issues.
As I took her gynecological history, she revealed she had experienced an elective abortion at age 13. Her parents had forced her to have the procedure. I noticed that suddenly, as she began speaking of this, it became more difficult for her to continue with the medical history. Now crying, she continued to explain that she wanted to deliver and love her baby. She explained, “I didn’t really understand what was happening to me. I was so young. I called the clinic the next day desperately asking for my baby. I asked them where my baby was and they told me I wouldn’t want to know.”
She went on to explain that she became very promiscuous thereafter and began to try to ease her pain with drugs, alcohol, and men. She explained she had other abortions thereafter and her children were now in state custody. She hoped the drug rehab program would help her be able to rise above her tragic circumstances in life.
Intuitively, I recognized that maybe she was suffering Post-Abortion Stress along with all her many other diagnosis. PAS involves the psychological affect of an abortion on a woman after the experience. Many women experience a type of post-traumatic stress related to a past abortion experience and its effect. Even men can experience this when they have been powerless to defend their unborn child’s life. The effect is very similar to other forms of post-traumatic stress.
A safe place to share
Knowing that the rehab patients in the program uncover, reveal, and address many devastating and hurtful events of their lives in their group sessions and workshops, I suggested that she might want to make sure she addresses (rather than represses) the pain and unresolved grief surrounding her abortion. I emphasized that this program is a safe place for her to share about this. I also explained that she could expect to have frequent one-on-one contact with her designated counselor as well as many, safe group sharing sessions.
She responded that she was surprised and stated, “No one has ever even mentioned that my abortion could be a part of my problem.”
I just encouraged her and promised that I would be praying for her. I could only hope and pray that those 28 days in rehab would be a healing time for her.
Our society doesn’t generally expect nor permit grief after an abortion. (Burke, 2002) American Psychological Association does not recognize PAS as an official diagnosis, although many experts find themselves addressing it routinely. Women experience one or more common symptoms which include anxiety, depression, relationship difficulties, shame, social isolation, self-hatred, flashbacks or nightmares, suicidal thoughts or feelings, compulsive thoughts and feelings that 
started after the abortion, or compulsive or addictive behaviors that started after the abortion. (Healp and Healing, 2006)
Nurses’ increased awareness of this form of unresolved grief could potentially lead to much healing and restoration for many patients in need of help in this area. Here are several of many resources available to aid you on holistic nursing:
- Abortion Recovery Network at http://www.abortionrecovery.org
- The National Office of Post-Abortion Reconciliation and Healing (NOPARH) at http://www.marquette.edu/rachel
- Kala's Group at http://www.seghea.com/cheryl/index-2.html
- The web site at www.menandabortion.info
References
T. Burke. (2002). Forbidden Grief: The Unspoken Grief of Abortion. (pp. 32, 108-109) Springfield,
Help and Healing (2006). You are Not Alone. Retrieved from http://www.theunchoice.com/healing.htm#Recovery
