Therapy is not routinely available for patients about to undergo an abortion on the NHS. The Department of Health says there is “little or no evidence” that counseling is effective in preventing mental health problems.

But the British Association for Counselling & Psychotherapy (BACP) says that pre-abortion counseling can reduce the risk of trauma after the operation, and that women should have the right to choose therapy before they have a termination.

BACP says that, leaving aside the moral debate, an abortion is unlike other surgical procedures – the psychological issues involved are multiple and profound. But because the legal consensus in the UK has ruled that safe medical abortion ought to be available, in some cases it has come to be regarded as a “routine” procedure. This is a “serious mistake”, says BACP.

A woman with an unwanted or accidental pregnancy has to consider the “immense consequences” of any choice she makes, says BACP. Pre-abortion counseling allows women and their partners the opportunity to talk about how they think the termination will affect their lives and relationship.

In addition, abortion can carry many complex emotional responses that are often paradoxical, for example, hope and despair or relief and bereavement. Many women who choose abortion still “mourn” the lost possibilities of the life that will not be, says BACP.

Counselor Pat Seber says, “Because abortion is not something that most women do on a regular basis but usually only once, they have no yardstick with which to measure their reactions. They don’t know how they will feel, they can only guess.” She said if they get it wrong, these women often develop severe depression, anxiety and punitive behavior both towards themselves and others.

“Often women say ‘if only I could talk to someone who has had it done’. They want to know what they may feel both physically and emotionally,” she says.

BACP believes that anyone who chooses to have an abortion should also be able to decide whether to have counseling to help cope with the emotional consequences. “It is a basic component of a woman’s right to choose,” says the association.

A patient who had an abortion is suing the NHS because she was not warned of the psychological complications that could follow the operation.

A spokesperson for the Department of Health said guidelines from the Royal College of Obstetricians and Gynecologists suggest that only a small minority of women experience any long term, adverse psychological problems after abortion. Early distress, although common, is usually a continuation of symptoms present before the abortion. Referral for further counseling should be available for the small minority of women who experience long-term post abortion distress.

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