Tis the season to feel guilty. Past abortion history and current infertility issues.

"Dealing with infertility after an abortion is fraught with complexities, surrounding feelings of guilt and anxiety about whether one's last chance to have a baby may have been squandered. Some patients feel that the pain of infertility is their divine, and justly deserved, punishment". - Joan Winograd, L.C.S.W.

Despite the fact that the overall rate of abortions in the United States have declined, the CDC reports that in 2006 (the most current data available) 846,181 recorded abortions were performed in this country.

Current data also indicates that one in 136 women (about two million annually) are currently under a doctors care for infertility.

Staggering numbers aside, it might be assumed that these two seemingly separate populations of women do not overlap. However, many women who have a past history of one or several abortions will at some point during their reproductive years find themselves in the unfortunate position of not being able to conceive a baby. Advanced maternal age, pelvic inflammatory disease, endometriosis, polycystic ovarian syndrome, premature ovarian failure, and other diagnosis unrelated to abortion will often be found as the reason why conception is now a challenge. What won't be found, most of the time, is a link between past abortion history and current infertility. Simply stated, rarely does a link exist.

According to Long Island based reproductive endocrinologist Daniel Kenigsberg, M.D., "Previous abortion is not often a problem for future fertility. As with any medical procedure, there are complications (of abortion) that can occur, such as infection, or scar tissue formation. Fortunately, both are very infrequent. One aspect often overlooked is that previous cervical dilation, which is necessary for the abortion procedure, may predispose the woman involved to cervical weakening, which can lead to premature delivery or even midtrimester pregnancy loss. If you have had an abortion, please tell your doctor, and make sure that your cervix is evaluated frequently during your pregnancy."

Despite clear evidence to the contrary, women experiencing infertility who have a past abortion history often blame themselves and believe that their current situation was created by their past choices.

The Infertility and Adoption Center's Executive Director, Joni Mantell, L.C.S.W., asserts that lowered self esteem may often be to blame. Says Mantell, "Human nature is to seek cause and effect. It is not uncommon for women who have had abortions prior to infertility to think that there is a causal relationship to all of this, even though in most cases medical evidence does not exist."

She goes on to state that "the mindset of a woman suffering from infertility is often one of great shock, disappointment, fear about whether they will ever be able to have a baby, and often loss of self esteem, because they cannot in fact do what they always thought was an essential part of their role as a woman. Lowered self esteem is in fact, fertile ground for self blame. Women may look back over their past, to try to figure out where they went wrong. This may be part of our human need to find rational explanations for the ills that befall us, or conversely, may actually be a form of self punishment, fueled by guilt about the prior abortion and also about not being able to conceive currently".

These feelings may be confusing to many women experiencing them, since the most common emotion experienced immediately after an abortion is performed is relief. However, according to Ms. Mantell, "Women may not have been aware of their feelings of prior guilt. Infertility can bring this emotion closer to consciousness, and with it a painful realization to confront at an already highly charged, stressful time. Renewed grief about the baby that could have been born, yet was instead aborted, may need to be worked through on a deeper level. These feelings would be occurring simultaneously along with the raw, immediate experience of pain and loss resulting from infertility".

Safe, legal abortion does not cause infertility in women. If you have had one or more abortions, you should talk to your gynecologist honestly about your past medical history and your concerns. If you are unable to conceive without the additional support of a reproductive endocrinologist, you have the right to acquire that support. If you feel that you would benefit from seeing a therapist, you should do so. Most IVF centers have highly competent therapists on staff who are ready to support you.

Your reasons for having had an abortion are your own. No matter how you currently feel about that past choice, it is important to acknowledge that your choice did not result in infertility.

Reprinted with permission from Examiner.com

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