As an accredited mental health social worker and counsellor who specialises in abortion and pregnancy-options counselling, I certainly get my fair share of funny looks at parties or bbqs, when asked by people what I do! It's 2019 and the taboo, shame and stigma around women considering all their options in regards to unintended pregnancy is still palpable. If I experience that stigma as a health professional, imagine what it's like for clients who are searching for non-judgmental support amidst the crisis that an unintended pregnancy can bring! Approximately one in three women in Australia will have an unintended pregnancy in their lifetime. Approximately one in three women will also have a termination of pregnancy in their lifetime. These statistics often shock women when I inform them in counselling that they are, as it were, not alone.
Women are often highly self-critical, chastising themselves for being 'silly', not careful, reckless, stupid ad.infinitum. We talk about the gendered experience of shame as well as talking about how their own and others' belief systems are impacting on what they're feeling now.
Other statistics gleaned from my 15 years counselling women at Marie Stopes Australia and The Women's Hospital are also meant to normalise women's experience. I'll sometimes tell women, who are already mothers, that the majority of women presenting for terminations at both those services were already mothers (i.e. women who have children and for a multitude of reasons decide it's 'not the right time to have another '). Each women's reasons are different; emotional, mental health, physical health, financial, practical, social and relationship issues, or a combination thereof. Each woman's reasons are as valid as the next in the context of her being expert in her life circumstances.
Of course not all women decide to terminate a pregnancy and each woman's decision is as individual as she is and counselling assists women to sort through the known risk and protective factors for choosing abortion and also for choosing to continue a pregnancy.
When I talk about abortion and options counselling it’s important to define it in its broader term as both personal support and empowerment, but in terms of feminist social work and counselling practice it’s important to be aware of the broader structural and political issues that women encounter: where the personal meets the political. Women often experience the collective societal shame in regards to abortion that I mentioned earlier. I’ve argued previously in a 2007 paper and I know it's selfish, but ...: public language, unplanned pregnancy decision-making in an anti-choice landscape that we must look at the public language used by Australian politicians in the first part of that decade: language which sought to further stigmatise women who were seeking to make a decision about unplanned pregnancy or to have an abortion, and to witness that the impact on women was both subjugation and resistance to such negative discourse.
I would love to be able to say that 12 years later such discourse has disappeared from public life and women no longer have to navigate such negative discourse, however I think I would be the first to argue that it has in fact not disappeared and indeed much of my work with women is work to understand its impact on them.
Feminist and women-centered counselling places women and their assessment of their lives firmly in the centre in regards to ethical decision making in this area. This might seem like an obvious statement, but in the area of women’s reproductive health, it’s sometimes the thing that gets relegated to the margins the most. Pro-choice counselling means she is the expert. She might or might not need support to work things out but she is capable of making the decision that is ‘most right’ for her, a phrase I love to use as I think women get and put a lot of pressure on themselves to be ‘100% right’ all the time or fear that they’ll be punished or proved foolhardy or somehow ‘lacking’. The act of empowerment in counselling I therefore seek to facilitate is thus assisting women to notice and navigate the systems of stigma, shame and sometimes discrimination they might face in trying to access this area of health care and in relations to making autonomous decisions around their bodies, the health and their lives. I also work with women to learn and practice self compassion for themselves, no matter what decision they make.
Of course, post-abortion and perinatal mental health counselling are also available and can help integrate whatever decision a woman has made into her life. My hope is that women leave feeling better and more in control of their lives, whatever decision they have made. Unintended pregnancy can create challenges to women’s sense of self and identity, as well as their hopes, dreams and goals, and gaining good non judgmental support is crucial -whether that be via counselling or through family and friends. Learning self-compassion and tolerance for uncertainty are valuable tools that will assist a woman in this period of her life and beyond.