By Elena Masilungan, Newsbreak’s Maggie De Pano Fellow. Originally published on Newsbreak.

MANILA, Philippines – Of the many potential side consequences of unsafe abortion, mental, emotional and psychological trauma are the most difficult to recover from.

Often, this is not overtly manifested but it stays with a woman long after the physical wounds of abortion have healed and the disabilities have been treated.

The stigma associated with abortion, however, is so prevalent that psychologists and counselors who provide the critical service of helping post-abortion patients cope with their mental and emotional trauma would rather tiptoe around the issue.

Patients recuperate from post-abortion complications at the Fabella Memorial Hospital (Photo taken by Elena Masilungan for Newsbreak)

Except for a few, psychologists and groups known in certain circles to be offering post-abortion counseling services refused to confirm that they are doing so for this report, afraid of being mistakenly seen as condoning abortion.

This attitude makes it difficult for women suffering from post abortion depression to access these services.

“Abortion is a continuing nightmare for me even though the one I had happened years ago already,” said Sonia, a 29-year old wife and mother. “I cannot fully enjoy my bonding moments with my three kids because I always feel guilty. I get angry with myself that I can enjoy these with them, yet I denied my baby the same experience.”

The depression gets most severe whenever the anniversary date of the abortion comes around. On those days, Sonia said. “I cannot concentrate on anything else, not even on work. All I want to do is to lock myself in my room and cry. I keep talking to my dead baby and I keep asking him to forgive me.”

Sonia had to be treated for post-abortion complications in a private hospital. These have not done any permanent damage to her health and physical wellbeing. But when asked if she wanted to undergo counseling with a psychologist for her post-abortion depression, Sonia shook her head. She fears the stigma and judgment that she is sure she is bound to get from people once they know her “secret.”

Ideally, post-abortion care should include counseling as one of the services that health care providers must offer their patients. If possible, it must be done in the health facility where they are undergoing treatment. But most hospitals in the country do not offer post-abortion trauma counseling.

“Our hospital does not provide any trauma counseling for our post-abortion patients,” admits a consultant with a tertiary teaching hospital in Quezon City. What they provide, the consultant said, is family planning counseling to help them prevent unwanted or unplanned pregnancy in the future.

The consultant said, however, that there have been instances when she had to refer a patient to a psychologist either because she was worried about her mental and psychological state at the time she was getting treatment for post-abortion complications or because the patient’s parents requested for it. But these instances are very rare.

At the Philippine General Hospital, doctors can ask counselors from the hospital’s social service department to see patients who show signs of mental distress and psychological trauma. And at the San Pedro Hospital in Davao, nuns go the rounds to give spiritual counseling to post-abortion patients.

There are also private groups of psychologists and counselors who give post-abortion counseling. But they do not openly disclose that they are available for such services. Mostly, it is through referrals from doctors or from help hotlines that patients find their way to them.

In a middle-class community in Manila, a shelter for unwed mothers that also temporarily takes care of unwanted infants provides counseling to post-abortion patients, although it does not openly promote this service. “Abortion is such a sensitive issue and we do not want to bring unnecessary attention to our group lest we be misinterpreted as condoning abortion,” the social worker, who refused to be named in this report, said.

In a province south of Manila, a rehabilitation center for substance abuse clients also has a program for post-abortion patients who need “spiritual healing.” These patients come from maternity homes run by nuns and from other rehabilitation centers dealing with drugs, alcohol and sex addiction.

“Some rehab centers send their patients to us because it is fairly common for those undergoing treatment for drugs, alcohol and sex addiction to have gone through an abortion, even multiple abortions at that,” explains the executive director who runs the center. Like the other sources for this story, he refused to be identified in this report.

According to the social worker, patients reach the Manila facility for unwed mothers and unwanted infants through an established network that includes hospitals and health facilities, shelters run by nuns and other pro-life organizations, and rehab centers whose programs are God-centered.

There are resource constraints. “Much as we want to reach as many distressed patients as we can, we are limited by financial constraints,” the psychologist said.

But the fact that abortion is a sensitive issue, the psychologist admitted, is also part of the reason why they don’t openly publicize the work they do. “We are just being careful because some people may get the mistaken idea and think that we see nothing wrong with abortion.” – Newsbreak

The series was produced under the Maggie de Pano Fund for Investigative Reporting on Health. The Fund, which is managed by Newsbreak, is made possible through a grant from Macare Medicals, Inc.

Also in this series:
Dying in silence: How abortion kills Filipino mothers
Abortion in the Philippines: what the law says
Desperate women seek desperate measures