The right to abortion and access to safe abortion care has been extraordinarily politicized in the US (and elsewhere) for decades now and women’s physical, emotional, spiritual, and psychological needs have been ignored, distorted, and caught in the cross-fire. So I have found it exciting to be able to read and review the ground-breaking new book “Abortion Counseling: A Clinician’s Guide to Psychology, Legislation, Politics, and Competency” by Rachel B. Needle, PsyD, and Lenore E.A. Walker, EdD. In a clear, straightforward, and informative style that is accessible to all, Drs. Needle and Walker emphasize the importance of abortion counseling for women who may be contemplating an abortion, or those who have had one. The authors emphasize that “abortion counseling has a critical role to play in ensuring women’s mental health is the priority not the goals of a political agenda.”

Powerful words. The authors deal with this theme admirably and thoroughly. They state unequivocally that “unintended child-bearing is destructive to the mental health of women and their families [and] women’s mental health has become a political weapon in efforts to restrict legal access to abortion.”

With readable scientific information covering a myriad of topics in a comfortable format, Drs. Needle and Walker give readers dynamic ammunition and knowledge to cut through the vast anti-choice rhetoric that legal abortion harms women. Women’s cognitive decision-making and competency skills, the reasons women choose abortion, women who are high-risk for negative post-abortion outcomes, the myth of “post-abortion syndrome,” family violence, debunking myths about women’s reproductive health care, a model program for post-abortion counseling, the endless legal restrictions that attempt—and often succeed—in denying women access to safe abortion care, and the impact of the abortion debate on women, therapists, and clinic workers—these are among the issues covered in this comprehensive book.

Dr. Needle has a compelling and unique motivation for co-writing this book. The book is dedicated to “abortion providers [as] the true unsung heroes of this movement.” This includes Dr. Needle’s mother, who has worked in the field of abortion care for more than thirty years.

“Growing up the daughter of an abortion provider, I witnessed first-hand the controversy surrounding abortion and how the controversy harmed women," says Dr. Needle. She goes on:

Mental health professionals, on the whole, are not trained to address women who are considering abortion, or women who have terminated a pregnancy. There is no training on abortion counseling for mental health professionals and therefore there is minimal awareness of what is involved. There is a lack of understanding about abortion legislation and regulations, and little appreciation for how legislation can impact a woman and her family.

As Dr. Walker and I began to notice this lack of information available to mental health professionals, we felt the need to provide this resource where currently practicing clinicians and clinicians-in-training could go to learn more about abortion, including legislation, the myth of post-abortion syndrome, decision-making, competency, and how to assist women prior to and following an abortion procedure. Therapists and health care professionals need accurate information to assist women in making their own decisions about pregnancy planning.

Most importantly, despite the fact that the majority of research finds no evidence for negative psychological affects following pregnancy termination, the construct of a "post-abortion syndrome" continues to be raised by politicians and in the media. But research continues to find that terminating an unwanted pregnancy by an induced abortion does not cause women to become mentally ill. Those few women who may develop emotional problems after an abortion are then likely to misattribute their distress to the abortion rather than to the other factors that actually are known to create such emotional distress. These factors include pre-existing psychiatric conditions and a history of physical and sexual abuse. When these factors are controlled, studies of women who chose to have an abortion find that they are no more likely to suffer from depression, anxiety disorders, psychotic problems, or suicidal behavior than those women who chose to carry the pregnancy to full term.

Given all of the anti-choice rhetoric, distortion, and misinformation, as well as the lack of training in the area of pregnancy termination, it was time for a book to educate all those who are engaged in both pre- and post- abortion counseling. In order to do so, again, it is important for therapists to understand the politics and legislative history affecting women’s decision-making, be knowledgeable about accurate information about the abortion procedure itself, and understand the psychological theories about the development of stable emotions to assist counselors and therapists in determining the woman’s emotional state both pre- and post- termination. Finally, therapists—as well as the public—must be aware that research demonstrates that "post abortion syndrome" does not exist, even though some women may have some temporary negative or ambivalent feelings.

This is why we wrote our book. We trust that it will be helpful.

Yes, it is. “Abortion Counseling: A Clinician’s Guide to Psychology, Legislation, Politics, and Competency” is a book for everyone interested in knowing the truth about women, abortion, and women’s mental health. Whether you are new to the issue or a veteran, there is much to learn from this excellent resource.

I wish this dynamic book had been available when I first started to counsel women having abortions in 1970. There was no developed profession of abortion counseling at that time and we created a new field. This compelling book puts it all together with updated information and clear scientific discussion and analysis. “Abortion Counseling” cuts through the lies and will help to frame the future for women’s mental health as we continue to articulate the truth about abortion.