SIX WAYS TO GET UNSTUCK EMOTIONALLY AND MOVE FORWARD

SIX WAYS TO GET UNSTUCK EMOTIONALLY AND MOVE FORWARD

I’m a lost cause
Baby, don’t waste your time on me
I’m so damaged beyond repair
Life has shattered my hopes and my dreams

Somebody save me, me from myself
I’ve spent so long living in Hell

These lyrics from Jelly Roll’s song Save Me speak about feeling like he has messed up so much that he’s beyond saving. And yet, he still has enough hope to call out for someone to help.
This song echoes the words and emotions of many of our clients, such as these:

– I don’t know how to live with this. I can’t forgive myself for having the abortion. I have no hope. I don’t think my life is important in any way anymore.
– I’ve been told countless times that I need to forgive myself but I can’t, how can I? Nothing I do has helped me feel like I will ever heal from this.
– I’m stuck. But I feel like moving on is betraying myself and my baby. I don’t know how to not get consumed by all of this grief. I don’t know how to forgive myself.
– Everyone tells me I need to move on, including my girlfriend, but I don’t know how. I try to feel better, but it’s like I’m just going through the motions of life. I feel helpless and like no one is there for me.
– Before my abortion, I thought I would feel relieved and be able to move forward. But I’ve been overwhelmed with sadness that I’m afraid won’t ever go away. I’m so stuck with grief. I need help.
– I wish people knew how lonely and suffocating it is after abortion. No matter what I do, I really can’t run from it. I’m hurting so much, and I can’t stop crying because the pain is just unbearable. Help.

Jelly Roll’s real-life story of transformation from unhealthy choices and patterns is inspiring – and so are those of our clients who forge paths of change.

The first step is moving past feeling stuck and without hope, unable to forgive ourselves. Although, as Save Me shows so eloquently, it may feel like it in the moment, none of us are a lost cause. So, let’s explore what it takes to get unstuck, forgive ourselves, and move forward.

AM I EMOTIONALLY STUCK?

Everyone experiences emotional challenges differently, and signs can vary from person to person. You might be emotionally stuck if you find yourself experiencing any of these symptoms:

  • Persistent negative thoughts
  • Lack of motivation
  • Constant worry, overthinking, or what-ifs
  • Emotional numbness
  • Experiencing flashback or triggers
  • Engaging in repetitive unhealthy behaviors
  • Depending on unhealthy coping mechanisms to avoid dealing with emotions, such as substance misuse, overeating, overworking, or excessive use of tv, internet or gaming

WHY AM I EMOTIONALLY STUCK?

We can feel stuck when we are disappointed about something. Worrying about what others think or how they might judge us can make us freeze. Sometimes we’re afraid we might have to give up something to make a change. Many times feeling stuck is a result of overwhelming negative emotions – we feel scared, sad, anxious, unworthy, guilty, angry, lonely, betrayed, ashamed… and it just feels too hard to move forward.

HOW DO I GET UNSTUCK?

1. ACKNOWLEDGE YOUR EMOTIONS

Grappling with our emotions and past experiences, decisions, or regrets can weigh us down. The burden can be heavy and leave us feeling trapped in a cycle of self-condemnation. It’s okay to feel stuck, overwhelmed, or even lost. The first step toward moving forward is acknowledging our emotions. Confront your grief, regret, anger, sadness, etc. head on without judgment. Avoiding the facts or denying your emotions only prolongs the process. So, take some time to identify and reflect on what happened and what you’re feeling. Some people find journaling to be a powerful tool that helps them see more clearly and make sense of their emotions. By understanding the root of your emotions, decisions, and behaviors, you can start to unravel the layers that keep you stuck.

2. IDENTIFY THE FACTS & ACCEPT RESPONSIBILITY

Explore what you feel guilty, regretful, or angry about. Understand the actions or decisions that led to the situation. Be specific and honest with yourself about what happened and acknowledge your role in the situation. Taking responsibility doesn’t mean blaming yourself excessively. Understand that everyone makes mistakes; it’s a part of being human. If your actions or words affected others, apologize sincerely and seek their forgiveness. However, remember that you can’t control how others will respond, and their forgiveness is not always within your control.

3. BE COMPASSIONATE WITH YOURSELF

Treat yourself with the same kindness and understanding you would offer a loved one facing a similar situation. You are not defined solely by your past actions. Speak to yourself with words of encouragement and compassion. Engage in activities that bring you comfort and joy. Incorporate positive habits into your daily routines, such as regular exercise, balanced diet, and sufficient sleep. Taking care of your physical and mental well-being can significantly contribute to a more compassionate outlook on yourself.

4. REFRAME NEGATIVE THOUGHTS & SELF-TALK

Our thoughts have a significant impact on our emotions. Identify your negative thoughts and patterns. Recognize when you’re being critical or condemning of yourself. Ask yourself questions to help you challenge these ideas. For example, are these thoughts based on facts, or are they assumptions or exaggerations? Try to change the way you talk to yourself. Try saying “I’m feeling stuck” instead of “I am stuck.” Substitute negative thoughts with positive affirmations that emphasize your strengths and achievements.

Often when we feel stuck, that particular area of life consumes our thoughts. Spend some time appreciating what is going well with your health, relationships, work, or other important parts of life. Watch our January 2024 webinar walking through a Life Balance Wheel Assessment, which can help you identify the most important areas of life for you and objectively assess what may need attention and what is working well. This exercise can help redirect negative thoughts and offer insight and a clearer picture of what’s going on.

5. SET REALISTIC GOALS & FOCUS ON SOLUTIONS

Shift your focus from dwelling on the past to living in the present and planning for the future. Set new goals and aspirations, and work towards them. Cultivate a positive mindset that emphasizes growth and progress.

Ask yourself What is the next smallest step I can take? Then commit to spending a short time – even 5-10 minutes on that. This technique can be especially useful when you feel frozen – stuck. Maybe today you feel so depressed you called in sick to work. Maybe your next smallest step is to get a shower or brush your teeth. Maybe you feel like you have no control in your life. Maybe your next smallest step is to identify one area of life – any choice – where you can feel control. Perhaps it’s deciding what you want for dinner, applying for one job, or texting one friend.

If your regret is related to a specific behavior, develop a plan for change. Outline concrete steps you can take to avoid repeating the same actions in the future. This proactive approach can help you regain a sense of control and empowerment.

6. SEEK SUPPORT

You don’t have to navigate this journey alone. Sharing your thoughts and feelings with someone you trust, whether that’s a family member, friend, peer facilitator, mentor, or therapist can provide a sense of relief and help you gain valuable insights.

If you find it challenging to forgive yourself or if the guilt and shame persist, consider seeking the support of a therapist or counselor. They can provide guidance, care, and strategies to help you navigate through your emotions and move forward.

CONCLUSION

Getting unstuck emotionally is a process. And the power to forgive yourself and move forward starts with acknowledging your emotions, identifying the facts and accepting responsibility, being compassionate with yourself, reframing negative thoughts and self-talk, setting realistic goals and focusing on solutions, and seeking support. Your emotional well-being is worth the journey. And Support After Abortion is here to listen and connect you to healing options that meet your needs and preferences.

RESOURCES

Two resources that are particularly helpful in exploring our emotions and behaviors are:

Keys to Hope and Healing, which is an introductory abortion healing resource available for women and men, in English and Spanish, religious and secular versions. Resources include booklets, journals, facilitator’s guide, training videos, and self-guided video series.

Unraveled Roots: Exposing the Hidden Causes of Damaging Behaviors, which helps individuals identify the root causes behind damaging choices and patterns to change their life and legacy by establishing new, healthier patterns one small step at a time. Resources include book, journal, facilitator’s guide, training videos, and self-guided video series. A men’s version is coming soon.

HAVE YOU EXPERIENCED ABORTION?

Reach out to our After Abortion Line by online chat, phone, text, email or messaging on Facebook or Instagram. We offer free, confidential, compassionate support. We can connect you to the healing resource that best meets your preferences – that may be one-on-one, group, or independent; counseling or peer facilitator; virtual, in person, or self-guided; religious or secular; weekend, weekly, or self-paced, etc. Check out our website for information, videos, self-guided healing, and more for women and men.

DO YOU – OR WOULD YOU LIKE TO – PROVIDE AFTER-ABORTION SUPPORT?

Explore our Provider Training Center and attend our free monthly Abortion Healing Provider webinars, Men’s Healing Matters webinars, and Quarterly Facilitator Trainings.

About the Author
Michele serves as Communications Manager for Support After Abortion. She holds a B.A. in International Business and a M.B.A. with an emphasis in Marketing. She and her husband have experienced reproductive loss through three miscarriages and stillborn twins. They live in Greenville, SC with their three daughters.

How to Better Handle Stress…A Great Holiday Prep

How to Better Handle Stress…A Great Holiday Prep

In our December 20 webinar, Support After Abortion CEO Lisa Rowe, LCSW, presented the window of tolerance as a tool we can apply for ourselves and our clients to assess how we handle stress and identify how it impacts us. She discussed what we can do to gain perspective and addressed skills and strategies we can use to restore calm and respond in effective, healthy ways to the demands and stresses of everyday life – and the holidays. She also unpacked the role trauma plays in our stress responses and how stress responses impact abortion experiences. She offered tips and techniques we can try when facing holiday stresses this month. 

INTRO

 

 

 

 

Lisa began by emphasizing how important it is for us to name things that are going on in our lives and the lives of those we touch in order to have a sense of control. 

SUBMARINE – LIMITED PERSPECTIVE

 

 

 

 

“Envision yourself in a submarine,” Lisa said. “As it gets darker and darker, all you can see is what’s in front of you.” She described the limited perspective in this situation and made an analogy to where we are – or where our clients are – and the anxiety and insecurity surrounding the unknown.

TOP OF BUILDING – LARGER PERSPECTIVE

 

 

 

 

Then she asked participants to envision themselves on the top of a building. “Notice all the things you can see,” perhaps an airplane overhead, an ambulance racing down the street to an accident, a band playing outdoors, people walking, etc. “Imagine what a larger view and perspective would feel like” compared to the restricted view from the tiny submarine window.

Lisa then invited attendees to share in the chat feature their ideas of what that would feel like. Responses included that it would feel freeing, empowering, like being able to breathe deeply. One person wrote, “Exciting! From the building top all possibilities are laid out before you…exploring and adventures await!”

WINDOW OF TOLERANCE

 

 

 

 

Lisa then segued into a discussion of the window of tolerance, which is a tool for examining our level of and responses to stress. She walked through the window of tolerance graphic illustrating how stress and trauma shrink our window of tolerance, what it feels like as we move into dysregulation and hyperarousal or hypoarousal, and how tools and training can expand our window of tolerance. 

“When stress, when trauma, when lived experience is causing pain in our life,” Lisa said, “Our ability to see everything, our ability to understand it, our ability to live through it in a healthy way begins to collapse.”

“That’s our goal today – what could you implement today for yourself and for those around you to bring a bigger scope, a bigger understanding,” Lisa shared. “Because when we can see everything that’s going on, the ability to make different decisions, the ability to see things that we couldn’t see [expands from the limited perspective] if we were only looking at it through that little submarine window.”

WINDOW OF TOLERANCE AWARENESS WORKSHEETS 

Lisa dove into awareness checklists for assessing symptoms of hyperarousal and hypoarousal – when our flight or flight or freeze symptoms kick in and may become out of control. She offered scenarios and client examples to illustrate the concepts. 

When experiencing these types of symptoms, Lisa recommended asking ourselves and our clients, Does this emotion really match what’s going on? If not, she encouraged identifying the reason behind a more intense reaction.

 

 

 

 

 

 

 

 

 

Lisa encouraged attendees to share what they do to help themselves or their clients to find a more balanced and less reactive space. Suggestions included deep breathing, using grounding tools, taking a timeout, working to stay in the present, body awareness, repeating a calming phrase like I’m safe, I’m okay

One provider said, “with clients we take a few breaths and change focus. We begin with questions that will encourage the client to be mentally and emotionally present. From there, we encourage the client to share pleasant experiences and guide them to the difficulties that trigger them to attempt to talk about it in a constructive way.”

Another advised, “Hear them,  acknowledge their feelings,  show concern and empathy.. say I’m sorry you are going through this.”

RECOGNIZING YOUR WINDOW OF TOLERANCE

 

 

 

 

 

 

 

 

 

 

Knowing how to recognize your window of tolerance is crucial to being able to self-regulate and bring yourself back inside your window of tolerance when you notice it is shrinking and you are moving into dysregulation. Lisa addressed four steps to follow in this process:

  1. Pay attention to your symptoms – Listen to the noise in your mind and the feelings in your body.
  2. Identify symptoms you experience – For example, you might realize that the sick feeling in your stomach isn’t due to something you ate, but rather it’s because you’re feeling angry or sad.
  3. Identify your distress level – Ask yourself, Is this stressful feeling a 1 or a 10?
  4. Identify the cause – Ask yourself what’s at the root of your distress. For example, you’re sitting at the dinner table and Uncle Bruce starts picking a fight with someone, and you feel your stress level rising. “You feel scared. Ask yourself why?,” Lisa said. “Maybe you realize I’m scared because Uncle Bruce is having one of his outbursts, and I’m scared he’ll yell at me.

SHRINKING OR EXPANDING YOUR WINDOW OF TOLERANCE

 

 

 

 

 

 

 

 

 

 

Lisa talked about various factors that cause our window of tolerance to shrink or expand. For example, our window of tolerance shrinks when fears and negativity rob us of feeling calm, cool, collected, and connected. Using self-soothing tools, positivity, and making new choices are some things that we can use to expand our window of tolerance and regain our equilibrium.

In the scenario with Uncle Bruce, Lisa suggested that to get to the top of the building, your first step would be to take a deep breath. Then consider your alternatives. “You don’t have to stay frozen in the dining room just tolerating his outbursts,” she said. “You might tell yourself I don’t have to be around Uncle Bruce. I can move to a different room, play with the kids, or leave the party.” 

She advised, “connect with yourself, understand why you feel frozen, and give yourself permission to see what other possibilities are there for you.” 

“For any situation,” Lisa continued, “Listen to yourself, connect with yourself, know what’s going on, and climb to the top of the building.”

“When you give yourself the space to be able to see things more objectively on top of the building, your ability to have more tolerance and handle the situation grows,” Lisa said. 

“The whole goal of handling our stress is to move from being able to see that moment or that experience through the submarine window to being able to get on top of that building and expand ourselves” using your soothing tools to feel more in control, regain your perspective, and move forward. 

“And just to reiterate,” Lisa added, “what’s going to shrink it are things that are our traumas, our triggers, our stressors.

WINDOW OF TOLERANCE & ABORTION

 

“Our stress responses impact abortion experiences,” Lisa explained. She asked attendees to imagine various scenarios that clients might experience over the holidays and how to prepare clients for the resulting increased stress they might feel and to plan ahead how to handle stressful situations. 

Lisa gave an example in which a client who experienced abortion a few years ago, might find themselves suddenly reliving those memories when a family member shares their ultrasound picture. “All they can do is breathe,” Lisa said. She described their struggle to handle the dynamic of everyone’s joy and expectations and said, “Their window of tolerance just got sucked in – shrunk.”

She encouraged providers to talk with clients before the holidays for how they can help themselves climb on top of the building and regain perspective and calm. She advised doing the same thing for ourselves.

Q&A

 

 

 

Q. What is your advice about sharing our perspective when someone talks about getting an abortion?

A: “Often we get asked about our perspectives, agendas, or belief systems. I urge people to display as much compassion and [lack of] bias as possible,” Lisa said. “My goal when someone is exploring the decision of abortion and is looking for support,  is always to stay as neutral as possible and to explore every angle. I want to get the client to the top of the building and ask them to do an inventory of what’s going on in their world.” She continued, “I never want to stop at my building and say Hey, this is how I feel about abortion and this is what I want you to do. Lisa added that if someone asks her opinion directly, “and it seems appropriate and healthy for me to be able to share, I am very careful about that. I might say I have met many men and women who have been hurt by abortion, so this decision has a lot of consequences.” Lisa explained that she encourages them “to explore before making this decision. That’s how I allow for my opinion to be heard, but not in a judgmental way.”

Q. I’m anticipating a painful situation with relational dynamics and sibling comparisons this holiday because one adult son is going to announce they’re expecting a baby, while another has been trying for many years to get pregnant.

A: Lisa advised that “the best scenario would be to get in front of this” and have a conversation about the anticipated announcement beforehand with the son who is struggling. 

Q: I haven’t told the struggling son because I’m trying to honor the expecting son’s desire to announce their pregnancy.

A: Lisa encouraged people to be prepared after such a reveal or issue to start a compassionate conversation afterwards with the struggling person by asking “What was that like for you?”

Q. Can cultural differences affect the window of tolerance?

A: “Religious, political, cultural perspectives – anything that can constrict your perspective can affect the window of tolerance,” Lisa said. “Remember those things are about the other person,” she continued. “Don’t let it shrink your window of tolerance. Stay on the building top.”

Q. Can the window of tolerance be applied to conflict resolution?

A: “Yes. If you notice your window of tolerance is getting smaller,” Lisa said, “just ask for a timeout. You can say This conversation isn’t going to end well. My vision is getting blurry and I can’t see everything I need to see right now. Can we take 30 minutes and come back to each other?

Q. Is there a connection between trauma and the window of tolerance?

A: “Yes. Trauma is a major root to our ability to get curious when we’ve had a really serious situation happen to us,” Lisa said. She told a story about a client who has been unable to move to the top of the building after her parents divorced. She had been very close with her dad, so when she learned about his affair, her world with him as her confidant and hero fell apart. She lost her ability to trust. She can no longer connect with her dad or the woman whom he married. And now her mom is getting remarried. The rest of the family has moved on, but she’s still stuck where she was back when she was 12 years old.

Q. How do we engage in conversation when a client seems to be shutting down?

A: “My favorite thing is to name that,” Lisa said. “I’ll say I noticed you’ve kind of shifted in the last 10-20 minutes. Have you noticed that? Would you like to tell me about that? or What do you think is happening?

 

Q. Is taking time to step aside and regroup the same as dissociation?

A: “No. Disassociation is a defense mechanism our brain uses to lift us out of a situation,” Lisa explained. “Separating from or leaving a situation is a coping skill. It’s saying I don’t have the skills in this moment to be able to handle or walk through this situation, so I’m going to take a break. It is a way of feeling responsive and empowered – making a choice to step away. And that’s healthy.” On the other hand, Lisa said, “If we’re thinking Holy cow that’s happening again and take off – that’s running; that’s a defense mechanism. So, they’re very different things.”

 

NEXT STEPS

  • Click here to watch the video of this webinar.
  • Click here to access the Window of Tolerance Awareness Worksheet.  
  • Click here to register for the next Abortion Healing Provider webinar.
  • Click here to access Support After Abortion’s Resource Library.
  • Click here to explore Support After Abortion’s services, resources, and training for Abortion Healing Providers.

 

© Support After Abortion

Navigating Abortion Grief During the Holidays

Navigating Abortion Grief During the Holidays

 

Hallmark, commercials, social media posts … They all paint a lovely picture of the holidays complete with family togetherness, joy, and fun. But what if the thought of all that family time makes you anxious and depressed? What if you’re grieving – whether or not those around you know? How can you navigate the holidays and the potential questions and comments from friends and family members?

Abortion experiences can compound these challenges. Maybe you’re thinking, “I haven’t experienced or been impacted by abortion and, over the holidays, I don’t think I’ll be around anyone who has either, so this isn’t for me.” The thing about reproductive experiences is that often people don’t talk about them. Since by the age of 45, 1 in 4 women experience abortion and 1 in 5 men experience it through a partner’s termination – and the ripple of those experiences can affect their parents, siblings, and others – it’s very likely that someone in your circle of friends and family has been touched by abortion.

Beyond abortion, other pregnancy experiences may make the holidays challenging for us and those we know, such as miscarriage, stillbirth, infertility, infant death, adoption placement, separation, etc. These holiday-survival tips can also apply to many stressors other than reproductive issues – job loss, divorce or break-up, illnesses or health challenges, death of a loved one, relocation, etc. For those grappling with loss or grief, this festive time can become an emotional minefield, making it a challenging time to navigate.

So, let’s talk about why the holidays may be extra stressful for those struggling with their emotions after abortion. Let’s identify some signs that we may be depleted or overstressed. Let’s look at the importance of setting boundaries for our own self-care. And let’s explore ways in which we can provide meaningful support for friends and family.

WHY THE HOLIDAYS MAY BE EXTRA CHALLENGING AFTER ABORTION

The American Psychological Association reports that almost 4 in 10 people suffer increased stress during the holiday season, which can lead to physical illness, depression, anxiety, and substance misuse.

For those coping with grief or loss, the backdrop of festive decorations, cheerful music, traditions, and expectations of joyful celebrations can amplify negative feelings such as sadness, loneliness, and depression. While people’s experiences and reactions to abortion can vary widely, and not everyone will feel the same way, experiencing abortion can be a complex and emotionally challenging process for many individuals, and the holiday season can exacerbate their emotions.

Here are a few reasons why the holidays may be extra challenging after abortion:

    • Emotional Strain: Abortion can evoke a range of emotions, including sadness, guilt, relief, and grief. The holiday season, often associated with joy and celebration, can intensify these emotions and make it more difficult for individuals to cope. The holidays can also serve as reminders of what might be perceived as a loss.
      • A client shared, I try to give myself grace and remember how scared I was at the time, but the holidays are really hard. I cried all day yesterday. I’m struggling with overwhelming regret, depression, and anxiety because of my abortion.
      • Another said, “I don’t necessarily regret my decision because I’m so young and have no resources to take care of a baby, but I feel sad. Last year at Christmas with my family I realized it would’ve looked so different with a three month old on my lap. This year, I’ll be thinking my baby would be a year old. And now my sister’s pregnant.”
    • Social Expectations: During the holidays, there is often pressure to be festive and socialize with family and friends. This can be challenging for someone who has experienced abortion. They may not feel like being around others, especially pregnant women or babies.
      • One client shared, “I had an abortion when I was 18 years old. My mind is still full of what-ifs and I still cry. But it’s not like anyone else knows or would understand. Christmas is coming, and I don’t know how I’m going to handle being around my pregnant sister, or how I can cope in the future watching her baby grow up. I think of my baby every day and feel so guilty. It really hurts.”
      • Another client said, “Emotions about my abortion come up all of a sudden when I see babies, pregnant women, and happy families. The holidays are coming, and I know it’s going to be so hard.”
      • One man in our research study shared that for over 40 years his partner’s abortion “always remains on my mind” when he’s around babies in his family.
    • Questions: They may worry about being asked questions about personal matters, plans for the future, or family size. These conversations can be particularly sensitive for someone who has experienced abortion or reproductive issues, as they may not want to share their struggles or discuss their feelings with others.
      • One client shared, “My family always asks when we’re going to have kids. They don’t know about my abortion, and I can’t talk to them about it.”
      • I remember the discomfort with these types of questions. I didn’t feel like getting into conversations about how many miscarriages, stillbirths, and years of infertility I’d been going through. So I would deflect and try to change the subject. It was uncomfortable and awkward.
      • Often people use such questions as fallback icebreakers, but it’s really best to avoid them. Consider instead asking questions such as, What are you most looking forward to next year? What made you happiest this year? Have you read any good books recently (or watched any good tv shows or movies)? What did you do in your free time last week? Anything that engages the person and sparks a friendly conversation makes for a good question.

SIGNS YOU MAY BE OVERLY STRESSED

The phrase “your cup is empty” is often used to suggest that a person may be emotionally or mentally overwhelmed. Some signs to be aware of include increased irritability, difficulty concentrating, lack of motivation or interest in things you used to enjoy, feeling anxious or on edge, decreased empathy for others, avoiding others, forgetfulness, negative thought patterns, procrastination, increased sensitivity to criticism or stressors, over-eating or excessive drinking, loss of appetite, change in sleep patterns, and physical symptoms, such as headaches, stomach aches, and muscle tension. Clients often describe these types of symptoms. For example:

“Since the abortion, I don’t do anything. I quit college. I’m just devastated. I thought it was the best decision for both of us at the time. I feel so broken.”

“I’m dealing with a lot of grief and guilt since my abortion. I’m struggling trying to find motivation to do my regular activities. It’s been hard. I feel severely depressed and find it hard to eat anything.”

“I’m at the breaking point. I’m always angry or really sad. I cry a lot. It’s affecting my work and now I’m on forced leave.”

“After the abortion, I fell into a depression of what if’s and spiraling thoughts. Honestly, I’m just shut down socially until I feel somewhat capable. I just feel numb.”

I struggled for 15 years with alcohol and drug abuse, acting out, poor decisions, and destruction after encouraging my girlfriend to have an abortion.

My girlfriend had an abortion 10 years ago. Soon after I started using marijuana to cope with my emotions, anger, grief, anxiety and depression.

I’m struggling emotionally from an abortion 12 years ago. Recently I lost my job, we moved, and it all hit me…the abortion…all the memories and emotions of it…and I keep replaying it. I can’t sleep. I feel regret. I’m in therapy, but she’s just focusing on why I can’t focus.

It’s easy to see how someone struggling to cope in these ways could find the holidays an extra strain and challenge to handle. Some ways to help navigate the holidays in a healthy way involve practicing self-care, setting boundaries, and seeking support from friends or professionals.

HOW TO SET BOUNDARIES FOR SELF-CARE TO GET THROUGH THE HOLIDAYS

Setting boundaries means establishing clear and healthy limits on what behaviors, actions, or treatment you are willing to accept from others, as well as what you are comfortable with in various situations. These limits can be physical, emotional, or situation-specific. They deal with personal relationships, work, and social interactions.

Boundaries protect your well-being while nurturing healthy relationships. They are a way to care for and safeguard your physical, mental, and emotional self in ways that you decide are in your own best interests.

Making time for self-reflection, accepting how you’re feeling, setting boundaries for social commitments, and prioritizing self-care are crucial to managing stress and maintaining a healthier emotional state. These are particularly essential through the holidays, especially for those who are coping with grief or loss. Give yourself permission to set boundaries – for yourself, with people who know what you’re going through, and with people who don’t know.

PRACTICAL TIPS FOR SETTING BOUNDARIES THIS HOLIDAY SEASON

Reflect on Your Priorities

Identify what is most important to you during the holiday season. This could be spending quality time with loved ones, taking time for yourself, or maintaining certain routines or traditions. If you really want to celebrate, but just don’t feel like doing all that you usually do, consider simplifying. Identify the traditions or activities that are most important to you, consider making a schedule for what you will do, and politely decline the things that don’t fit your needs this year.

Choose Your Events and Activities & Learn to be Comfortable Saying No

Assess your emotional capacity and choose social engagements wisely. It’s okay to decline invitations or requests that make you feel uncomfortable, stressed, or overwhelmed. If you know certain places or people will push your buttons or trigger your emotions, it’s okay to choose to not participate. Saying no is not a sign of weakness; it’s a way to protect your mental and emotional well-being. If you feel anxious or depressed just thinking about attending a certain event, choose your health and politely decline. And if you think it’s best for you this year, know that it’s okay to choose not to celebrate at all. Instead of doing what you think you should, do what you know will be healthiest for you – whether that’s listening to your favorite music, binge watching your favorite show, or going for a hike. Others may not understand, but it’s important to your own healing journey to do what you need for your own mental health.

Plan ahead

Take time to think about how you want to be treated and what you do or don’t want to talk about. Rehearse responses to comments or questions you think you might encounter. If you know Aunt Millie always asks when you’re going to start dating, or get married, or have a baby, be ready. Prepare topics you are comfortable talking about. When someone tries to discuss something you don’t want to, you can say “let’s talk about ____ instead.” Or, you can simply ignore their remark or question, and ask one of your own that would lead to a conversation you would welcome. If that doesn’t work, you may choose to turn to someone else or walk away. Just because someone wants to talk about a certain topic, doesn’t mean you have to cooperate. Allow yourself to be in control of what you discuss.

Make an Exit Plan

Make an exit plan for conversations and events so you can remove yourself or leave early. Give yourself permission to do what you need. Remember you have control over where you go and what you talk about. If a particular question or conversation makes you uncomfortable, you can ignore it, walk away, and/or say “I prefer not to talk about it.” This can be especially important if no one knows what you’re going through, or if they choose not to respect the boundaries you have communicated. It can also be helpful to have a trusted friend or family member act as a buffer. You can work out a signal ahead of time so they know when you want their help. Then they can interrupt the conversation, guide you away, or even say it’s time to go and help you leave.

Communicate Your Needs

If the people you will be around know about your situation (abortion experience, job loss, reproductive issues, divorce, etc.), clearly communicate your boundaries ahead of time. Often people want to help, but don’t know what to do or say. Consider letting your loved ones know how they can support you – whether that’s helping you decorate the tree, shop, go for a walk, acting as a buffer with others, or respecting your need to spend time alone. Let them know your priorities and any limitations you have. That could include if and how you want them to acknowledge your grief or loss and what you do or don’t want to discuss. Be honest about what you can and cannot do. For example, you may consider letting the host know ahead of time that you may not be able to stay for the whole event, if that won’t lead to uncomfortable conversation. That way if you do opt to leave early, you can just go without feeling a need to explain in the moment. Open communication helps manage expectations and fosters understanding.

Prioritize Self-Care

Schedule time for activities that bring you comfort and peace. Whether it’s reading, listening to music, engaging in a hobby, or taking a quiet walk, make time for activities that help you relax and recharge you physically and/or emotionally. Avoid numbing or pushing down feelings by using alcohol or other substances, which can worsen anxiety and depression.

Once you’ve taken the time and decided on your boundaries, standing your ground and reinforcing your boundaries is essential – regardless of the other person’s feelings or opinions. Remember, self-care is not selfish; it’s necessary for maintaining your mental and emotional health. By setting boundaries, you can enjoy the holiday season while taking care of yourself.

WHAT YOU CAN DO TO HELP OTHERS HAVE A MORE PEACEFUL, RELAXING, AND WELCOMING HOLIDAY SEASON

You may not know what others are going through right now. Here are some suggestions that we can all follow that will have the benefit of helping others have a more peaceful, relaxing, and welcoming holiday season: be kind in your words and actions, be mindful of others’ feelings and accept that they may not be up for celebrating the holidays as usual or how you may prefer, be flexible and extend grace if someone says they aren’t able to attend or need to leave early, create a warm and welcoming environment, encourage self-care, offer support, be a good listener, and respect boundaries others set. Even small gestures can have a big impact on others’ well-being during the holidays. The key is to be thoughtful, considerate, and open to creating a positive and caring atmosphere.

HOW TO NAVIGATE THE HOLIDAYS WITH SOMEONE WHO IS COPING WITH GRIEF OR LOSS

If you have a friend or family member navigating grief or loss during the holidays, your support can make a significant difference. These suggestions assume that the person has shared their abortion experience(s) or other situation(s) with you directly. If that is not the case – if you learned about what they’re going through from someone else, it is probably best to support them with compassion, but without speaking to them about the situation unless and until they bring it up with you.

Here are ways to help:

  • Acknowledge what they’re going through and let them know that it’s okay for them to feel whatever emotions they are feeling.
  • Ask how they want to approach the holidays.
  • Be flexible and supportive. Understand that their emotions may vary, and they may not be up for participating in all the usual holiday festivities.
  • Be a safe, non-judgmental space for them to express their feelings.
  • Be a good listener. Let them share their thoughts and feelings without feeling the need to offer solutions.
  • Respect their need for alone time.
  • Avoid making assumptions about how they should feel or behave or for how long.
  • Offer ongoing support. Grieving doesn’t have a set timeline, and the holiday season can be especially challenging. Continue to offer support beyond the immediate holiday period.
  • Encourage them to seek support, especially if their grief is overwhelming and persistent. You can refer them to Support After Abortion and we can connect them to the type of help they prefer.
  • Respect their boundaries. Understand that they may need to set boundaries for self-care. Respect their decisions and avoid pressuring them into activities they are not comfortable with.

Don’t worry if you feel like you don’t have all the answers. Your role is to provide caring support and understanding. Simply being there for the person and acknowledging their feelings can make a huge impact. As one client recently said to us, “Thank you for making me feel like I matter.”

CONCLUSION

Navigating heavy emotions, grief, or loss during the holidays is a complex and individual journey. Understanding the unique challenges posed by the festive season, recognizing signs of emotional distress, setting boundaries for self-care, and offering compassionate support to friends and family are essential aspects of this process. By fostering open communication, empathy, and understanding, we can create a more supportive environment for those who find this season challenging. As we approach the holidays, let’s remember that kindness, compassion, and connection can be powerful tools in helping others and ourselves through the journey of grief.

GET SUPPORT

“It is important and healthy to ask for help,” said clinical psychologist Angelica Attard in Positive Psychology, to have someone “work with you to start to talk about your emotions, make sense of your experiences, and learn more effective coping strategies to manage your emotions.

Abortion healing is the process of working through your emotions, grieving, sharing your story, and restoring well-being. No one should have to walk through this alone. Let us be there for you. You deserve a safe space of compassion, caring, and access to healing.

Reach out to our After Abortion Line by online chat, phone, text, email or messaging on Facebook or Instagram. We offer free, confidential, compassionate support. We can connect you to the healing resource that best meets your preferences – that may be counseling, support group, virtual, in person, religious, secular, etc. Check out our website for information, videos, self-guided healing, and more for women and men.

DO YOU – OR WOULD YOU LIKE TO – PROVIDE AFTER-ABORTION SUPPORT?

Explore our Provider Training Center and attend our free monthly Abortion Healing Provider webinars.

Take a deeper-dive into stress responses with our How to Better Handle Stress – a Great Holiday Prep webinar that will be held 12-1p ET on Wednesday, December 20th. Register here!

About Support After Abortion

Support After Abortion is a nonprofit dedicated to helping women and men impacted after abortion by (1) connecting them with healing options they prefer, and (2) equipping providers with curriculum, resources, and trainings. Support After Abortion’s free resources include an After Abortion Help Line, a National Abortion Healing Provider Directory, and an introductory abortion healing program.

About the Author

Michele serves as Communications Manager for Support After Abortion. She and her husband have experienced reproductive loss through three miscarriages and stillborn twins. They live in Greenville, SC with their three daughters.

Understanding Codependency & Abortion

Understanding Codependency & Abortion

Intro

“Codependency is one of the biggest topics in abortion healing,” said Lisa Rowe, CEO of Support After Abortion and licensed mental health therapist, as she opened the webinar on Codependency. She explained that questions and comments from abortion healing providers during recent months indicated a desire to explore more about codependency for themselves and their clients. 

Support After Abortion is responding to those requests by offering a three-tiered look at codependency: a toe-dip into the topic today, followed by a 90-minute waist-deep look next week, and continuing with multiple opportunities for a deep dive by joining a group working through an 8-10 week course on codependency.

What is CODEPENDENCY?

Lisa explained, as someone who has been in codependency recovery for over a decade, that the description of codependency that makes the most sense to her is that “in order for dysfunctional relationships to exist – we need someone who makes a mess and somebody who cleans it up.” 

She explained that as a child she “quickly learned that love meant helping or fixing other people” because that’s what was modeled to her and that’s where she found value and affirmation. Lisa shared that she realized much later in life that by carrying this way of finding love and acceptance into adolescence and adulthood, she found partners who made messes and needed her help. 

Lisa noted that helping people is a good thing, but it may be a red flag depending on our motives.

Lisa read a paragraph from her book Unraveled Roots: Exposing the Hidden Causes of Damaging Behaviors that discusses how trees planted too close together can become intertwined and limit their growth potential, drawing a parallel to codependency in relationships.

What does codependency look like?

Lisa unpacked the image at the top of this flyer and encouraged attendees to look for the following while reflecting on the image :

  • Notice the body language
  • Notice what you think they’re thinking about themselves
  • Notice the way the strings are attached
  • Notice if the strings are really attached, or if it is a perception
  • Think of someone you connect with this image – maybe yourself or a client  
  • Think about how this shows up in unexpected pregnancies, and in our offices

Lisa described how in her own life she “at times lacked self-esteem and purpose.” She “tried to wrangle people who turned away from me to try to wrangle them back in. Trying to control everything, including men I was in relationships with, coworkers, my kids.” She explained codependency as an unhealthy attachment to being needed in order to be in control.

Codependency and Unexpected Pregnancy

Lisa pointed out that both women and men can be codependent. So while the image illustrates a woman who is codependent, the ideas being communicated could easily be related to a man.

“Envision the woman in the blue shirt being unexpectedly pregnant and how the dependent connection to her partner influences her abortion decision,” Lisa said. “Or vice versa, imagine a man in the blue shirt with an unspoken tether to the woman and how that impacts his abortion thinking.”

10 Signs of Codependency

Lisa then went through each of the ten signs of codependency on the flyer including:

fear of rocking the boat or upsetting others, having a hard time thinking about your needs in a relationship, worrying about others excessively, obsessing about pleasing others, easily losing yourself in others’ drama/problems, being more comfortable taking care of others than yourself, tending to overshare or overgive, struggling to set boundaries, suffering from self-doubt, and having been raised by a caregiver who was narcissistic, non-nurturing, or had an addiction.

Q&A

How Many of the Signs Mean You’re Codependent?

“If you have one that hits you,” Lisa said, “I’d want you to do a deep dive to better understand why that one area exists in your life. We don’t have to call it codependency, but let’s just say this is a risk factor for unhealthy behavior in relationships. It could be an indicator of low self-esteem. It could be an indicator of looking to somebody else to value you because you don’t value yourself.” 

Lisa said the goal is to understand yourself in a different way, and she offered some questions for self-reflection:

  • How do I feel about myself? 
  • Can I be alone? 
  • If I can’t be alone, what’s the reason for that? 
  • When I am in relationships, do I feel like an equal partner, or do I feel like I’m pulling the weight a lot? 
  • Can I make decisions by myself, or do I struggle with that? 
  • What was my paradigm growing up? 
  • What did I see in relationships that were modeled to me? 
  • How did I see conflict resolved? 
  • What is my motive?

“There are so many things in there that really require us to do deep dives within ourselves and see what our motive is,” Lisa said.” That’s the number one indicator. What is our motive? Do we know who we are, and can we really determine who we are without somebody else? These can be really hard things to ask ourselves.” 

How can we identify if a relationship can become healthy or not?

“All relationships can be renewed or rectified,” Lisa said, “as long as you have renewed… yourself.” She continued, “If we trust ourselves, have an alignment in ourselves so that we know what we want and what we don’t want. We know what our needs are and what we don’t need. We know what we’re secure with and what we’re not. From there, you can enter into any situation and decide how you want to handle it.”

“Often codependent people are like castles,” Lisa said. “Picture them as a Rapunzel-like castle protected by a moat and controlling the drawbridge that lets people in or keeps them out. She explained that we have control, but many have let the bridge down and open – or shut tight – for too long “making all or nothing decisions in relationships.” 

Lisa talked about the importance of connecting with ourselves first. Then we can decide what relationships, situations, or places aren’t healthy for us.

What’s the best practice language for codependency?

Lisa described two schools of thought regarding terms that describe codependency in people. 

Person-first language means we would say “a man with codependency” or “a woman who struggles with codependency” rather than saying “a codependent woman.” This is similar to the recommendation to say “person with substance abuse disorder” instead of “addict” or “person who struggles with alcohol” not “alcoholic.” 

Alcoholics Anonymous follows a different protocol. Their 12-Step “belief system is that we are powerless over that thing,” Lisa said. “And in order to start a healing journey, we need to admit that that thing has power over us. So oftentimes you hear people say I’m an alcoholic rather than saying I struggle with alcohol.”

She cautioned though that many people don’t want to be identified by their issues. For example, we often talk about this with abortion. “Rather than saying post-abortive woman, we encourage this language: woman who has experienced abortion.” 

What can we do to learn more? Next Steps

Today was a toe-dip into codependency.  “If you’re contemplating what else this could mean for you, your clients, your relationships,” Lisa said, “We have several options for you.” She encouraged providers to remember, you can’t sit with somebody else’s junk until you’ve sat with your own. We’re really helping you develop that space for yourself to get the healing you need and better understanding.”

Waist-Deep Dive into Codependency 

90 minute webinar with Lisa

11:30a-1:00p ET OCT 25

Register here

Topics will include attachment, early childhood trauma, lived experience, and intersections with codependency. The webinar will include time for dialogue and Q&A, so come with questions!

Deep Dive into Codependency

Three options for groups that will last 6-10 weeks. 

HEIDI – SUPPORT AFTER ABORTION

This group is for women and will take a religious approach to looking at Codependency using the book You’re Not Crazy, You’re Codependent. The group will meet on Wednesdays at 12p-1p ET beginning NOV 8. MAX 10 people

To register, email: programvolunteers@supportafterabortion.com

SUE KETCHUM – HEARTS RESTORED

This group is for women and will take a religious approach to looking at Codependency using the book Conquering Codependency. The group will meet on Tuesdays at 1p-3p ET beginning JAN 23, 2024. To register, email: HeartsRestored@claritycares.org

KARIN BARBITO / GREG MAYO – SUPPORT AFTER ABORTION

This group is for men and women and will take a secular approach to looking at Codependency. The group will begin in January. TBD: dates, time, and book.

For more info, email: programvolunteers@supportafterabortion.com

What would you do first today if you identified symptoms of codependency in yourself?

“I wouldn’t go changing the world today,” Lisa said. She encouraged attendees to sit with their feelings, pause in that space. She suggested expressing what you’ve learned with a healthy friend, reading Unraveled Roots, journalling, and taking a deeper leap with the 90-minute webinar and/or the weeks-long groups. “Don’t walk away from today thinking something really stuck with me, but it scares me; I’m going to ignore it,” Lisa advised. “Remember it’s a journey. You didn’t get here overnight,” she continued. “Some people want to go change every relationship. I want you to take a pause in that space, create a network of support, and walk slowly into this.” 

Conversations with Attendees

Deborah shared, “How I would have loved to have heard this early on.” She said it’s interesting to look back on her journey in light of the 10 Signs You May be Codependent and realize what she was doing back then. She said she and her husband didn’t discuss their abortion for 23 years, leading to “a lot of life patterns and self destructive things.” She said, “How codependency affects our lives and our choices is very real.”

Georgia said, “I had the privilege of doing an Unraveled Roots virtual group. It was eye-opening. I didn’t realize I had a codependency problem. But it explained a lot through childhood, adolescence, and adulthood. Some of the choices I made, most of which were self-destructive, stemmed from certain aspects of codependency, and I wasn’t aware of it. I didn’t even know there was such a thing. It helped me get to the point where I’m able to identify when my borders are coming down, especially when I’m working with a client. Then I stop and ask myself, Is this an actual need or my needing to help. It allows me to step back if this isn’t going to benefit my client. It’s not something we may be readily aware of, but it’s there, and it interferes with effectively serving our clients.”

Click here to watch the video of this webinar.

Click here to email for more information about Support After Abortion’s coaching program for facilitators. 

Click here to register for the next Abortion Healing Provider webinar.

Click here to access Support After Abortion’s Resource Library.

Click here to explore Support After Abortion’s services, resources, and training for Abortion Healing Providers.

Facilitation in Action

Facilitation in Action

This month’s training webinar topic, Facilitation in Action, is the finale of a four-month series on facilitating support groups. The previous months’ topics were How to Assess if Your Client is Group Ready, Ethical Responsibilities of Abortion Healing Providers, and Support Group Guidelines. Each of this month’s speakers has facilitated groups for years, trained facilitators, and participated in support groups.

What are the most common problems support group facilitators experience with group participants?

During last month’s webinar on group guidelines, providers shared via online survey that the most common problems they experience with support group participants are:

  • Monopolizing conversation
  • Not attending all sessions
  • Giving advice
  • Filling silence

This month’s training showcases how to effectively navigate each of these issues.

How can facilitators best respond to these challenges to create positive group dynamics?

Lisa Rowe, licensed mental health therapist and Support After Abortion CEO, led an engaging, educational, and rather entertaining four-part role play with Greg Mayo, Men’s Healing Strategist, and Heidi Inlow, Case Manager, to illustrate best practices for facilitators – and what not to do.

Lisa played the role of facilitator, something she is well-versed in having done so in real life for over 100 support groups. Greg and Heidi played group participants. Greg earned the collective amusement and irritation of attendees for his expert portrayal of a problematic participant. Perhaps his acting was honed by real life, as he said at the outset that he would be playing a past version of himself having been a source of each of these problems at some point over his many years of attending and facilitating support groups. Heidi and Lisa also perfectly showed how these problems creep in, often without any intentional thought. Lisa demonstrated how facilitators can miss the mark, as well as how they can navigate these challenges, redirect conversations, and successfully guide reflection and dialogue.

As the role plays unfolded, attendees observed which of the four behaviors was being depicted, what went well, and what didn’t go well in the role play group.

Recap – Watch the Video!

Normally our recaps provide the meat of our training webinars so that people who prefer to read a recap rather than watch the hour-long video replay will be able to receive all the important information in a text format. However this month, to receive the content, essence, and significance from the role playing, you really need to listen and watch to observe and absorb each person’s words, facial expressions, body language, non-verbal cues, etc. – just like in an actual support group. So, we’re just going to provide you with a short summary, a few highlights, and then encourage you to watch the replay! We think you’ll really enjoy it – and learn a thing or two or ten that you’ll want to incorporate into your next support group facilitation adventure.

Monopolizing the Conversation

Man, Greg did a “fabulous” (read “really irritating”) job monopolizing the conversation. Look for how Lisa missed the mark as a facilitator in setting the tone from the outset by oversharing and talking too long. Look for how Heidi responded after Lisa’s and Greg’s lengthy openings. Then watch for how Lisa shifted and shows how a facilitator can do a better job setting the structure and consistently following through on expectations.

Advice Giving

Look for how Lisa again illustrates missing the mark, this time by interjecting unsolicited advice. And watch how Heidi perfectly portrays a participant jumping in to offer unsolicited advice directed to another participant. See how in both cases the result truncates the conversation and the sharing person’s processing of their own thoughts and feelings, and how it boxes them into only the direction of the advice. Then observe how Lisa gently redirects the conversation to set a healthy boundary and explains to the group the reasons behind doing so.

Skipping – or Skipping Out During – Sessions

In the third role play scenario, look for how Greg’s mid-session disappearance – and how the less-than-ideal way in which Lisa deals with it – shuts down Heidi’s ability and willingness to speak and work through the emotions she was getting ready to dive deeper into before the interruption. Then reflect on Lisa’s pivot and her example of how to better deal with such a situation. Several ideas offered by attendees were discussed.

Filling Silence

Observe how Lisa effectively sets the expectation and skillfully redirects as needed to safeguard silence for reflection. Many attendees commented on how illuminating this filling silence role play was. One new facilitator said she realized during the role play that in her group they all – including herself – interject during others’ stories. She said it was helpful to see through the role play what holding space means and that she will bring that into her group. Another provider said, “It was great to see a real life example of what it looks like to intentionally invite silence into the conversation.”

Don’t Miss It!

Attendees shared how helpful the role plays were – both for seasoned and new facilitators. Many said it was a great way to teach/demonstrate what to do and what not to do when facilitating support groups. Click here to watch the video.

**NEW**

Men’s Keys to Hope & Healing Video Facilitator Training Series

Greg shared that after months of work by many Support After Abortion team members, we are launching our new Men’s Facilitator Training video series!

Greg noted that as he travels and speaks he sees more and more men coming forward and sharing their stories and their desire for healing. This resource fills a gap to train men to facilitate KHH support groups for men.

Both the Men’s Keys to Hope & Healing Client video series and Facilitator Training series will be added to Bright Course / Bright Training this fall.

Click here to email for more information about Support After Abortion’s coaching program for facilitators.

Click here to register for the next Abortion Healing Provider webinar.

Click here to access Support After Abortion’s Resource Library.

Click here to explore Support After Abortion’s services, resources, and training for Abortion Healing Providers.

Support After Abortion: Acknowledge abortion as pregnancy loss this month

Support After Abortion: Acknowledge abortion as pregnancy loss this month

NORTH PORT, FL–As the 36th Pregnancy and Infant Loss Awareness Month begins October 1, the research and education group Support After Abortion is urging the mental health community to recognize that pregnancy loss also includes abortion loss.

“Nearly one million women experience abortion each year,” said Support After Abortion CEO Lisa Rowe, a licensed therapist and social worker. “Yet many suffer its adverse issues silently, unable to fully acknowledge and work through their loss because abortion is too often viewed as a political or religious issue instead of appropriately as pregnancy loss.”

Support After Abortion’s nationally representative research shows that one-third of women who experienced medication abortion and 71% of men who experienced abortion through a partner’s termination suffer grief, loneliness, anger, and other issues. This included 78% of men and 55% of women who identified as pro-choice. Yet just 18% of women and men know that after-abortion healing resources exist.

Rowe said acknowledgements of pregnancy and infant loss help families feel supported – which makes the absence of abortion mentions even more conspicuous. “Our culture needs an entire shift,” she said. “Popular medical websites, federal agencies, and elected officials acknowledge the tragedy of pregnancy loss, as well as the emotional difficulties women may face after losses such as miscarriage or stillbirth. But that acknowledgement is missing for people who suffer after abortion experiences, which causes women and men to unhealthily suppress their pain.”

Support After Abortion provides a number of anonymous, professional resources to assist women and men who experience pregnancy loss through abortion:

“Support after pregnancy loss is really about meeting hurting parents where they are and letting them know they’re not alone,” concluded Rowe. “But healing is much harder when people feel ignored, condemned, or stigmatized.”

About Support After Abortion

Support After Abortion is an abortion-healing organization that promotes compassion, collaboration, and capacity to create gold-standard care for women and men suffering from abortion’s adverse impacts.