Mental health awareness means putting people ahead of stigma

Mental health awareness means putting people ahead of stigma

Abortion stigmas often get in the way of providing compassionate, safe spaces for healing.

Support After Abortion CEO Lisa Rowe, a licensed mental health therapist and social worker, released the following statement at the end of National Mental Health Awareness Month:

President Joe Biden launched National Mental Health Awareness Month with a reminder that “we all have a role to play in ending the stigma around mental health.” For those without mental health challenges, he correctly said their role “starts by showing compassion, so everyone feels free to ask for help.”

America has come a long way on mental health since the first Awareness Month in 1949. Unfortunately, some mental health challenges are still stigmatized, which is why the estimated 22 million Americans who struggle after abortion are often ignored because abortion is portrayed as a political or religious debate.

Support After Abortion’s research shows that 34% of women who experience a medication abortion and 71% of men whose partners or ex-partners experienced any abortion suffer adverse impacts. And over 80% of women and men have no idea where to look for emotional and psychological support. It’s no wonder that they often suffer for years in silence.

Our After Abortion Help Line and After Abortion Referral Directory were created to be a pathway to improved mental health. Our therapist, counselor, and other referral partners focus on the humans in front of them, using best practices from the Academy of Certified Social Workers, Support After Abortion’s research, and other resources.

For almost 20 years, I’ve worked with underserved communities facing mental health crises. I first helped teenage girls and their families; then girls and women escaping sex trafficking, and women facing unintended pregnancies. Today, I work with women and men who are facing emotional and psychological challenges after one or more abortions.

Each of these people deserves compassion for their struggles and the freedom to ask for help, even if it challenges the rest of us to go outside of our comfort zone.


Special Guests 

Support After Abortion was joined by special guests Melissa Ohden (Abortion Survivors Network), Missy Martinez-Stone (Reprotection), Michelle Lawler (Hugs Over Ginger), and Brittany Paladino (Abiding Love Adoptions and Charities). 

What is Wrap-Around Care?

Wrap-around services are part of a team approach to client care based on the strengths and specialities of various professionals who can support a particular client’s needs. This webinar’s guests addressed specialized care for clients who have survived abortion, parent survivors, desire justice after harmful abortion clinic experiences, suffer from hyperemesis gravidarum (a complication of pregnancy), or may be interested in birth-mother focused adoption placement, or who have experienced adoption placement. 

What is the Connection with Abortion Healing?

Specific circumstances have heightened risks of abortion and therefore intersect with the need for abortion healing. For example: women who experience failed, stopped, and reversed abortions often feel deep guilt and shame. Women who have experienced traumatic abortions and/or medical complications often feel intense anger, regret, and guilt. The severe physical, emotional, and financial toll on women who suffer from hyperemesis gravidarum (HG) leads many women to terminate otherwise wanted pregnancies. One study found 15% of women with HG terminated at least one pregnancy due to HG and 6% had multiple abortions due to HG. And, women who place children for adoption and do not receive after-placement support are more likely to choose abortion for a future unintended pregnancy due to undealt with emotions. There’s a beautiful intersection of healing across each of these organizations and providers were encouraged to collaborate to better care for clients with these needs.

Melissa Ohden – Abortion Survivors Network 

Melissa shared that people are often captivated by her story as a survivor of a failed abortion, but in the webinar she focused on the work her organization does. In addition to serving adult survivors of abortion, the Abortion Survivors Network works with women who experience failed, stopped, and reversed abortions. They support women who are raising their children afterward. They come alongside adoptive parents, such as a couple she spoke with yesterday who are parenting a 10-month old who survived abortion pills. 

Who is an abortion survivor?

An abortion survivor is “literally, a baby who survived an attempt to abort them,” Melissa said. She talked about the importance of language and noted that “some refer to themselves as an abortion survivor if their mother considered abortion,” but that is more appropriately termed “targeted for abortion.” 

How to care for women who experience failed medication abortions?

She discussed how pregnancy centers and other providers can best care for women in this situation. She said women who experience failed medication abortions are “in incredible crisis” and under “so much stress” because “This is not what they were told to expect. They were told this problem would go away.” 

She also emphasized what not to do. Melissa said, “This is NOT the time to say to a woman, What a miracle! Congratulations! No! We may not ever get there. What she needs to hear you say is, Oh my gosh, this must be so overwhelming. You’re probably shocked right now.

She said often they are “reaching out for answers on failed abortions” and will ask “tell me what I did to my baby?” They “want truth and need hope.” They need help to address their crisis and stress. 

Melissa said that the medical community’s response is to continue the process, “Unless they have a pro-life ob-gyn, they are being counseled for another abortion.” She explained that may be another medication abortion, and if the pregnancy still continues, then a surgical abortion.

Melissa urged providers to “assess, address, and reduce the stress the woman is under – it’s sky high.”

What support does the Abortion Survivors Network offer?

The Abortion Survivors Network offers one-on-one support through clinical social workers, grief support, and help biological mothers and adoptive parents who are parenting survivors of abortions (age infancy to 30yo). “Our care goes beyond pregnancy,” she said “into parenting and recovery from failed abortion.” She spoke about the need for long-term wrap around support in these situations for improved parenting. “The fear, shame, and guilt don’t end when the crisis is averted in pregnancy. This is not a green meadow where we get to just arrive and say, hurrah.” Yet she said, “As hard as that can be sometimes, it’s exciting to me because there’s hope in the midst of that. Those are circumstances we can all enter into with them to have a dramatically different outcome in families.”

Engaging attendees in the chat, Melissa said, “We are working on a research study that should be conducted this summer. We will be taking that research and creating a formal model of response and care–medically, emotionally, socially, even in messaging to her and how to speak to her/identify her when she’s coming into a pregnancy resource center or healing program. You can sign up on our website to be included in upcoming trainings we’ll be providing for that.”

Missy Martinez Stone – Reprotection 

Missy described the experience of pregnancy centers and providers whose clients tell them about a terrible experience at an abortion facility. “Before Reprotection, there was never really a consistent and safe place to take that information and make sure that it was acted upon in a way that was client-forward that really put the woman’s needs first,” she said. “We partner with pregnancy centers, we take that information,  we find out what law was violated and who is responsible for oversight, we get it into the hands of the authorities, and we make sure that they are held accountable for the harm that they cause.”

She offered examples of an abortion facility that was disciplined because their office manager was handling the informed consent conversations. Another example was a woman “running out of the facility screaming Call 911 because she was afraid for her life.”

Is there a fee for Reprotection’s services?

No. Missy explained that Reprotection’s work is not medical malpractice or civil litigation. They are not attorneys. Rather, they identify state and local agencies “responsible for general medical regulations,” such as medical boards, zoning authorities, and health departments to help women get justice. And they use government processes and resources for filing complaints. “We volunteer our time for clients,” she said.

What language and protocols does Reprotection recommend?

“Everything we do puts the client first,” Missy said. She encouraged conversation with clients and then providing general information, not  a client’s private information. 

She urged pregnancy centers to comply with HIPPA. She also said, “We have a policy that we don’t ever take information that was obtained illegally.” She told attendees, “Don’t violate any rules when obtaining information about the abortion facility. Don’t trespass onto property and dig through their dumpster.“ 

She also urged attendees not to take pictures. “People like to take pictures of ambulances at facilities. We don’t need it,” she said. “It can feel very invasive to the woman going through a complication. If she looks out the ambulance window and there’s a person holding their phone, that feels very insensitive.” 

Rather than client specifics, she encouraged providers to share with Reprotection trends they see as they talk with clients and listen to their experiences. For example, a center might share that several women told them “they were put in a room with ten other people and given the pill all at the same time.” Another example she offered was that of a case in Arizona where “people on the inside” of a Planned Parenthood facility told them when a particular doctor worked there would be “a lot of complications” because “he cuts corners.” She explained “That does not violate HIPAA. That’s not giving away any kind of patient information. So you can report that to us in a way that honors their privacy, honors their care, but also gets us the information we need to hold [the facility] accountable.” She continued, “We can use that information to figure out how is this facility running? What are their tells? How are they treating women? And we can use that information to create a strategy and narrative to take it to the agencies.” 

What training does Reprotection Offer?

Reprotection offers a Client Safety Advocacy class through Heartbeat Academy. They offer discount codes if cost is a barrier. The class “gets into the minutiae of how to identify violations.”

Missy described three categories of states in Post-Roe America: nearly illegal abortion, fully accessible abortion, and those in the middle. She described scenarios that might be observed. For example, in states where abortion is illegal, is someone doing illegal abortions? In states with full access, she said Reprotection is looking at cases of human trafficking, mandatory reporting violations, zoning rule violations. She also said, “It doesn’t have to be an abortion specific rule, especially in places like New York, California, Illinois. We can make cases of general medical negligence without ever touching abortion code.”

She said Reprotection’s philosophy is “If you see something, say something, and we can determine, if a violation occurred and what are the next steps.”

What questions to ask women when you get the sense something is wrong?

Who did you see? Where did you go? Did you feel heard and cared for during the process? Did you have any questions or concerns that weren’t answered? Did you feel prepared for what you experienced? Missy noted that especially with medication abortions, “We’re hearing they’re not being properly prepared for going home and losing their child in their bathroom and what they’re going to see.” Did you have complications? Missy commented that women are reporting facilities telling them they don’t do follow up appointments and telling women experiencing complications, “You’re not our patient. Go to the ER. This is not our problem.”

Missy said, “If they’re upset, you’re going to get an ear full. They’re going to tell you they want justice. They want to be told that what they experienced was wrong.” She explained that we’re taught to trust medical practitioners “so when that is violated, that is really traumatic. And when you have complications and they’re not answering your questions, it is really upsetting. This is a vulnerable place to be in.” And that’s why Reprotection exists – for “women who have an unsafe or traumatic experience who desire justice for the harm done to them.”

Michelle Lawler – Hugs Over Ginger 

What is Hyperemesis Gravidarum

Michelle discussed her new ministry, Hugs Over Ginger, which she is developing to support women with a specific pregnancy complication called Hyperemesis Gravidarum(HG), which Michelle noted “literally translates to excessive vomiting of pregnancy” and is often described as extreme morning sickness. Michelle explained, “It’s not just vomiting, but it’s the feeling that you have to, so that it actually causes you to become malnourished and dehydrated, inability to eat and drink normally, inability to function.” She said women often need medications and intravenous feeding for nutrition and hydration. Michelle addressed the emotional, physical, and financial toll that HG causes for women who experience the condition.

Michelle shared that she realized only after the fact that she had suffered from HG during her first pregnancy. She said she was really sick throughout her pregnancy and lost 20 pounds but thought, “everybody gets morning sickness, why am I not handling this very well? I need to get over this. I had a lot of guilt and shame that I was missing work and being a baby.” She said she thought she could just “power through this pregnancy.” 

She anticipated the condition in her next pregnancy “because if you have it once, you’re much more likely to get it again.” She said, “I was sitting there thinking, I’m thankful that I have the support that I need around me when I get sick. But how many women don’t have that? They have other kids, and they can’t work, they can’t pay their bills. Everyone’s telling them they’re crazy. It’s in their head. And what about those women? Who’s there for those women? And that’s when I said, I need to do something about that.” 

She said it’s been a few years and the desire to help other women suffering HG has grown deeper, so she is launching Hugs Over Ginger as an official 501(c)(3) with the goal to “come alongside women” and to educate pregnancy centers about the condition “and help you walk alongside that woman.” 

One service she plans to offer is care packages tailored to HG. In answer to a question in the chat, Michelle said the care package “will include things such as socks, water bottle, headband, a devotional/journal that I am writing to keep her going each day in her pregnancy, coloring book, colored pencils, etc.”

Why is HG a pro-life issue?

HG is a pro-life issue because women suffering from HG have “a much higher abortion rate than your average pregnancy,” Michelle said, “because women are so ill and it just inhibits so much of what you’re able to do in your life.” 

One attendee echoed this in the chat, “I had horrible morning sickness on top of the unplanned pregnancy and all the stuff I was dealing with. I felt horrible all day and could barely make it to work. It was one of the main reasons I decided to terminate both pregnancies.” 

Michelle said online HG communities such as a Facebook group “were super helpful, because they help you with remedies or they give you encouragement.” However, if a woman “even mentions that they’re thinking of an abortion due to their condition, these women will just say, you go do that. You need to think about yourself in this situation.” She was even privately messaged by the group Admins when she offered an “alternative to their idea of abortion.” She noted the groups are “just inundated with very abortion minded people.”

What’s in a Name? Why “Hugs Over Ginger”

Michelle shared that the reason she named her organization Hugs Over Ginger. The H and G are a nod to the condition Hyperemesis Gravidarum.  “Ginger is kind of the classic remedy that people will offer when you say I’m sick with my pregnancy.” She shared that this is often a source of frustration for HG sufferers because it minimizes the extreme nature of their suffering. Hugs references the need to offer support, validation, and compassion.

“Once they’re in the heat of HG, you just have to really manage the symptoms and give them support,” Michelle said. One woman wrote Michelle, “I’m going to Planned Parenthood, I just can’t do this anymore.” Michelle said her message to the woman was, “You can do this. You are strong. This is temporary. And that’s all she needed – just the encouragement to keep going. She needed somebody to have faith in her and understand that she was hurting and she wasn’t alone.” 

Brittany Palladino – Abiding Love Adoptions and Abiding Love Charities

Abiding Love Adoptions is an adoption agency licensed in Florida, South Carolina and Georgia. Abiding Love Charities is a separate 501(c)(3) national charity that offers after-placement support for birth mothers, adoptive parents, and adoptees. “What makes us different,” Brittany said, “is that we are only working with the expectant mom. We focus on her needs because making an adoption plan is a journey, not necessarily just a decision.” 

How do Abiding Love Adoptions clients find adoptive families?

Brittany explained that Abiding Love wants birth mothers to have “as much choice as possible.” They work with “trusted faith-based adoption consultants” so “she gets more choice of families that she can select.” She also said that because they work with consultants, they are not bound by a set wait list nor do they need to consider wait list fees. 

What is best practice language to use regarding adoption?

Brittany explained why the frequent terms “put up” and “give up” are discouraged when discussing adoption. She shared that “Put up” derives from the Orphan Trains and said the focus was “not necessarily to be adopted,” rather “These children would be put up on platforms outside of the train station to see if there were families interested in adopting them to work on their farms. And when they weren’t adopted at that station, they were loaded back up on the train and then put up on another one. So that’s why we don’t say “put up.” It was a form of slavery. It is a really negative thing to say.“ She said, “give up is a little different.” 

Brittany said the term “give up” is a misnomer. As a birth mother herself, having placed a child for adoption almost 13 years ago, Brittany said when she hears the term “give up,” she asks, ” What makes you think I gave up on my daughter? Rather than “giving up” she said, “I explain it as a role change. Before I signed her paperwork, I am her biological mother. Now that that adoption has been finalized, I’m still her biological mother. But I’m her birth mother now, so my role in her life has changed, but my connection to her and my love for her has not changed.”

>So the best practice language, Brittany advised, is to say “she made a placement, she’s placing for adoption, or she placed with another family.” 

What’s the best way to talk about adoption on the sidewalk outside clinics?

“How about you don’t?” Brittany says she replies when asked how to have better adoption conversations outside abortion clinics. She encouraged attendees who themselves faced an unintended pregnancy and were in this situation. “What was your state of mind when you were outside the clinic? Were you open to logical, rational discussion? No. There are so many things firing on your brain and the one thing that isn’t firing is rational thought. She’s there. She’s frightened. And the only thing that she’s going to think at that point is, I just have to get this over with. So having a rational discussion with her about adoption is not going to work. In fact, it makes them more abortion determined – that’s what the research shows.

Brittany advises sidewalk advocates to “form better partnerships with your local pregnancy resource centers around that clinic.” She suggests they build relationships  and save contacts in their phones so when they’re speaking with a woman they can offer support and immediately connect them with someone at a center.

She discouraged the signs that say “I’ll adopt your baby” describing them as “not helpful at all.” She said the focus needs to be “getting her to slow down, getting her away from the point of entry so she has time to think things through.” 

“Does she need to make an adoption plan? I don’t know,” Brittany said. “That’s something we can learn as we get to know her.

Several attendees agreed with this approach and the importance of building relationship and being concerned for the woman and her situation. One said, “It may be the life of the baby that has you on the sidewalk, but it is the life of the mother carrying it in immediate need. Let us start there first.”

How can placing for adoption impact future parenting and unintended pregnancy? How can we mitigate that impact?

Brittany shared that “women who have placed children for adoption and women who have experienced abortion, when they’re parenting, have a lot of the same issues come up,” such as shame, guilt, and feeling undeserving like “I can’t be a good mother.”  Yet Brittany said, “There’s five times more help for women who have an experience in abortion than there is for women who have placed children for adoption.” 

She discussed the importance of after-placement support for women so that they can heal and move forward, similar to after-abortion healing. To meet that need, Abiding Love Charities has developed an after-placement healing program to support women who have placed children for adoption called Seen. 

“Women who have placed, who have not had any post-placement support are very likely to have subsequent abortions,” Brittany said. “Because whether that experience placing for adoption was real or perceived, it was real to her. If she feels wrong, forgotten, taken advantage of, the one thing she’s going to say is, I would never do that again

Brittany shared that “these are the stories I read about all day: They didn’t care about me. All they cared about was my baby. And after the placement, everybody forgot about me.”

This is why Brittany said, “There have to be more post-placement healing and recovery options for her. Maybe she doesn’t want to go to a support group, but she would like to talk to a professional counselor online about her experience. Maybe she doesn’t want professional counseling, but she wants a birth mother mentor like myself that she can call and talk to about the parts of her own adoption journey that feel hard.” 

Click here to watch this webinar and to register for next month’s free webinar. 

Click here to watch Support After Abortion’s weekly TV show where men and women share their abortion stories and we talk about the need for compassion, the need for healing, and the importance of this within the church and outside the church. 

Click here for the Reprotection questionnaire Here are some things to consider about your pregnancy termination appointment

The missing seat at mother’s day brunch – how to navigate it

The missing seat at mother’s day brunch – how to navigate it

Licensed mental health therapist and Support After Abortion CEO Lisa Rowe says people – families, church leaders, and others – need to have awareness of women who have experienced reproductive loss and show compassion on Mother’s Day. My overall message to women on Mother’s Day who have experienced reproductive loss – miscarriage, stillbirth, abortion, adoption, loss of older children – is that it can be an emotionally packed day.” 

The celebration of Mother’s Day is a cultural connection that is everywhere – cards at Target, promotional emails from retailers, recognition at church. “The bittersweetness is that it’s a joyous day for so many people – they’re going to dinners and having celebrations,” Rowe said. “Yet it can be an overwhelming and triggering experience for those with strong feelings connected to it due to reproductive loss, especially abortion.”

Rowe has spent nearly 20 years helping girls and women from at-risk teenage girls to women experiencing unintended pregnancies to women escaping sex trafficking. She described three stages of change that apply to a multitude of situations including coping with grief after abortion: awareness, acceptance, and action.

“Some women avoid Mother’s Day not knowing why they feel off or why they avoid church that day,” Rowe said. “Undealt with grief can come out as avoidance, anger, sadness.” She described how one mom related that she struggled for years to go to church on Mother’s Day after her abortion. Now she stands up to be recognized as a mother to honor her daughter’s life. Other moms have shared that they want to stand up, but don’t out of fear of being asked about their children. 

Rowe explained that acceptance is being able to say this hurts, I need healing. She said the day can be particularly challenging for women who have a mixed experience – celebrating with their living children while feeling the loss of children who aren’t with them. Some of the day might be really good, and some of the day might hurt. Rowe suggested, “Maybe on this day I need to take the first hour to myself to experience the grief, so I can enter into the joy of the moment.”

One mom, decades removed from her abortion, shared with Support After Abortion, “My two living children made the day special, but there was a deep sadness in the back of my mind thinking what would it have been like if my other child were here, too.” She shared that one trigger has been going to church on Mother’s Day when her pastor recognizes all mothers and includes those who miscarried or whose child died, “but abortion is never, ever mentioned as a loss.”

Rowe explained that action involves facing these things with tools, resources, and help. She said it might involve calling a person who is supportive, making a counseling appointment right before or after Mother’s Day, or reaching out to Support After Abortion

“Healing actions are unique to the person and help them embrace their feelings and the present moments, perhaps in ways they may not have before,” Rowe said. Another woman, who doesn’t have other children, shared that Mother’s Day “is a little weird.” In the four years since her abortion, she hasn’t done anything particular to mark the day. Yet she said, “Every Mother’s Day there’s a part of me thinking about it and my baby.” After going through Support After Abortion’s healing program, she said, “A part of me would really love to do something to celebrate Mother’s Day, but I don’t know what that would look like exactly. Maybe this year I’ll plant a flower or do something to memorialize my baby in some small way.”

“These are the experiences we’ve journeyed through with women and it’s taught us a lot,” Rowe said. “Working through emotions after abortion is already hard enough, but on Mother’s Day it’s like a spotlight is on it.” Rowe encourages friends, loved ones, and church leaders to show love and compassion for the women in their lives who are navigating Mother’s Day after experiencing reproductive loss, especially abortion. Be aware of the potential for the day to stir up a lot of emotions for them. And, don’t just avoid mention of abortion loss.

Consider asking your loved one how she would like to be acknowledged on this day rather than assuming that she would or wouldn’t. Engage her in conversation. Some women may want to just survive the day. Others may want to go on a nature walk and talk about their abortion loss with you. Others may wish to have a brunch or have a seat set at the table to honor their missing child. Recognize that her experience may be different each year, so if you have talked about it in the past, ask how she would like to approach it this Mother’s Day.


About the Author: Michele has experienced reproductive loss through three miscarriages and stillborn twins. She lives in Greenville, SC with her husband and three daughters.

Marilyn Monroe — Victim of Unhealed Trauma

Marilyn Monroe — Victim of Unhealed Trauma

Originally Published October 31, 2022 on DC Journal

Trauma begets trauma begets trauma.

That’s the story shown in “Blonde,” the controversial and graphic new Netflix movie about 20th-century sex icon and Golden Globe-winning actress Marilyn Monroe. The first major trauma viewers see is Monroe’s mother trying to drown her in a bathtub; other traumas include being abandoned by her father, being placed in orphanages and foster homes as a child, and being raped as a young adult.

Psychological literature and licensed clinical therapists’ daily experiences show there is a link between unresolved trauma and future traumas. That’s what “Blonde”shows — Monroe needed acceptance and love, but what she got were abuse and exploitation. She couldn’t even live as her real self — what began as a stage name became her “real” face, hiding the traumatized Norma Jean for decades.

Probably the most controversial part of “Blonde”is the graphic portrayal of her abortions and a song that one of her unborn children sings to her. They are controversial because, in part, like the rape and attempted drowning scenes, the movie is unnecessarily horrifying. But they are also controversial because many believe the abortions make the film political in light of the Supreme Court’s Dobbs decision, which overturned Roe v. Wade.

But abortion isn’t political for the mother; it’s a human issue that affects real people. For example, a recent national survey of women who experience medication abortions found that 40 percent of women’s self-image changed after the abortion. About one in 14 of these women’s perspectives changed for the better, but 86 percent saw negative self-image changes. This was true regardless of their view about abortion, as 75 percent of women in the survey identified as pro-choice.

Like Monroe in “Blonde’s”portrayal, the people who attend Support After Abortion’s healing conferences and contact our anonymous After Abortion Line deal with lifelong traumas that often played a significant role in their abortion(s). Significant financial and relationship challenges are rarely one-time issues, and a 2005 Guttmacher Institute survey shows that 73 percent of women who had abortions did so because they couldn’t afford a child, and 48 percent were having relationship problems or didn’t want to be a single mother.

Unresolved traumas like sexual abuse, addiction and abandonment are often at the heart of these challenges. But while Americans accept that these traumas present themselves in our lives in ways like alcoholism, divorce and depression, we neglect to include abortion as a symptom of trauma because it is viewed as a political issue — not a problem with real people behind it.

Trauma defined Norma Jean’s life to the point where she hid behind an entirely different persona. That seems extreme — but how many Norma Jeans hide behind Marilyn Monroe faces in our churches, at the grocery store, or at Christmas parties? How often are we putting on a good face to the world to avoid condemnation or alienation or the pain of past traumas?

Abortion is a human issue, not a political one. It often comes from trauma and, as research shows, leads to more trauma. In Norma Jean’s case, the Marilyn Monroe mask only held for so long; she died of a drug overdose at 36 in what was deemed a possible suicide. It’s time to see the faces of millions of women whom research and the famous Turnaway Study find are suffering from abortion-related trauma.