Dear Ministers Proulx and Dubé,

We are writing to draw your attention to a serious but largely overlooked issue: post-abortion trauma among women in Quebec. Many women, following a voluntary termination of pregnancy, suffer in silence from psychological and physical distress. These post-abortion struggles—depression, post-traumatic stress, profound regret, health problems—remain hidden and downplayed. Yet they represent a public health and women's well-being emergency, which calls for your leadership.[1]

Currently, the experiences of thousands of women suggest that a significant proportion endure deep and lasting consequences after an induced abortion. Numerous peer-reviewed studies, published in respected medical and psychiatric journals, show an increased risk of mental health disorders following abortion. For instance, a 2013 Italian study concluded that “abortion is a risk factor for mental illness compared to childbirth.” Likewise, a 2011 meta-analysis in the British Journal of Psychiatry found that women who had undergone abortions faced an overall 81% higher risk of psychological issues compared to those who had not. This is not propaganda—it is the consensus in medical literature.

Why act now? Because these women remain invisible in our system. The topic is taboo: society struggles to admit that, for many, abortion is not the end of their problems, but the beginning of new and profound suffering. Out of fear of being judged, these women suffer alone, consumed by guilt and convinced they have “no right” to feel unwell after an abortion. It is our duty to break this silence.

As Ministers responsible for the Status of Women and for Health and Social Services, you have both the power and the responsibility to recognize this reality and respond. We appeal to your compassionate leadership on behalf of these forgotten women. Enclosed with this letter is an advocacy dossier detailing the consequences of post-abortion trauma, as well as a citizen petition requesting concrete action.

Ministers, we urge you to lead a true provincial awakening. By officially recognizing post-abortion trauma, informing the public, and establishing specialized support services, Quebec can become a leader in the compassionate care of women after abortion. This is a major human and social issue—one that affects the mental, physical, and even spiritual health of many Quebec women, as well as their families.

We sincerely hope you will heed this call. The women of Quebec need your support to heal from their invisible wounds.

Respectfully yours, with hope for your action in favour of women’s health in Quebec.

 

Georges Buscemi
President, Quebec Life Coalition

 

[1] This English-language document is a translation of the authoritative French-language document which can be found HERE. In case of doubt, please refer to the French-language document. To support each of the statements made in this communication, we have included a report entitled The consequences of Post-Abortion Trauma: An Unrecognized Public Health and Social Issue, based on a thorough review of scientific literature.

The Consequences of Post-Abortion Trauma: An Unrecognized Public Health and Social Issue

Many women experience deep emotional distress after an abortion—a distress that remains largely unrecognized by society and the healthcare system. Testimonies and research indicate that induced abortion can lead to a host of psychological, spiritual, and physical consequences in the medium and long term. This dossier aims to shed light on these impacts in an accessible way, to illustrate the reality of the suffering involved, and to highlight the urgent need for action.[1]

Psychological Consequences for Women Post-Abortion

• Depression, anxiety, and suicidal thoughts: After abortion, the risk of mood and anxiety disorders increases significantly. A 30-year New Zealand study showed that women who had abortions had about 30% more mental health issues than those who had not—even after adjusting for socio-economic factors.[2] A 2011 meta-analysis of more than 877,000 women found an overall 81% increase in the risk of psychological issues among women who had abortions.[3] Even more concerning are specific risks: for instance, in Italy, suicide rates are more than twice as high among women post-abortion compared to new mothers.[4] In China, a study on migrant workers found nearly twice as many suicidal thoughts among women who had aborted (OR: 1.9).[5] These chilling numbers reflect real lives—women who, years later, struggle to find joy again.
• Post-Traumatic Stress Disorder (PTSD): For some, the experience of abortion is profoundly traumatic. Flashbacks, nightmares, anxiety, and avoidance behaviours—symptoms akin to those seen in victims of assault or war—may emerge. One comparative study showed that 65% of American women who had abortions exhibited multiple PTSD symptoms, and 14% met full diagnostic criteria for PTSD linked to their abortion.[6] These figures suggest that a significant minority of women suffer real psychological trauma, often invisible to those around them.
• Profound regret and feelings of loss: Once the crisis of the unexpected pregnancy passes, many women experience a wave of emotional backlash. Questions haunt them: “Did I make the right choice?” “What would my child have become, if…” A 2023 U.S. study found that 60% of post-abortive women would have preferred to carry to term if they had received more support or felt more financially secure. 67% described their abortion as unwanted, coerced, or against their values.[7] Even among university students, more than 60% later expressed regret.[8] One qualitative study revealed that 42% of women experienced negative psychological effects for over 10 years post-abortion—including depression, shame, and intrusive thoughts about the lost child.[9] Regret is often layered: sadness, self-directed anger, and idealization of the lost child’s potential life.
• Guilt and shame: Morally and spiritually, many women carry an immense burden of guilt. While some manage to suppress these feelings at the time, over time they can become overwhelming. In one study, 37.5% of women reported guilt immediately after the abortion, and 33.3% reported regret.[10] Other studies suggest nearly 8 in 10 women feel guilt at some point.[11] Psychologists often describe a form of complicated grief, where the woman blames herself for the outcome and struggles to forgive. Sometimes guilt becomes obsessive, leading to self-punishment or self-sabotage—such as substance abuse, toxic relationships, or rejection of happiness as a form of self-imposed penance. This invisible moral weight is among the heaviest psychological burdens post-abortion.[12]
• Self-esteem collapse and social isolation: Shame following an abortion can devastate a woman’s sense of worth. Many suddenly feel “bad” or even “monstrous” for ending a pregnancy. This leads to withdrawal. Women often refrain from sharing their experience, even with close loved ones, for fear of judgment. Some report a sense of alienation—a feeling of emotional and social disconnection—based on deeply personal narratives.[13] The result is profound loneliness: believing no one can understand, their distress festers silently.

In short, post-abortion psychological effects go far beyond a passing “blues.” For many, it is a deep and lasting wound. While not all women are affected to the same extent, and some feel definitive relief, many suffer profoundly. Their reality must be acknowledged with compassion and realism.

Social and Relational Pressures Leading to Reluctant Abortions

It is equally important to understand the circumstances that lead many women to undergo abortions they do not truly want. Abortion is not always a freely made choice—external pressures often weigh heavily. These pressures may come from partners, families, or socio-economic conditions, and they leave women feeling a deep sense of injustice and trauma.

• Partner pressure (spouse or boyfriend): Studies reveal a troubling phenomenon: more than half of women feel explicitly pressured to abort by the father of the child. In Sweden, a survey of women seeking abortions found that 52% said their partner wanted them to abort.[14] Half of all unplanned pregnancies occur in a climate of male persuasion that leaves little room for real choice. The underlying message is cruel: “If you keep this child, you’re on your own. If you love me, you’ll have the abortion.” Under such emotional pressure, many women reluctantly comply. Later, they often describe the abortion as a coerced ultimatum, not a real decision. In the same study, 8% of women said they had an abortion against their core will—usually those whose partner or a parent had strongly insisted.[15]
• Family and social pressure: This is especially common among younger women. A pregnant teenager is emotionally and financially dependent on her family. If her parents insist on abortion (e.g., “You’ll ruin your future,” “Think of the shame”), it is difficult for her to resist. Some women report being physically brought to the clinic by their mothers, or being threatened with eviction by their fathers if they kept the baby. These experiences leave deep scars: women often feel they betrayed their values under duress, and may harbour long-term resentment or suppressed anger.[16]
• Economic and societal pressure: Even without explicit coercion, many Quebec women feel cornered into abortion by their circumstances. Financial instability, lack of housing, ongoing studies, or insecure employment often make abortion feel like the “only option.” Many say, “I didn’t see any other way.” These are not “convenience” abortions—they are default decisions, made in the absence of real support. Our society prizes professional success and stability before motherhood to such a degree that a pregnant woman often believes it would be irresponsible to carry the child. This subtle but powerful social pressure internalizes the message: “In my situation, I have to abort.” Yet when the heart isn’t in it, such circumstantial abortions often feel like a traumatic rupture.

What are the consequences of these pressures? Research shows that coerced or ambivalent abortions drastically increase the risk of post-abortion trauma. When the decision wasn’t truly hers, a woman is far more likely to suffer regret, depression, and PTSD.[17] Many women say, “If I’d had help, I would have kept my baby.” In one study, 32% of women said they might have changed their minds and avoided abortion if they had felt more supported or encouraged.[18] This number reflects the tragic human loss of abortions that women never truly wanted: unborn children they longed to welcome, and bereaved mothers haunted by “what ifs” for the rest of their lives.

As a society, we cannot close our eyes to this relational dimension of abortion. The best prevention for post-abortion trauma is ensuring that women do not abort against their will. That requires better support for pregnant women in distress, public awareness (especially among men) about reproductive coercion, and clear access to resources that allow every woman to make a truly free and informed choice.

 

Guilt, Isolation, and Stigma Among Women Who Regret Their Abortion

For many women, the end of the abortion procedure marks the beginning of a new struggle: coping with post-abortion emotions in a social environment that neither understands nor validates their experience. As noted, guilt and regret affect a significant proportion of women. What makes their distress worse is often the feeling that they must hide it—or worse, the denial of their suffering by others or by dominant cultural narratives.

In our society, abortion is typically framed in terms of rights and relief at avoiding an unwanted child. There is little space for the voices of women who say, “I’m hurting.” These women often encounter hurtful reactions like: “If you regret it, you weren’t strong enough,” or “Why complain? It was your decision.” This lack of empathy makes them feel even more misunderstood and judged.[19]

The result? Many women keep their feelings to themselves. They isolate, believing they are alone in feeling this sadness or emptiness. Out of shame or fear of being labelled “anti-choice” or “weak,” they hesitate to speak up or seek professional help. This silence is deadly—it blocks access to healing. Pain unspoken becomes pain that hardens.

Stigma also targets women who dare to speak out publicly about regretting their abortion. They may be harshly criticized as “traitors to women” or “tools of religion,” deterring others from sharing their stories. A genuine public taboo surrounds post-abortion syndrome. Women internalize it, suffering a double burden: not only are they in pain, they feel guilty for being in pain.[20]

Emotional isolation also undermines their relationships. Many struggle to rebuild trust or form new bonds. Some even break ties with the partner involved in the abortion. In many cases, the relationship does not survive the trauma—the woman resents the man for pushing her into it, or the man doesn’t understand her lingering sorrow. This emotional disconnect can cascade: the woman closes off emotionally, or couple dynamics unravel, leading to separation.[21]

For all these reasons, we must fight the stigma around post-abortion trauma. Step one: talk about it. Publicly. Humanely. Without judgment. Let women know they are allowed to struggle. Allowed to speak. Allowed to be helped. Their pain takes nothing away from anyone else—it is simply a human reality that deserves compassion. Official recognition of post-abortion syndrome would go a long way to breaking the taboo. If our health authorities and political leaders validate this suffering, then women can come out of the shadows and begin to heal.

 

The Critical Lack of Post-Abortion Support Services

Despite the depth of post-abortion suffering described above, Quebec’s healthcare system remains largely unequipped to respond. Currently, when a woman undergoes an abortion, her immediate physical recovery is ensured—but then she is left on her own. There is no province-wide program for post-abortion psychological or medical follow-up. This lack of a safety net is particularly troubling, given that, as we’ve seen, many women will never ask for help on their own.

Yes, some isolated services do exist. For instance, the CIUSSS de l’Est-de-l’Île-de-Montréal invites patients to “book an appointment with a psychosocial worker” if feelings of discomfort persist beyond two weeks.[22] This is a positive step—but it also reveals the system’s limits. It waits for women to self-identify and to know this resource even exists. But how many women leaving abortion clinics are told this? And of those in distress, how many have the strength or clarity to call a CLSC and say, “I need help, I’m struggling after my abortion”? Very few, unfortunately. Many don’t even know support is available—or they believe they don’t deserve help because their pain is seen as illegitimate.

Outside the public system, a few community groups try to fill the gap—some churches or non-profits offer support groups or post-abortion counselling, often led by volunteers who have been through it themselves. But these initiatives lack visibility and funding, and some women hesitate to use them for fear of encountering a “moralizing” approach. It is therefore essential that support services be available within the formal public health system, ensuring equitable and stigma-free access.

There is also a gap in medical follow-up. Some late-onset complications—like chronic pelvic pain or uterine adhesions—may occur after an abortion, but there is no systematic check-up to catch them. Future reproductive risks are also poorly communicated. Did you know that a meta-analysis confirmed a significant increase in the risk of premature birth in subsequent pregnancies for women who have had abortions?[23] A Finnish study involving over 300,000 births found that two abortions increased the risk of preterm birth (<28 weeks) by 69%, and three abortions by 178%.[24] These preterm babies face serious health complications. Yet women are not told that they should have enhanced prenatal care in future pregnancies—because abortion is not officially recognized as a long-term risk factor.

Similarly, in breast cancer screening, oncologists such as Dr. Angela Lanfranchi have published studies suggesting that abortion before 32 weeks may increase breast cancer risk later in life.[25] A large-scale 2019 Chinese study found abortion to be one of the strongest predictors of breast cancer: women with 1–2 abortions had a 151% increased risk; those with 3 or more had a 530% increase.[26] And yet, to our knowledge, no specific breast health recommendations are provided to Quebec women with a history of abortion. This absence of medical guidance has serious implications: late diagnoses mean more intensive treatment and worse outcomes. In Canada, cancer remains a major cause of death for women. Public health authorities have a duty to inform women of all known and preventable risks.

In short, the current system delivers abortion as a medical procedure—but fails to account for its consequences. Once the woman exits the clinic, it’s as though she’s “out of the woods.” But as this dossier shows, that is far from true. Quebec urgently needs a comprehensive post-abortion care program, including:

• Systematic psychological follow-up: A check-in one month post-abortion with a psychologist or social worker to screen for emotional distress, regret, or dark thoughts, and refer women to additional support if needed. Even a short visit would send the powerful message: We care about your mental health.
• Support groups: Safe spaces in CLSCs or community centres where post-abortive women can speak freely, break isolation, and help one another. Peer-led or professionally facilitated healing circles do exist in some places (e.g., a Quebec City non-profit hosts “coffee meetups” for post-abortive women), but these should be available across the province, with no financial barriers.
• A dedicated helpline: Like pregnancy support hotlines, a province-wide, post-abortion-specific phone line staffed by trauma-informed counsellors. Talking anonymously to someone who understands can be a crucial first step for those not yet ready to seek in-person help.
• Healthcare staff training: Family doctors, OB-GYNs, nurses, and psychologists should be trained to recognize signs of distress and ask the right questions: “How are you coping with this experience? Would you like to talk?” Often, the topic is avoided out of fear of “guilt-tripping” the patient—when in fact, offering an open door could bring great relief.
• Medical follow-up protocols: Clinical recommendations should be updated for women with abortion history. For example, an ultrasound a few months post-procedure to check for complications. Noting the increased risk of preterm birth in a patient’s file for future pregnancies could prompt extra obstetric care. Small steps like these would show that a woman’s whole health matters, not just the procedure.

Currently, none of these measures exist at scale. The lack of post-abortion care is stark—and it sends an unintentional message: “You’re on your own.” We would never let someone who miscarried leave without support—offering counselling, grief resources, peer groups, etc. Why should a woman who had an abortion—a different form of pregnancy loss—not receive the same care and compassion?

The Hidden Human and Social Costs of Post-Abortion Trauma

Finally, we must zoom out. What happens in the hidden corners of a woman’s heart can have wider social repercussions. Ignoring post-abortion trauma is not just an individual issue—it results in significant, though often invisible, costs to society.

• Mental health and productivity costs: A woman experiencing post-abortion depression may require more medication, therapy, or mental health services—or worse, may spiral without support, leading to prolonged work absences or even disability. Some studies suggest that up to 10% of mental health disorders in women may be linked to a history of abortion.[27] This translates to lost workdays, increased health system costs (hospitalization for suicidal ideation, chronic anxiety treatment, etc.). From a public policy standpoint, it is more responsible to prevent these conditions than to treat them once entrenched.
• Family and intergenerational costs: A mother’s distress affects her existing children (if any), or those she may later have. One study found that women with abortion history were more likely to suffer from stress and depression during subsequent pregnancies—potentially impacting their unborn children in utero.[28] This cycle of suffering may extend across generations. A guilt-ridden mother may be less emotionally available to her children, or less likely to engage in family or community life.
• Physical health care costs: If, as some studies show, abortion raises the risk of certain physical illnesses (breast cancer, obstetric complications, etc.), failing to monitor and inform women of these risks leads to late diagnoses, more invasive treatments, and higher costs. For example, a woman who develops breast cancer linked to an interrupted pregnancy may not be considered high-risk—meaning screening is delayed. Late-stage cancers are not only more dangerous but costlier to treat. Since cancer is a leading cause of female mortality in Canada, informing women about avoidable or mitigable risks is a public health responsibility. The same applies to premature births, which entail massive costs (neonatal intensive care, lifelong health monitoring). Reducing even a fraction of preterm births by preventing unwanted repeat abortions or improving post-abortion obstetric care would yield both human and economic gains.
• Social cohesion costs: A society where thousands of women carry silent pain, feeling misunderstood and abandoned, is a society where isolation and distrust grow. By contrast, addressing these intimate wounds can strengthen social bonds, restore trust in healthcare institutions, and foster solidarity. Women who heal from post-abortion trauma often want to help others—sparking a community-driven ripple effect. But that healing cannot begin until society acknowledges the trauma itself and responds with care.

In short, even from a purely pragmatic standpoint, it is in Quebec’s interest to address post-abortion trauma. Doing nothing means letting silent human suffering continue, along with depression, broken lives, and unrealized human potential. But by investing in support, prevention, and awareness, we invest in women’s well-being, in families, and in the future.

The cost of a post-abortion care program is modest compared to the cost of ignored mental distress. And beyond the numbers lies a question of values: a truly humane society cannot turn a blind eye when so many women are suffering from a preventable cause.

 

Conclusion – Breaking the Silence, Supporting Healing: A Call to Action

Post-abortion trauma is neither a myth nor a rare exception. It is a lived reality for countless women. Whatever one’s personal beliefs about abortion, this suffering deserves to be acknowledged, understood, and addressed. This dossier has outlined, with scientific evidence, the many facets of the issue: profound psychological distress (depression, PTSD, suicidal ideation, guilt...), social pressures leading to coerced or unwanted abortions, silence and isolation due to lack of public recognition, insufficient services, and broader impacts on society.

The time to act is now. That means, first and foremost, officially recognizing the existence of post-abortion trauma. Quebec’s two key ministries—Health and the Status of Women—must speak with one compassionate, evidence-based voice:
“Yes, some women suffer after abortion, and their pain is valid. Yes, we will help them.”

This includes a public awareness campaign, and the creation of a comprehensive post-abortion care program—one that serves the whole woman (body, mind, and, where desired, spirit).

Quebec has the opportunity to lead the way. Around the world, some initiatives are beginning to emerge—quietly, tentatively. Here, with your leadership, we can be pioneers and repair a silent injustice.

The women of Quebec who have endured this experience are waiting for your signal. On their behalf, and on behalf of all those who believe in a truly humane approach to women’s health, we thank you in advance for your attention—and for your concrete action.

 

Citizen Petition for the Recognition and Care of Post-Abortion Trauma in Quebec

To: Minister Caroline Proulx, Minister responsible for the Status of Women, and Minister Christian Dubé, Minister of Health and Social Services

Whereas:

• Many women suffer psychological, spiritual, and physical consequences after an induced abortion (depression, anxiety, suicidal thoughts, PTSD, deep regret, guilt, medical complications such as increased risk of breast cancer and preterm birth);
• A large number of women have had abortions under social or relational pressure (especially from their partners), against their true desires, and this coercion worsens their subsequent distress;
• Women suffering after abortion often live in guilt and isolation, made worse by stigma and a social silence that prevents them from seeking support;
• There is a critical lack of appropriate support services: no structured public program exists to address post-abortion trauma, and current offerings (ad hoc psychosocial services, community groups) are insufficient and poorly known;
• The human and social cost of this issue is poorly recognized but real: untreated psychological disorders, suicides, family strain, unaddressed long-term medical risks, and loss of full participation by these women in Quebec society;

We, the undersigned citizens of Quebec, respectfully ask the Government to:

1. Launch a province-wide awareness campaign on post-abortion trauma, jointly led by the Ministry of Health and the Ministry of the Status of Women. The campaign, widely disseminated (in health centres, media, etc.), would aim to:
   a) Inform the public that some women experience post-traumatic effects after abortion, to break the taboo and end their isolation;
   b) Encourage women to seek help without shame or fear, reassuring them they are not abnormal or alone—that others have felt the same, and support exists;
   c) Raise awareness among family members and communities (including partners) to adopt an empathetic approach to women who may suffer or regret their abortions, to create a non-judgmental environment of support.
2. Establish a province-wide, multidisciplinary post-abortion care program, including:
   a) Proactive medical and psychological follow-up for all women who have had an abortion, through CLSCs or medical clinics, to detect and address complications—whether physical (e.g., persistent pain, hormonal issues) or psychological (distress, depression, etc.);
   b) Creation of specialized support services: subsidized counselling with psychologists or social workers trained in post-abortion trauma, supervised support groups, and where desired, referrals to spiritual counsellors;
   c) Training for healthcare providers (family doctors, OB-GYNs, nurses, psychologists) to better understand post-abortion trauma so that no woman is left alone without knowing where to turn;
   d) Partnerships with community organizations and crisis helplines to strengthen the safety net around post-abortive women and connect them effectively to services across the province.

By responding to this call, you affirm a simple but essential principle: women’s health includes their mental and emotional well-being, and every woman deserves compassion and support—before and after an abortion.

It is time for Quebec to recognize and respond to post-abortion trauma with the seriousness it demands.

In witness whereof, we sign this petition and respectfully request, Madam Minister, Mr. Minister, that it be met with all the attention and humanity it deserves.

The undersigned: (Names follow)

Sign the Petition HERE.

 

[1] In addressing post-abortion trauma and the need for an awareness and support program for women who suffer from it, Campagne Québec-Vie wishes to make clear that it in no way condones induced abortion. The organization consistently views voluntary termination of pregnancy as an unjustifiable violation of the life of an innocent human being, which should be prohibited by law in any truly just and humane society.

[2] This report is based in large part on two expert scientific opinions submitted in the court case Caron v. Attorney General of Quebec (2019), namely:

• Expert Opinion of Angela Lanfranchi, M.D., F.A.C.S., in Support of Canadian Sidewalk Counselors, and
• Expert Report of Dr. Priscilla Coleman, Ph.D., on the Psychological Risks Associated with Abortion and the Protective Role of Sidewalk Counseling.

Although not admitted into evidence for procedural reasons, these documents rely on research published in reputable scientific journals. For instance, on pages 6–7, Coleman cites the 2008 New Zealand study by Fergusson et al., which found that, after adjusting for socio-economic and personal factors, women who had had an abortion had a 30% increased risk of mental health disorders (depression, anxiety, suicidal thoughts) compared to women who had not.

[3] Coleman, Priscilla K. Abortion and Mental Health: Quantitative Synthesis and Analysis of Research Published 1995–2009, British Journal of Psychiatry, vol. 199, no. 3, 2011, pp. 180–186. This meta-analysis, covering over 877,000 women, concluded that the overall risk of psychological disorders is 81% higher in women who have had an abortion compared to those who have not.

[4] Maternal suicide in Italy: https://pubmed.ncbi.nlm.nih.gov/31104119/

[5] Luo M. et al. (2018) – Association between Induced Abortion and Suicidal Ideation among Unmarried Female Migrant Workers in Three Metropolitan Cities in China: A Cross-Sectional Study, BMC Public Health: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-5527-1

[6] Induced Abortion and Traumatic Stress: A Preliminary Comparison of American and Russian Women: https://pubmed.ncbi.nlm.nih.gov/15448616/

[7] The Effects of Abortion Decision Rightness and Decision Type on Women’s Satisfaction and Mental Health: https://pmc.ncbi.nlm.nih.gov/articles/PMC10257365/

[8] Reproductive Regrets among a Population-Based Sample of U.S. Women: https://journals.sagepub.com/doi/10.1177/23780231221142969

[9] Ibid.

[10] Psychological Consequences of Abortion among the Post-Abortion Care Seeking Women in Tehran: https://pmc.ncbi.nlm.nih.gov/articles/PMC3395931/

[11] Rue, V. M., Coleman, P. K., Rue, J. J., & Reardon, D. C. (2004). Induced Abortion and Traumatic Stress: Preliminary Comparison of American and Russian Women. Medical Science Monitor, 10, SR5–S16.

[12] Priscilla K. Coleman, Expert Report, 2019, in the case of Dr. Roseline Lebel Caron et al. v. Attorney General of Quebec, pp. 15–17. The author summarizes commonly observed psychological effects following abortion, including symptoms of “intense guilt” and “unresolved grief” as described in A Clinician’s Guide to Medical and Surgical Abortion (Paul et al., 1999). These symptoms include: self-punishing behaviours (substance abuse, destructive relationships), obsessive rumination, fetus-related nightmares, avoidance of memory triggers, and interpreting misfortunes as divine punishment. Coleman also cites Hess (2004), who reports that some women feel like they are “on an emotional rollercoaster for decades,” and Coleman & Nelson (1998), who found that 73% of women frequently think about the child they did not have.

[13] Ibid. Coleman cites A Clinician’s Guide to Medical and Surgical Abortion (Paul et al., 1999), which describes symptoms of severe shame following abortion, including recurring thoughts such as “I am a bad person,” self-destructive behaviours, fear of others finding out about the abortion, and profound social isolation. She also references several qualitative studies (Kero & Lalos, 2000; Kimport, 2012; Soderberg et al., 1998) showing that many women feel alienated from others after the procedure and are reluctant to speak about it—even to close friends or family—due to shame or fear of judgment.

[14] Ibid. The author cites a Swedish study (Kero et al., 2001) in which 52% of women who had just had an abortion said their partner wanted them to terminate the pregnancy.

[15] Ibid. The same study reported that 8% of women said they had the abortion “more or less against their will,” often due to pressure from a partner or parent.

[16] Ibid., pp. 13 and 20. The report highlights that women who have abortions in contradiction with their personal values—often due to external pressure—are at higher risk of guilt, regret, and even anger or resentment toward those close to them, especially partners or parents identified as sources of emotional coercion (see also Allen, 2015).

[17] Priscilla K. Coleman, Expert Report, 2019, Dr. Roseline Lebel Caron et al. v. Attorney General of Quebec, pp. 20–22. The report reviews numerous studies showing that pressure or coercion to abort is a major risk factor for severe psychological consequences, including depression, intense regret, anxiety, PTSD, and even self-harming behaviours. Women who do not freely consent to abortion face a significantly higher risk of long-term mental suffering.

[18] Ibid., p. 12. According to a Swedish study cited by the author (Kero et al., 2001), 32% of women who had abortions admitted that they might have changed their minds if their circumstances had been more favourable or if someone had encouraged them to keep the baby.

[19] Ibid., pp. 15–17. The report emphasizes that in a context where abortion is framed as a right or a relief, women who suffer after the procedure find little space to express their pain. Coleman reports that several studies (notably Kimport, 2012) reveal socially invalidating reactions such as “You weren’t strong enough” or “You chose it,” which deepen shame, internalized judgment, and isolation.

[20] Ibid., pp. 15–17. Coleman describes a real public taboo surrounding post-abortion regret, fuelled by social pressure to see abortion as a right without consequences. Women who publicly express pain may be labelled as “traitors to women’s rights” or “puppets of religion.” This rejection creates a culture of silence, leading many women to self-censor, feeling guilty for suffering after what was supposedly a “free choice.”

[21] Ibid., pp. 15, 17, 22. The report shows that emotional isolation after abortion often harms romantic relationships. Many women report broken trust, emotional distance, or resentment toward the partner—especially if he encouraged the abortion. Coleman also notes cases where the woman’s sadness is misunderstood by the partner, degrading communication and frequently leading to separation. These disturbances often extend beyond the couple, affecting the broader emotional and social network.

[22] Integrated Health and Social Services Centre of East Montreal – After Abortion: https://ciusss-estmtl.gouv.qc.ca/soins-et-services/avortement/apres-lavortement

[23] Priscilla K. Coleman, Expert Report, 2019, Dr. Roseline Lebel Caron et al. v. Attorney General of Quebec, p. 24. Coleman cites a meta-analysis by Shah and Zao (2009), published in BJOG, reviewing 37 studies, which found that induced abortion is a risk factor for premature birth in future pregnancies.

[24] Angela Lanfranchi, Canada Sidewalk Counselors Expert Report, 2019, p. 5. Dr. Lanfranchi cites a Finnish study by Klemetti et al. (2013) involving 300,858 first live births, which found that two abortions increase the risk of delivery before 28 weeks by 69%, and three abortions increase it by 178%, compared to women who had never aborted.

[25] Ibid., pp. 4–6. Dr. Lanfranchi, a breast cancer specialist, explains that terminating a pregnancy before 32 weeks prevents full maturation of breast tissue, making it more vulnerable to carcinogens. She cites numerous studies (notably a Chinese meta-analysis of 36 studies) showing an increased risk of breast cancer after induced abortion, especially among nulliparous women.

[26] Wang, L., Liu, L., Lou, Z. et al. Risk Prediction for Breast Cancer in Han Chinese Women Based on a Cause-Specific Hazard Model, BMC Cancer, 19, 128 (2019). DOI: 10.1186/s12885-019-5321-1. https://pubmed.ncbi.nlm.nih.gov/30732565/

[27] Priscilla K. Coleman, Expert Report, 2019, Dr. Roseline Lebel Caron et al. v. Attorney General of Quebec, p. 6. Coleman cites her own 2011 meta-analysis in the British Journal of Psychiatry, which concludes that nearly 10% of all mental health disorders among women may be attributable to a prior abortion, after adjusting for other factors.

[28] Ibid., pp. 7–8. Coleman cites several studies showing that women who have undergone an abortion are more likely to experience anxiety, guilt, or depression during subsequent pregnancies—even if the pregnancy is wanted. She notes that maternal stress can negatively affect the unborn child’s development, particularly via elevated cortisol levels and the mother’s emotional dysregulation.