Barbara Almond, M.D.

Barbara Almond M.D.

Maternal Ambivalence

Is Abortion Infanticide?

Abortion is not infanticide.

Posted Nov 21, 2010

     I don't think so. I have never thought so, although I have been depicted as someone who does. Recently, I had the very good fortune to have my book, "The Monster Within: The Hidden Side of Motherhood," reviewed in the New York Times Sunday Book Section. The reviewer, Pamela Paul, gave me a measured and generally favorable review. However, she questioned my appraisal of "abortion as constituting some form of infanticide, evoking the "blame the mother" interpretations that Almond is otherwise eager to dispel."
      I think she mis-read me. I did include a section on abortion in my chapter on Child Murder. The latter is a fortunately rare but horrible outcome of extreme maternal ambivalence, occurring in situations where the mother feels totally unable to cope and is, moreover, psychotic or temporarily dissociated from reality. Infanticide is a phenomenon much influenced by hormonal shifts and environmental pressures where the mother, suffering from mental illness, poverty, and shame (often about illegitimacy) attempts to get rid of her infant, by murder or abandonment.
      Abortion is not the murder of an infant, but the termination of a pregnancy, mostly during the embryonic phase of development. It is never an easy decision to live with. In the early seventies I counseled women who were ambivalent about seeking abortions. The great majority of these women were single, young and often abandoned by their partners. Things did not get easier, from a psychological point of view, even after abortion became legal. But at least they were safe for the mother.
      When I was a fourth year medical student on the Obstetrics Service, I witnessed the horrible sequel of an illegal abortion. A 42 year old married woman, mother of four children, came to the emergency room running a low-grade fever, following an abortion that she had secretly undertaken when she found herself pregnant with a fifth child. She was told to return to the hospital if her fever, then low-grade, went above 100.4 degrees Fahrenheit. Feverish and frightened, she misheard this advice as 104 degrees. By the time she returned to the hospital she had widespread septicemia (blood poisoning) that did not respond to antibiotics and she died on the operating table as the result of a futile attempt to remove her infected uterus. This was an experience I could never forget. The murder in this case was matricide! And the point that the reviewer missed was that desperate mothers driven to "back alley" means are victims of matricide. It is hard enough to give up a pregnancy to an abortion done by skilled hands and no matter how much relief the mother feels, somewhere she also feels grief and loss.
      This subject, the termination of pregnancy, has always been a troubling one. There just are no easy answers. If the mother I described had had this fifth child, would she have been happy? Would her already overburdened family (living in poverty) been happy? I don't think so. Were they grieved and angry at their abandonment by their mother? I am sure they were. But, had she survived the abortion, time would have healed the loss for everyone.