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A Thematic Analysis of Men's Experience With a Partner's Elective Abortion

Authors:
  • Alliance for Post-Abortion Research and Training
  • Alliance for Post-Abortion Research & Training

Abstract

Research concerning men's experience with a partner's abortion is limited. To foster understanding of this topic, the authors used online surveys to gather data from men whose partners underwent induced abortion. A thematic analysis of men's comments about their experience revealed 3 salient themes: loss and grief, helplessness and/or victimization, and spiritual healing. Findings are discussed in terms of future research and counseling practices as they relate to pregnancy outcome decisions. © 2015 by the American Counseling Association. All rights reserved.
138 Counseling and Values October 2015 Volume 60
Research
© 2015 by the American Counseling Association. All rights reserved.
Received 03/21/13
Revised 08/05/14
Accepted 10/02/14
DOI: 10.1002/cvj.12010
A Thematic Analysis of Men’s
Experience With a Partner’s
Elective Abortion
Catherine T. Coyle and Vincent M. Rue
Research concerning men’s experience with a partner’s abortion is lim-
ited. To foster understanding of this topic, the authors used online surveys
to gather data from men whose partners underwent induced abortion. A
thematic analysis of men’s comments about their experience revealed 3
salient themes: loss and grief, helplessness and/or victimization, and spiritual
healing. Findings are discussed in terms of future research and counseling
practices as they relate to pregnancy outcome decisions.
Keywords: men, abortion, abortion counseling
Research concerning the psychological outcome of elective abortion has
focused primarily on women. By comparison, the literature regarding
men’s reactions to elective abortion is quite limited (Coyle, 2007), with
only about 50 scholarly papers published in the last 4 decades. Induced
abortion is one of the most commonly performed surgical procedures in
the United States, affecting 30% of women (R. K. Jones & Kavanaugh, 2011).
Because every pregnancy involves a man as well, there is a great need for
more research concerning men’s roles in and responses to pregnancy out-
come. Even if only a small percentage of men are negatively affected by a
partner’s abortion, the actual numbers of men needing help may be large,
considering that more than 1 million abortions are performed annually in
the United States (R. K. Jones & Kooistra, 2011).
Men and Abortion
Despite the lack of scientific studies pertaining to men and abortion, com-
mon findings have been reported among the existing studies. For example,
investigators have found that most men do not find elective abortion to be
an easy experience (Gordon & Kilpatrick, 1977; Poggenpoel & Myburgh,
2002; Shostak, 1979, 1983). Rather, reports indicate that men tend to find the
experience to be distressing, with a large majority of them describing abor-
tion as a difficult experience that left them with lingering and disturbing
Catherine T. Coyle, Alliance for Post-Abortion Research and Training, Madison, Wisconsin; Vincent M.
Rue, Alliance for Post-Abortion Research and Training, Jacksonville, Florida. Correspondence concerning
this article should be addressed to Catherine T. Coyle at ctcoyle@hotmail.com.
Counseling and Values October 2015 Volume 60 139
thoughts (Shostak, 1979, 1983; Shostak & McLouth, 1984). In studies of men
whose partners underwent abortions, a number of adverse outcomes have
been reported, including ambivalence (Kero & Lalos, 2000, 2004), feelings
of responsibility or culpability (Reich & Brindis, 2006; Rodrigues & Hoga,
2006), helplessness (Coyle & Rue, 2010; Hallden & Christensson, 2010),
anxiety (Coyle & Rue, 2010; Schelotto, & Arcuri, 1986), posttraumatic stress
reactions (Coyle, Coleman, & Rue, 2010; Lauzon, Roger-Achim, Achim, &
Boyer, 2000; Robson, 2002), anger (Naziri, 2007), guilt (Rothstein, 1991; Rue,
1996), and grief (Coyle & Rue, 2010; Speckhard & Rue, 1993). The grief may
be experienced as disenfranchised grief (Coyle & Rue, 2010), complicated
mourning (Speckhard & Rue, 1993), or depression (DuBois-Bonnefond &
Galle-Tessonneau, 1982; McAll & McAll, 1980; Stern, 1999). Other adverse
outcomes include emasculation (Holmes, 2004; Reich, 2008; Rue, 1985), sexual
dysfunction (Berger, 1994; Rothstein, 1977b), and relationship problems or
relationship failure (Coleman, Rue, & Coyle, 2009; Coyle et al., 2010;
Mattinson, 1985; Myburgh, Gmeiner, & van Wyk, 2001). Only one study
(Kero, Lalos, & Wulff, 2010) reported that relief was observed among the
male partners of women who aborted.
Despite perceptions that men are largely unsympathetic toward their
partners or that they pressure them to terminate their pregnancies, several
investigators have observed that men perceive their primary role to be one
of support for their partners (Ferguson & Hogan, 2007; Gordon & Kilpatrick,
1977; Patterson, 1982; Shostak & McLouth, 1984). In addition, several authors
have noted a need to provide counseling for men before and/or after the
abortion (Gordon, 1978; Lauzon et al., 2000; Papworth, 2011; Rothstein 1977a).
The primary goal of this web-based study was to identify the salient themes
among men whose partners underwent elective abortion. Previous research
involved single case studies or very small samples, and investigators did
not always identify if and which qualitative methods were utilized. The
use of an Internet survey facilitated the obtainment of a larger sample and
provided the participants with anonymity to encourage disclosure. In addi-
tion, the use of thematic analysis, an accepted qualitative method, provides
rigor and credibility.
Method
Sample
The present study used an Internet convenience sample. We posted a survey
at a website developed specifically to gather data concerning men’s experi-
ence of a partner’s abortion. The website was not owned by or related to a
religious or political organization. Conditions for participation required that
a respondent be an adult male whose partner had undergone an induced
abortion. Crisis pregnancy centers and other organizations that offer post-
abortion counseling were informed of the survey, and potential respondents
could also find the survey by simply performing a search using phrases such
140 Counseling and Values October 2015 Volume 60
as “men and abortion” or “abortion research.” Although most of the survey
questions had specific response choices, the survey also included an open-
ended item that allowed participants to reply in their own words. That item
is the focus of this analysis and was worded as follows: “Please feel free to
share any comments or thoughts about your abortion experience.” Eighty-
nine men responded to this item and composed the sample for this study.
Only 13 of these men were married to their partners at the time of abortion,
and the time lapse between abortion and their participation in this study
ranged from 1 day to 46 years. The respondents ranged in age from 19 to
64 years, with an average age of 40.8 years. The men’s ethnic characteristics
were Caucasian (86.5%), African American (8%), Hispanic (1%), Asian (1%),
and other (3.5%). For educational attainment, 35% were college graduates,
26% had associate/technical degrees, 18% had a high school diploma, 19%
had a graduate degree, and 2% did not complete high school. Finally, 82%
of the sample identified as Christian, 9% had no religious affiliation, 8%
identified as other, and 1% identified as Jewish.
Procedure
Qualitative research has been conducted successfully online (S. Jones, 1999).
A unique benefit of using the Internet for such research is that it can provide
the participants “with the opportunity to reflect on and revise their state-
ments before actually uttering them” (Markham, 2004, p. 106). There is evi-
dence that Internet surveys may provide responses that are more clear and
complete (Petit, 2002; Walsh, Kiesler, Sproull, & Hesse, 1992), more honest
(Locke & Gilbert, 1995; Mangan & Reips, 2007), and less influenced by social
desirability (Richman, Kiesler, Weisb, & Drasgow, 1999) than those obtained
from more traditional methods.
We applied a thematic analysis to the men’s comments to try to answer
the very broad research question, “What are the salient issues or themes for
men who experience a partner’s abortion?” It was assumed that participants
who chose to share additional comments were motivated to disclose thoughts
about their experience that were of particular importance to them.
This analysis was inductive rather than based on a priori theories, and it
was semantic rather than latent (Braun & Clarke, 2006) in that we identified
codes and themes based on the actual surface text rather than on perceived
underlying notions influencing the text. We each independently read the
responses several times to become familiar with the data. We used the con-
cept of bracketing to set aside our preconceptions and personal knowledge
(Penner & McClement, 2008) as we independently established initial codes
by noting keywords or phrases that captured the thoughts and feelings com-
municated. We compared notes and discussed discrepancies until mutual
agreement was reached concerning those few occasions when we did not
identify the same code(s) or when we were unsure of a predominant code.
Because respondents’ verbatim responses frequently named specific emotions,
Counseling and Values October 2015 Volume 60 141
those emotions, or codes, were often obvious. Given the large sample size,
we created a frequency chart to record codes identified in each participant’s
response and to help us recognize the most common or prevalent codes
across the data set. The list of identified codes was confirmed to be com-
prehensive when all participants’ comments could be categorized by one
or more of the codes. Following the identification of codes, we reread the
data carefully and discussed our perceptions of more general meanings as
emergent themes were sought.
Results
Three salient themes among men who experienced a partner’s abortion be-
came apparent. These themes were (a) loss and grief, (b) helplessness and/
or victimization, and (c) spiritual healing.
Loss and Grief
The men’s expressions of loss and grief were often passionate. In particular,
the loss of the child and the loss of fatherhood were associated with intense
grief, as the following comments illustrate:
I was a father one day and not the next. She told me she had a miscarriage, then I got a
call from the abortion clinic, she forgot her medication. I have never felt so awful in my
life. (2 years postabortion)
I am so sad. I know that it’s not that we almost were parents; we are parents. But our baby
is not with us anymore. I miss him. I was getting all prepared for him, not just practically,
but in my heart and mind. I wish I could just go pick him up from somewhere. I wish
God would let me see him and look in his eyes and he could feel my kisses and hugs, and
know how much I want him. (<1 month postabortion)
I wish I could know more about the baby. I often imagine what he/she would look like
now. (13 years postabortion)
I would have made an excellent father, and I feel now at my age (49) my chance has prob-
ably gone. And this makes me sad. (9 years postabortion)
For some men in the study, grief included a component of guilt or regret
that was associated with a loss of self-image or self-worth and with judg-
ments of personal failure:
The clinic wouldn’t even let me go back there; she was left alone; I couldn’t hold her hand.
I feel as me being a man, I didn’t provide for my child. Nor did I protect the mother of
my child. (1 month postabortion)
I can’t describe the emptiness of the fatherhood lost. The loss of honor and self-respect in
skirting my responsibility to be a father, not to mention the taking of my own child’s life,
is a very heavy burden indeed. (28 years postabortion)
The absolute worst thing I have ever done. Words can’t describe the pain and overwhelming
guilt that is always with me. I have no one to blame but myself. (26 years postabortion)
I would trade places with my child in a heartbeat. I would rather be dead and know my
child lived than be alive and know I took part in a murder. (25 years postabortion)
142 Counseling and Values October 2015 Volume 60
It is interesting that none of the men referred to a lost “fetus” or a lost
“pregnancy.” Rather, they all consistently referred to a lost “baby” or “child,”
suggesting that their perceived loss was real rather than hypothetical. They
grieved the death of a child, a child they fathered and failed to protect.
The persistence of the men’s sorrow was particularly striking, with many
of the men sharing the still raw pain of the abortion experience decades
after its occurrence.
Another source of the men’s grief was related to the loss of their relation-
ships or damage to the quality of the relationships with their partners. The
abortion clearly contributed to relationship stress and, in some cases, to
relationship demise.
Since the abortion we have separated. We constantly argue. She constantly looks at baby
things. She desperately wants to become pregnant again. I want our baby back. (1 month
postabortion)
I have been isolated from her ever since [the abortion]. (2 months postabortion)
It has taken a long time to forgive her totally. It has strained our relationship more than
it was. (13 years postabortion)
I can never bring myself to forgive my ex-girlfriend for her actions. (3½ years postabortion)
Some men described feeling rejected by their partners or a loss of trust
in their partners. Moreover, for some men, this lack of trust seemed to be
generalized toward all women. Relationship stress was apparent regardless
of whether the partners agreed to abort or not.
If you really want a baby with that woman, the rejection feels so strong that eventually
will put the whole relation down. (1 month postabortion)
Don’t trust your woman even if you are engaged and she says she wants to have your
baby. When it happens, they change their minds. (2 years 8 months postabortion)
The abortion destroyed all the good in our relationship and all the hope I had in the kind-
ness of others. (3 months postabortion)
Helplessness and/or Victimization
Helplessness and victimization seemed to be two sides of the same coin,
with both arising from men’s lack of power to determine the pregnancy
outcome. Both of these feelings are generally not a part of men’s lexicon
and, as such, are often not communicated even when present. Helplessness
implies vulnerability, incompetence, and dependency, which are negative
self-attributions of male coping expectancies (Leahy, 2003). Victimization is
even more antithetical to normative male functioning because victims tend
to feel powerless, demeaned, minimized, and disrespected. In our study, the
men’s expression of helplessness had an element of sadness:
I had no control or no say about the abortion. She said she would have one if I agreed to
or not. She had the abortion without me. I would have taken care of the baby myself if
she would have just had the baby. (26 years postabortion)
Counseling and Values October 2015 Volume 60 143
I didn’t want the abortion; it was my girlfriend’s mother’s decision. At the abortion clinic,
I cried for her to leave so we could have our baby but she was afraid of her mother’s
reaction. (1 month postabortion)
She is going through hell and I can’t help her. I only remind her of it. (2 months postabortion)
For some of the men in our study, victimization, conveying a sense of
violation, was more often associated with anger:
As a man, I was totally in the dark. No one gave me any information or even cared what
I thought. (14½ years postabortion)
The overwhelming sense is one of evisceration—of having the decision taken from you, and
told you don’t matter, you don’t come into it. Sense of powerlessness. (17 years postabortion)
It’s the worst thing to do . . . this damn f++king feminist society doesn’t even think of
man in any way . . . men are projected as assholes having no feelings for the child. (3
months postabortion)
I felt dehumanized. I had no say whatsoever. (43 years postabortion)
I was notified of the abortion a couple months after it. I felt betrayed, lied to, and so much
more. I already loved the child. I think a man needs more rights. At least they should
legally have to be informed and confronted beforehand. (3 months postabortion)
Despite their expressed helplessness, the men attempted to be helpful to
and supportive of their partners. This concern for their partners was evident
even among the men who were opposed to the abortion.
It just makes me really sad that she had to do it alone without me and that I couldn’t
support her. (1 day postabortion)
My whole thought was that I didn’t want the abortion to take place. No matter what it
would cost me. I had previously told her that I was against it, but I also told her that
whatever her decision would be that I would support her. (7 months postabortion)
I acceded to her wishes, although I stifled my own concerns about the morality of the
decision and the ultimate impact it would have on both of us. (25 years postabortion)
In an attempt to do what I felt was the right thing at the time I reluctantly agreed to the
procedure. I accompanied her to the procedure. (33 years postabortion)
I wanted to be there for my girlfriend to show her I still loved her. (Time since abortion
not indicated)
The desire to support their partners is consistent with other research find-
ings (e.g., Ferguson & Hogan, 2007; Hallden & Christensson, 2010) and may
represent a type of coping mechanism as the men’s own painful emotions
were put aside or repressed while they comforted their partners.
Spiritual Healing
Participants were not specifically queried about healing. However, in every
case where a man chose to comment on the topic, he did so in spiritual
terms. Not surprisingly, every respondent but one who described a healing
experience identified himself as a Christian, and, of those men, all but one
144 Counseling and Values October 2015 Volume 60
said his faith was very important to him. The men consistently referred to
“God” or “the Lord” or “Christ” as the source of their healing.
I’m only free today because the Lord Jesus Christ has set me free. (20½ years postabortion)
God has given me the grace to confess and feel forgiven. (7 years postabortion)
I have now committed my life to Christ . . . I know I am forgiven and free but the grief is
still felt. (30 years postabortion)
God saved me from what I had done. (2 years postabortion)
God forgave me making it possible for me to forgive myself. (33 years postabortion)
By God’s grace and mercy I have been forgiven through Jesus’ blood. It is this healing
power I am committed to bring to others. (20 years postabortion)
Most (81%) of the men’s statements concerning healing included some
mention of forgiveness, including receiving forgiveness, self-forgiveness, or
both. Some men acknowledged their struggle to forgive themselves even as
they were sure of having received forgiveness from a higher power.
I know that God forgives me and I am working on my own forgiveness. (27 years
postabortion)
Though I believe God has forgiven me, I don’t have the same strength as He, and have
found great difficulty forgiving myself. (28 years postabortion)
Discussion
Since the legalization of induced abortion in the United States in 1973, 55
million elective abortions have been performed (Guttmacher Institute, 2011).
Given that elective abortion is one of the most common surgical procedures
performed in the country and that each pregnancy involves both a man and a
woman, further research including men is warranted. Future research would
benefit from large-scale studies of men whose partners undergo induced
abortion. Studies should include the following variables: men’s reactions
to pregnancy, men’s consideration of and involvement in abortion decision
making, men’s short-term and long-term mental health following pregnancy
outcome, the quality of men’s relationship with their partners before and
after pregnancy outcome, and the quality of men’s relationship with his
own and others’ children before and after pregnancy outcome. In addition,
confounding variables should be addressed, such as mental health prior to
pregnancy and pregnancy resolution, substance abuse history, history of
physical or sexual abuse, and other trauma history.
A limitation of this study is that it involved primarily Caucasian men who
identified as Christian. Therefore, we do not know how the experiences of
the men in this study compare with those of men from other ethnic groups
or men with different belief systems. Nonetheless, the existential questions
raised by abortion would seem to present considerable challenges for men
of other faiths as well as for men without a religious worldview. Therefore,
Counseling and Values October 2015 Volume 60 145
future research should aim to explore abortion’s aftermath among a more
diverse sample and to explore whether or how ethnicity and religious beliefs
may contribute to men’s experience of a partner’s abortion. Findings from
such research may serve to inform the development of appropriate and ef-
fective treatment programs.
Based on the men’s descriptions of their experiences with a partner’s abor-
tion, it is evident that, for these men, induced abortion was not a benign
or even a neutral event. The men described acute grief related to multiple
losses. The most obvious identified losses included loss of the child, loss
of fatherhood, and loss of the relationship with the partner. These losses
resulted in immediate, painful injury as well as a forfeiture of the future in
the sense that the men were grieving all that could have been but was lost
forever after the abortion. Whereas other studies have reported profound
grief among men whose partners abort (e.g., Coyle & Rue, 2010; McAll &
McAll, 1980; Poggenpoel & Myburgh, 2002; Speckhard & Rue, 1993), this
study is the first to draw attention to the persistence of men’s grief over
time and strongly suggests that some men may need professional help in
resolving their grief.
The men in our study also grappled with guilt about culpability for the
abortion, and this took a toll on their self-image. Consequently, they judged
themselves as having failed as men and suffered a loss of self-esteem. This
raises a number of challenging questions, such as the following: Are unre-
alistic or contradictory cultural expectations contributing to men’s negative
assessments of themselves? Do men have innate instincts that are violated
by induced abortion? Should male partners of women seeking abortion
routinely be offered pre- and postabortion counseling?
Helplessness among men facing unplanned pregnancy and termination
has been reported by other researchers (e.g., Coyle & Rue, 2010; Hallden &
Christensson, 2010; Poggenpoel & Myburgh, 2002) and was confirmed here.
Victimization, however, is a new finding but nonetheless logically related
to the notion of helplessness. Both of these feelings may be at least partially
explained by men’s lack of legal, relational, and biological power concerning
pregnancy and its outcome. In addition, men may simply have little experi-
ence to draw on or they may be excluded intentionally or inadvertently by
professionals involved with the provision of abortion. All of these factors
may contribute to men feeling helpless, victimized, or both.
Given the men’s anger associated with their perceptions of victimization,
it would seem beneficial to provide them with opportunities to be more
involved in pregnancy outcome decisions. A professional counselor might
effectively facilitate adequate communication between a man and his part-
ner, thus assisting full and open communication and perhaps a decision ac-
ceptable to both. Although the female partner has the final say in American
jurisprudence, a deliberate and mediated discussion of options may enhance
a couple’s communication, mitigate anger, and, as a result, be protective of
the woman even if no mutual agreement can be reached.
146 Counseling and Values October 2015 Volume 60
Although some men did seek professional or clerical counseling, their
descriptions of healing did not include typical expressions related to mental
health treatment such as “I was able to resolve my grief” or “I effectively
processed the experience.” They did, however, use spiritual terminology that
was consistent with or indicative of a Christian worldview and commitment.
Whether this religious focus was a unique characteristic of this sample is a
question for future research. It is clear that, for these men, their Christian faith
was an important source of healing, specifically the mandates to love one’s
self and one’s neighbor and to forgive, tenets that are common to a number
of world religions. Both receiving forgiveness from a higher power and self-
forgiveness seemed to be significant features of their healing. This finding is
consistent with the research by Coyle and Enright (1997) describing a forgive-
ness therapy program that taught men skills to facilitate both self-forgiveness
and the forgiveness of others. The program was tested with postabortion men
and found to be effective in reducing their anger, anxiety, and grief.
Counseling Implications
Given the sample size and the self-selection of participants in this study,
generalizations cannot be made and implications must be offered with
circumspection. Nonetheless, the findings may be useful in the develop-
ment of future research and to inform counseling practices as they relate to
pregnancy outcome decisions.
The profound and persistent grief observed among respondents whose
partners underwent induced abortion raises concerns about men’s vulner-
ability and the lack of services currently available to them. It seems prudent
to recognize that induced abortion may present psychological risk for some
men and that there is a need for more research, inclusive counseling, and
perhaps a reassessment of cultural expectations of men.
On the basis of our findings, a key implication for counselors is that they
should consider the exploration of their clients’ reproductive history as a
standard part of the intake procedure. Making such exploration routine will
increase the likelihood of identifying those who need postabortion counseling
and provide an opportunity for them to receive appropriate intervention.
Counselors should be aware that even if the abortion experience occurred
years ago, gentle probing concerning the experience will help to determine
whether the client has found resolution.
When clients appear to be still struggling with the abortion experience,
it is helpful to affirm that abortion can be a difficult, even traumatic event.
Such affirmation may facilitate awareness and lead to a willingness to
work on any unresolved grief or anger. Men who have repressed the
emotional aspects of the abortion experience may suffer from complicated
grief (CG) or mourning (Speckhard & Rue, 1993). Symptoms of CG include
“rumination about the circumstances of the death, worry about its con-
sequences, or excessive avoidance of reminders of the loss” (Shear, 2012,
p. 119). These symptoms may overlap with normal grief, depression, and
Counseling and Values October 2015 Volume 60 147
posttraumatic stress disorder (Shear, 2012). Consequently, “differential
diagnosis can be challenging . . . and comorbidity is common with CG”
(Shear, 2012, p. 123). The Inventory of Complicated Grief (Prigerson et
al., 1995) combined with measures of depression and trauma may be
useful in differentiating CG from these others diagnoses as well as from
normal grief. Differential diagnosis is critical because it determines ap-
propriate treatment plans.
The marginalization of men in the context of abortion and its aftermath
leads to men’s experience of disenfranchised grief, in which “survivors are not
accorded a ‘right to grieve’” (Doka, 2002, p. 5) and are therefore at greater
risk of developing CG. Disenfranchisement not only hinders the grieving
process but may also contribute to feelings of helplessness and anger. As men
make progress in processing their grief, their helplessness may be relieved
through encouragement to use their painful experience to benefit others. As
their right to anger is affirmed, it may decrease. Just as disenfranchisement
can foster negative emotions, validation can be an effective therapeutic
tool. In addition, structured exercises (e.g., journaling, letter writing) can
be useful in safely releasing and finding relief from painful emotions. The
men’s frequent use of Christian terminology and concepts in explaining
their healing indicates that spiritual issues may be critical as men attempt
to deal with the irrevocable ending of a life that they had a part in creating.
Therefore, counselors who are unfamiliar with their clients’ spiritual beliefs
may refer these clients to those who practice from a spiritual perspective,
such as pastoral counselors, or to other professionals who have knowledge
of the client’s worldview.
Familiarity with forgiveness therapy, which involves educating clients
about the dimensions and phases of forgiveness and supporting them as
they work toward forgiving, may also be advantageous with clients who
have an abortion history. The Enright Forgiveness Process Model (Enright
& The Human Development Study Group, 1996) may be applied to giving
and receiving forgiveness as well as to self-forgiveness, and forgiveness
therapy has proved effective with many different populations suffering
from a variety of personal injuries (Baskin & Enright, 2004). The model
includes 20 steps or units divided into four phases. Successful movement
through the process requires the individual to first explore the injury and
its emotional consequences (uncovering phase), make a decision to forgive
(decision phase), develop empathy and compassion toward the offender
(work phase), and ultimately experience emotional release (outcome phase).
A counselor may be a valuable and supportive guide as the client processes
his painful experience and discovers that he himself is healed as he offers
the gift of forgiveness to another.
Conclusion
At a time when men are expected to contribute more to domestic duties
and child care and are being called to task for shirking basic paternal duties,
148 Counseling and Values October 2015 Volume 60
bringing attention to the potential suffering that men may experience from
a partner’s abortion would fill a void in existing support systems. It is in
both men’s and women’s best interests to acknowledge the roles men play
in creating life, to explore how men respond to the consequences of un-
planned pregnancy and its resolution, and to encourage men to participate
in reproductive health care.
Our findings suggest that men ought to be routinely included in both
pre- and postabortion counseling. As cocreators of human life, they have a
physical and psychological stake in pregnancy and its outcome. Involved
men are more likely to provide support to their partners, thus enhancing
women’s reproductive health as well.
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... Studies were also excluded if they investigated the grief experiences of men who had experienced an elective abortion or termination for viable foetal anomaly, as there is literature to suggest that these types of losses may lead to different psychological outcomes compared to other forms of pregnancy loss [52,53]. ...
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Background: Emotional distress following pregnancy loss and neonatal loss is common, with enduring grief occurring for many parents. However, little is known about men’s grief, since the majority of existing literature and subsequent bereavement care guidelines have focused on women. To develop a comprehensive understanding of men’s grief, this systematic review sought to summarise and appraise the literature focusing on men’s grief following pregnancy loss and neonatal loss. Methods: A systematic review was undertaken with searches completed across four databases (PubMed, PsycINFO, Embase, and CINAHL). These were guided by two research questions: 1) what are men’s experiences of grief following pregnancy/neonatal loss; and 2) what are the predictors of men’s grief following pregnancy/neonatal loss? Eligible articles were qualitative, quantitative or mixed methods empirical studies including primary data on men’s grief, published between 1998 and October 2018. Eligibility for loss type included miscarriage or stillbirth (by any definition), termination of pregnancy for nonviable foetal anomaly, and neonatal death up to 28 days after a live birth. Results: A final sample of 46 articles were identified, including 26 qualitative, 19 quantitative, and one mixed methods paper. Findings indicate that men’s grief experiences are highly varied, and current grief measures may not capture all of the complexities of grief for men. Qualitative studies identified that in comparison to women, men may face different challenges including expectations to support female partners, and a lack of social recognition for their grief and subsequent needs. Men may face double-disenfranchised grief in relation to the pregnancy/neonatal loss experience. Conclusion: There is a need to increase the accessibility of support services for men following pregnancy/neonatal loss, and to provide recognition and validation of their experiences of grief. Cohort studies are required among varied groups of bereaved men to confirm grief-predictor relationships, and to refine an emerging socio-ecological model of men’s grief.
... Studies were also excluded if they investigated the grief experiences of men who had experienced an elective abortion or termination for viable foetal anomaly, as there is literature to suggest that these types of losses may lead to different psychological outcomes compared to other forms of pregnancy loss [52,53]. ...
Preprint
Full-text available
Background : Emotional distress following pregnancy loss and neonatal loss is common, with enduring grief occurring for many parents. However, little is known about men’s grief, since the majority of existing literature and subsequent bereavement care guidelines have focused on women. To develop a comprehensive understanding of men’s grief, this systematic review sought to summarise and appraise the literature focusing on men’s grief following pregnancy loss and neonatal loss. Methods : A systematic review was undertaken with searches completed across four databases (PubMed, PsycINFO, Embase, and CINAHL). These were guided by two research questions: 1) what are men’s experiences of grief following pregnancy/neonatal loss; and 2) what are the predictors of men’s grief following pregnancy/neonatal loss? Eligible articles were qualitative, quantitative or mixed methods empirical studies including primary data on men’s grief, published between 1998 and October 2018. Eligibility for loss type included miscarriage or stillbirth (by any definition), termination of pregnancy for nonviable foetal anomaly, and neonatal death up to 28 days after a live birth. Results : A final sample of 46 articles were identified, including 26 qualitative, 19 quantitative, and one mixed methods paper. Findings indicate that men’s grief experiences are highly varied, and current grief measures may not capture all of the complexities of grief for men. Qualitative studies identified that in comparison to women, men may face different challenges including expectations to support female partners, and a lack of social recognition for their grief and subsequent needs. Men may face double-disenfranchised grief in relation to the pregnancy/neonatal loss experience. Conclusion : There is a need to increase the accessibility of support services for men following pregnancy/neonatal loss, and to provide recognition and validation of their experiences of grief. Cohort studies are required among varied groups of bereaved men to confirm grief-predictor relationships, and to refine an emerging socio-ecological model of men’s grief.
... Exclusion criteria were articles not published in English, abstracts, editorials or opinion pieces, discussion or review articles not reporting primary data, and studies using a comparator (e.g., women) that did not present the data pertaining to men separately. Studies were also excluded if they investigated the grief experiences of men who had experienced an elective abortion or termination of pregnancy for viable foetal anomaly, as there is literature to suggest that these types of losses may lead to different psychological outcomes compared to other forms of pregnancy loss [52,53]. ...
Article
Full-text available
Background: Emotional distress following pregnancy loss and neonatal loss is common, with enduring grief occurring for many parents. However, little is known about men's grief, since the majority of existing literature and subsequent bereavement care guidelines have focused on women. To develop a comprehensive understanding of men's grief, this systematic review sought to summarise and appraise the literature focusing on men's grief following pregnancy loss and neonatal loss. Methods: A systematic review was undertaken with searches completed across four databases (PubMed, PsycINFO, Embase, and CINAHL). These were guided by two research questions: 1) what are men's experiences of grief following pregnancy/neonatal loss; and 2) what are the predictors of men's grief following pregnancy/neonatal loss? Eligible articles were qualitative, quantitative or mixed methods empirical studies including primary data on men's grief, published between 1998 and October 2018. Eligibility for loss type included miscarriage or stillbirth (by any definition), termination of pregnancy for nonviable foetal anomaly, and neonatal death up to 28 days after a live birth. Results: A final sample of 46 articles were identified, including 26 qualitative, 19 quantitative, and one mixed methods paper. Findings indicate that men's grief experiences are highly varied, and current grief measures may not capture all of the complexities of grief for men. Qualitative studies identified that in comparison to women, men may face different challenges including expectations to support female partners, and a lack of social recognition for their grief and subsequent needs. Men may face double-disenfranchised grief in relation to the pregnancy/neonatal loss experience. Conclusion: There is a need to increase the accessibility of support services for men following pregnancy/neonatal loss, and to provide recognition and validation of their experiences of grief. Cohort studies are required among varied groups of bereaved men to confirm grief-predictor relationships, and to refine an emerging socio-ecological model of men's grief. Trials registration: PROSPERO registration number: CRD42018103981.
... In an online qualitative study involving men concerned in abortion (N ¼ 89), Coyle and Rue (2015) revealed the following three major themes in the collected responses: ...
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Although a man is as well concerned in each case of induced abortion as a woman is, the amount of existing studies that attempt to describe and gain insight into the psychological effects of induced abortion on men is extremely small, either when considering this number in itself or when comparing it to the number of related studies focusing on women. The present article gives an overview of the existing psychological knowledge of men’s perspective on induced abortion including their typical reactions; roles; participation in, and responsibility for, decision-making; and their impact on the female partner. Furthermore, a number of related but understudied issues are addressed.
... Whereas previous explorations of men's abortion experiences described sentiments of loss, grief, helplessness, and victimization (Coyle and Rue 2015), our interviews with male partners at the time of an abortion provide a broader perspective, recognizing the willingness of some male partners to cede decision-making power to women and find value in the provision of support. Their reformed masculinity accepted traditionally feminine characteristics such as caretaking and affection. ...
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Although women are the focal point of abortion care, a woman’s male partner may accompany her to the abortion appointment. Using Connell’s “hierarchy of masculinities” framework, this study examines how male partners negotiate their identity and role in an unfamiliar setting while their female partners undergo an abortion. Twenty-seven in-depth interviews with male partners of women obtaining abortions at a community-based and a university-based abortion clinic were conducted. The interviews reflected the tension male partners felt while attempting to maintain characteristics of hegemonic masculinity (e.g., dominance, stoicism, ambition, and fatherhood) in an environment where their female partner’s needs were prioritized. Some male partners expressed distress about their inexperience with the process and procedure as well as their inability to participate or better care for their partners. Others negotiated alternative definitions of masculinity, emphasizing a duty and/or desire to provide support during his female partner’s pregnancy decision-making and abortion experience.
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A mixed methods approach was utilized to investigate men's experience of their partners' elective abortions. Data were collected through in-depth, semistructured interviews and men were evaluated for occurrence and degree of anxiety, anger, and grief using clinical measures. Male participants were found to demonstrate clinical levels of anxiety, higher than normative anger scores, and greater levels of grief than men who experienced involuntary pregnancy loss., The primary meaning ascribed by the men to abortion was profound loss. Men experienced multiple losses following abortion that were associated with relationship difficulties, helplessness, grief, and guilt.
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Current estimates are that one in every five women in the United States will have undergone at least one abortion with 1.4 million abortions occurring annually. Increasingly, long-term reactions to abortion have been documented in the literature.
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