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In a recent revelation from her memoir, The Woman in Me, pop icon Britney Spears wrote about her abortion at 19, following alleged pressures from her then-partner, Justin Timberlake. Spears wrote if the decision was hers alone, she would have never gone through with the procedure.
"To this day, it's one of the most agonizing things I have ever experienced in my life," she wrote in her book, released Oct. 24.
Spears' poignant account sheds light on the complex emotional journey many people face after undergoing a pregnancy termination, regardless of the circumstance.
Yahoo Canada recently spoke to reproductive health experts on how to navigate abortions and what grief supports are in place for Canadians.
Abortion in Canada
Abortions are legal in Canada and the procedure is regulated through provincial healthcare rules and guidelines.
Someone can receive an abortion medically, where the patient is administered medication that causes the uterus to expel the pregnancy tissue, or surgically, where a clinician removes the pregnancy tissue from the uterus.
Medical abortions are typically available until nine to 11 weeks of gestational age (how far along your pregnancy is, measured from the first day of the woman's last menstrual cycle to the current date). Surgical abortions are usually available up to 24 weeks of gestational age.
Dr. Amanda Black, a professor of obstetrics and gynecology at the University of Ottawa and the president of the Society of Obstetricians and Gynaecologists of Canada, said patients are always counselled on their options when it comes to pregnancy and pregnancy termination.
Women may experience some cramping and bleeding as the pregnancy passes and are expected to resume their periods in six weeks. If someone is experiencing significant pain, bleeding or discharge, they should seek medical attention.
Black points to Planned Parenthood as a great resource in Canada because of the careful guidance patients receive when it comes to talking about options, deciding what to do and providing support after a pregnancy termination.
"It's almost like we're sometimes better at providing that care than we might be for people having a miscarriage," Black said.
People experiencing grief after a miscarriage have been reported to be similar to those who've experienced a loss of a close relative.
"I think that emotional burden isn't necessarily recognized by health-care professionals or the public and people often won't talk about it," Black explained.
Navigating grief around pregnancy termination
Abortion, whether wanted or unwanted, can lead to feelings of grief, decreased self-esteem, anxiety, depression and post-traumatic stress. Post-abortion grief can also impact one's partner.
In Canada, women coping with the emotional aftermath of an abortion or miscarriage can seek support from various avenues. This includes organizations like the Pregnancy and Infant Loss (PAIL) Network and medical professionals, social workers, psychotherapists, counsellors and reproductive psychiatrists.
These resources can provide essential guidance and a compassionate environment for processing grief and finding solace.
Many women's centres in Canada will also have programs for grief counselling after an abortion or miscarriage.
Dr. Yolanda Kirkham, an OBGYN at Unity Health and an assistant professor at the University of Toronto, emphasized having open conversations, especially on days like the Pregnancy and Infant Loss Remembrance Day on Oct. 15.
"Though people don't volunteer their experiences, there is a collective shared experience that can be therapeutic when talked about," she said.
Talking through loss specific to pregnancy and infants is exactly the service Aditi Loveridge provides in her support centre in Calgary.
Loveridge opened her support centre after spending years as a pregnancy loss coach and noticed a gap in the supports offered to patients.
Her decision to found the clinic also came from a personal experience of loss after an ectopic pregnancy, a life-threatening condition where the pregnancy has implanted in one of two fallopian tubes, instead of the uterus or the womb. "Because the fallopian tube is the size of a finger and cannot grow or stretch to accommodate a growing pregnancy, it can rupture or burst, causing internal bleeding," Kirkham said.
It doesn’t matter how you've lost a pregnancy — if you're experiencing grief around it, we will support you.Aditi Loveridge
She added people often forget that those who have an ectopic pregnancy similarly need support for a pregnancy loss and because there is concern for maternal health, some might experience fear to become pregnant again and could benefit from counselling.
Loveridge said it's fulfilling to be able to provide a space for people that wasn't there when she was going through her grief.
The Pregnancy and Infant Loss Support Centre provides text and online support, working one-on-one with a professional, support groups, peer mentorship and more cost-free pathways to healing.
Loveridge and her team also approach their work with an anti-racism lens, constantly having conversations on how to decolonize their practice more.
"People come to us because they know they won't feel judged," she said.
"It doesn't matter how you've lost a pregnancy — if you're experiencing grief around it, we will support you."