Abortion and Mental Health

Up to 10% of mental health problems among women may be affected by a history of abortion, according to a new review published by the Royal College of Psychiatrists in their  British Journal of Psychiatry.

 

Publication of this new review, which included 877,181 women from six countries, has reawakened accusations that the American Psychological Associations Task Force on Mental Health and Abortion deliberately understated abortion’s mental health risks for ideological reasons.

The findings of the new review appear to contradict the conclusions published by the task force in 2008, which stated that a "single abortion" of an "unwanted" pregnancy for an "adult" woman did not "in and of itself" pose significant mental health risks.

According to an expert in the field, Elliot Institute director Dr. David Reardon, that carefully nuanced conclusion was designed to obscure rather than clarify the risks of abortion.  "If you pay close attention you will find reluctant admissions that certain subgroups of women are at higher risk."

For example, the APA review admits that multiple abortions may be problematic. But it then fails to mention that fully half of all abortions are second, third or fourth abortions.

Similarly, Reardon notes that the APA recognizes that abortions of wanted pregnancies, and cases where women feel pressured to abort by other people, are also clearly problematic. But these cases may account for 30% to 65% of all abortions. Abortions for minors are also known to be associated with elevated suicide rates.


The meta-analysis in this publication revealed that women with a history of abortion face higher rates of anxiety (34% higher) and depression (37% higher), heavier alcohol use (110% higher) and marijuana use (230% higher), and higher rates of suicidal behavior (155% higher).

The study also found that women who delivered an unplanned pregnancy were significantly less likely to have mental health problems than similar women who aborted unplanned pregnancies.  Women with a history of abortion were 55% more likely to have mental health problems than women who did not abort an unplanned pregnancy.

Talk to your pregnant daughter about these statistics.  If your pregnant daughter is a minor, and/or people are pressuring her to abort her child, she may be facing mental health consequences after the abortion.  With your pregnant daughter, learn more about the psychological impact of abortion.


You may find it helpful to read the chapters “Trying to Hide” and "Where is God in all of this?" in our book “How To Survive Your Teen’s Pregnancy“.


Have questions? Want to talk about this post or other issues? Write a comment, join us on Facebook, or talk with us on our new Grandparent Support Group!  

One Flaw In Women

I got this in email today and found it inspirational. I hope you do to.

Women have strengths that amaze men...

They bear hardships and they carry burdens,

but they hold happiness, love and joy.

They smile when they want to scream.

They sing when they want to cry.

They cry when they are happy

and laugh when they are nervous.

They fight for what they believe in.

They stand up to injustice.

They don't take "no" for an answer

when they believe there is a better solution.

They go without so their family can have.

They go to the doctor with a frightened friend.

They love unconditionally.

They cry when their children excel

and cheer when their friends get awards.

They are happy when they hear about

a birth or a wedding.

Their hearts break when a friend dies.

They grieve at the loss of a family member,

yet they are strong when they

think there is no strength left.

They know that a hug and a kiss

can heal a broken heart.

Women come in all shapes, sizes and colors.

They'll drive, fly, walk, run or e-mail you

to show how much they care about you.

The heart of a woman is what

makes the world keep turning.

They bring joy, hope and love.

They have compassion and ideas.

They give moral support to their

family and friends.

Women have vital things to say

and everything to give.

HOWEVER, IF THERE IS ONE FLAW IN WOMEN,

IT IS THAT THEY FORGET THEIR WORTH.

Depression affects children

"National Research Council and the Institute of Medicine, estimates that in any given year, 7.5 million U.S. parents are depressed and at least 15 million U.S. children live with a parent who has major or severe depression." A WebMD.com news article summarizes some information from this report.

Was your pregnant daughter depressed before she became pregnant? Is she depressed now that she is pregnant? Make sure she gets medical treatment for her depression! Her depression can adversely affect her child. The report shows that:

Depressed pregnant women may be less likely to get prenatal care.

Depressed moms may be less attentive or less able to respond in a healthy way to their babies' needs.

Parental depression has been linked to children's early signs of, or vulnerability to, having a more "difficult" temperament, including more negativity, less happiness, poorer social skills, more vulnerability to depression, more self blame, less self-worth, and a less effective response system to stress.

William Beardslee, MD, of the psychiatry department at Children's Hospital in Boston notes that
"Early in life, we worry most that somehow the fundamental bond between the mother and father and the infant may be weakened because of depression. A little later on, when children are older, parents are vitally important in providing structure, order, encouragement, support, helping with school, helping with friendships, and those processes tend to be disrupted when a parent is depressed".

Depression Treatment during Pregnancy

A new report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists finds that women should talk to their doctors about whether they should continue to take antidepressant medication during pregnancy.

"Pregnant women who experience psychotic episodes, have bipolar disorder, or who are suicidal or have a history of suicide attempts should not be taken off antidepressants, the report concludes."

"Separate studies from Sweden and the U.S. suggested an increased risk for congenital heart defects in babies born to women who took Paxil during pregnancy. But the joint panel found the evidence linking Paxil use during pregnancy to heart problems in newborns to be inconclusive."

Antidepressant "use during pregnancy has also been linked in some studies to an increased risk for miscarriage, low birth weight, and preterm delivery. But once again, the report found no definitive link between the use of the antidepressants and these pregnancy outcomes."

Recommendations in the report include:

"Women who are already pregnant should not attempt antidepressant withdrawal if they have severe depression. Psychiatrically stable women who want to stay on antidepressants during pregnancy should consult with their psychiatrist and ob-gyn about the potential risks and benefits. Women with recurrent depression or those who have symptoms despite drug treatment may benefit from psychotherapy when available."

If your pregnant daughter is taking antidepression medication, talk to her doctor as soon as possible about the risks and benefits of her medication.

Postpartum depression

Postpartum depression can affect as many as 50%-80% of new moms, and is more likely in teen moms. After your daughter gives birth, watch her closely for symptoms and get her to a doctor right away if she is having trouble.

CNN copied an article from Parenting.com that has information about postpartum depression (PPD). Here are two paragraphs from that article:

New moms should expect to feel overwhelmed at times, incompetent now and then, nervous about being left on their own to take care of the baby, and to overreact and tear up over seemingly minor things. What's not normal: a darkening storm of anxiety and panic. "The big difference between baby blues and PPD is duration and intensity," Howard explains. "It is a prolonged sense of sadness lasting for two weeks or more."

There are also different degrees of PPD, notes Dalfen. Women who are not enjoying motherhood but can go through the motions of taking care of the baby and themselves may have mild PPD, but are getting by. Those who feel down all the time, have trouble connecting with their baby, and find it hard to get through every day have a stronger case of the illness. Severe PPD sufferers are extremely depressed and unable to take care of themselves or their babies. All of these women need treatment, Dalfen emphasizes.

14 Characteristics of Successful People

With your pregnant daughter, sit down with a piece of paper and a pen. Give yourself one point for each of these traits that you have, and your daughter gets a point for each trait she has.

According to productivity expert Jeffrey J. Mayer, successful people have 14 traits in common. They are:
1. have a dream
2. follow a plan
3. have specific knowledge
4. are willing to work hard
5. don't take no for an answer
6. are strongly motivated
7. are focused
8. learn how to get things done
9. take responsibility for their actions
10. make decisions
11. are self-reliant
12. look for solutions
13. cooperate with other people
14. are enthusiastic

What did each of you score?
Which success traits do you lack? Which success traits does your pregnant daughter lack? What actions can you and she take to improve these areas?
Which success traits do you possess? Which does she possess? Start by acknowledging your strong points and promising yourself to improve them. Experience shows that you'll make more progress by improving your strengths than by correcting your weaknesses.

1. have a dream. What are your daughter's dreams for her child? For her own education? For her career? For her personal life?

2. follow a plan. Sit down and write out a plan of how your pregnant daughter will reach for her dreams. Exactly how will she finish her education? Exactly what training does she need for a career that can support her? Exactly what does she need to do to improve her personal life? Be as specific as possible. Add dates where possible.

3. have specific knowledge. What does your pregnant daughter need to learn about in order to follow her dreams? What does she need to learn about in order to make a solid decision about parenting/adoption, and her relationships? Where can she get this knowledge?

4. are willing to work hard. How much time and effort is your daughter honestly willing to put into being successful as a parent/spouse/employee?

5. don't take no for an answer. Does your daughter get discouraged easily? How could she improve her self-confidence and resolve so that she can tackle the many challenges she will face in life?

6. are strongly motivated. What does your daughter feel are the things that motivate her? Money? Friends? Fun? A dream? Are these motivations enough to help her face obstacles?

7. are focused. What are the focuses of your daughter's life? Does she feel she needs to change her focus to other things? If so, what?

8. learn how to get things done. Does your daughter follow-through on tasks and complete them? Does she need to learn how to break down tasks so that they aren't so overwhelming?

9. take responsibility for their actions. Does your daughter take responsibility for her actions that contributed to her pregnancy and lifestyle?

10. make decisions. Has your daughter learned decision-making skills such as making pro/con lists so that she can evaluate a decision and then stick to it?

11. are self-reliant. Does your pregnant daughter expect everyone else to cater to her whims?

12. look for solutions. Does your daughter seek solutions to her problems, or simply whine about them and hope that someone else will take action?

13. cooperate with other people. Does your daughter allow other people to help her, and does she help other people in turn?

14. are enthusiastic. What topics is your daughter enthusiastic about? Is she enthusiastic about being a single parent? Or about getting married? Or should she look at adoption so that a family that is enthusiastic about being parents can pour their energy into her child?

Abortion impacts future parenting

The Elliot Institute News (vol 8, no 8) ran an article titled "Abortion has greater impact on parenting than other forms of pregnancy loss, new review finds." This article summarizes the findings of a study (performed by Priscilla Coleman of Bowling Green University) published in "Current Women's Health Reviews". This research study "focused on psychological reactions to these various types of loss and discussed how they might affect a mother's relationship with children born after the pregnancy loss."

"It is now known that women usually begin feeling maternal attachment in the early stages of pregnancy." Ask your pregnant daughter if she has begun feeling attachment to her child in her womb.

The paper notes that despite the increased responsibilities and stress involved in raising children, "numerous studies have documented positive psychological characteristics associated with motherhood including increases in life satisfaction, self-esteem, empathy, restraint, flexibility and resourcefulness in coping, and assertiveness." Losing a child before or at birth, for any reason, however, "can be a profound source of suffering."

Examining your own motherhood, have you found that being a mother has increased your life satisfaction? Your self-esteem? Your empathy? Your restraint? Your flexibility and resourcefulness in coping? Your assertiveness? Have you lost a child before or at birth for any reason, including abortion? Did you find this loss to be a source of suffering? If you did suffer the loss of a child, would you prefer that your pregnant daughter receive the possible positive psychological benefits of motherhood or the possible suffering of child loss?

"While all forms of pregnancy loss can cause emotional distress that can impact future parenting, the available research indicates that emotional responses after induced abortion are more likely to go unresolved and to persist for a longer time period."

Why would that be true?

While "society understands that women who miscarry or relinquish a child through adoption may experience sadness and grief; however, grief after socially sanctioned because abortion is not acknowledged by our culture as a human death experience," and help to deal with the experience is usually not offered. ... Finding help and support after abortion is further hampered by the belief that, unlike other forms of pregnancy loss, abortion is optional and therefore women experience less distress afterwards.

Having an abortion is "sometimes quite inconsistent with the woman's true desires" (one survey found that 64 percent of American women who had abortions reported feeling pressured to abort), and many women, especially those who feel conflicted or didn't want the abortion, do feel emotional distress afterwards.

Ask your daughter to be honest with you... does she really want to abort her child? Is she feeling conflicted? Is she feeling pressured to abort?

"The best evidence regarding negative effects of abortion indicates that 20-30 percent will experience serious psychological problems," Coleman wrote. "With 1.3 million U.S. abortions performed annually, a minimum of 130,000 new cases of abortion-related mental health problems appear each year."

And while abortion advocates frequently argue that abortion is better than carrying
an unplanned pregnancy to term, the evidence suggests otherwise.

Studies of women with unplanned pregnancies found that women who aborted had higher risks of depression, substance abuse and anxiety, and teens who aborted an unintended pregnancy were more likely to experience negative mental health outcomes than their peers who carried to term. Further, a recent New Zealand study led by a pro-choice researcher found no evidence that abortion provided any mental health benefits to women even in cases of unplanned pregnancy.

Many times, a pregnant woman will say that she is choosing abortion because she wants to be a parent later in life instead of now. The research study describes "a number of ways that a previous abortion can effect a woman's relationship" with the children she gives birth to later at some point after the abortion.

1) Increased depression and anxiety. Abortion has been linked to higher rates of maternal depression and anxiety before and after birth, which may effect the woman's relationship with her children. In addition, depression is a common predictor for child abuse.

2) Sleep disorders and disturbances. Women who have had an abortion are more likely to experience sleep disorders compared to women who carry to term, and one survey found that many women attributed the sleep disorders to a past abortion. These sleep disturbances "could render the high energy demands of parenting more complicated."

3) Substance abuse. Studies have found that women who had an abortion were more likely to engage in substance abuse, and also more likely to smoke or use drugs or alcohol while pregnant. Mothers who abuse drugs or alcohol are more likely to "engage in authoritarian and punitive parenting practices," and parental substance abuse increases the risk that the children will suffer abuse or neglect.

4) Child abuse. Abortion has been associated with lower emotional support for one's children and with a higher risk of child abuse and neglect.

Abortion has also been linked to higher rates of suicide and to a wide range of mental health disorders. Coleman was also the lead author of a study published in The Journal of Child Psychology and Psychiatry, which found that the children of women who had abortions have less supportive home environments and more
behavioral problems than children of women without a history of abortion. [2]

While the review noted that not every woman may experience psychological problems after abortion that will carry over into their personal relationships, "some women will have carryover effects into the parenting realm." The paper pointed to a need for better screening and awareness of possible psychological problems after miscarriage, adoption and abortion, and for more research to examine the effects of abortion.

Citations

1. PK Coleman, "The Psychological Pain of Perinatal Loss and Subsequent Parenting Risks: Could Induced Abortion Be More Problematic Than Other Forms of Loss," Current Women's Health Issues 5: 88-99, 2009.
2. PK Coleman, DC Reardon, JR Cougle, “Substance use among pregnant women in the context of previous reproductive loss and desire for current pregnancy,” British Journal of Health Psychology 10: 255-268, 2005.

If you or your pregnant daughter are considering aborting her child, take the time to research the possible physical, emotional and spiritual risks that are associated with this action... not only risks to her own well-being but risks to her future children as well.

Would counseling help?

You and your family are in a stressful situation when your daughter is pregnant outside of marriage! You might want to seek counsel if you are feeling anxious, or if you need help making the multitude of decisions you face, or if you are working through the grief cycle, or if your relationships are being strained by the stress of your daughter's pregnancy. You could seek counsel from a religious leader, a peer counselor, a professional counselor, or trained mentors at a pregnancy resource center.

Would counseling benefit your daughter, your family, and you? You don't need to wait until you've hit bottom before you seek counseling, and you don't need to delve into the past if you don't want to... just have a conversation about what you're experiencing right now during your daughter's pregnancy.

The above tips were adapted from "A Conversation with a Counselor" by John Van Regenmorter, in the March/April 2009 "Stepping Stones" newsletter by Bethany Christian Services.

Depression and Diabetes

A recent article at Forbes.com was titled "Diabetes linked to depression during and after pregnancy". Here are some points from the article.

• "Low-income women with diabetes who are pregnant or recently gave birth face almost twice the risk of depression compared to women without the blood sugar disorder."
• "It didn't matter whether the women developed diabetes before or during pregnancy, or if they were taking insulin or oral medications. The risk of depression was still much stronger for women with diabetes".
• "Women who'd never been depressed before appeared to be at risk, too. 'One in 10 women who had no indication of prior depression received a diagnosis of depression within a year following delivery'".
• "Post-partum depression affects about 10 percent of new mothers, usually between two and six months after birth, according to background information in the study. If left untreated, post-partum depression can affect the mother-child relationship as well as the child's development."
• "Risk factors for post-partum depression include a history of depression, troubled relationships, domestic violence, stressful life events, financial problems, lack of social or emotional support, a difficult pregnancy or delivery, and health problems with the baby."
• "No matter what your income, if you're expecting, you should try to set up a support system before the baby arrives. Try to set up extra help so you're not alone with the baby day after day".

If your pregnant daughter develops gestational diabetes, or had diabetes before her pregnancy, help her learn about postpartum depression and help her develop a plan of how she will get help to cope with a new baby. Ask her doctor to screen her for depression at every visit, both during pregnancy and at checkups after birth.

New research on depression after childbirth

As discussed in our previous posts about postpartum depression (here and here), teens and women under the age of 35 are more likely to develop depression after childbirth.

A recent research study found that "increased levels of corticotropin-releasing hormone (CRH), which is produced by the placenta, identifies women who are at risk for developing depression after their pregnancy ends".

The article suggests that in the future, doctors may be able to pre-screen pregnant women to see if they are more likely to experience postpartum depression. This would allow earlier intervention. In the mean time, make sure you and your pregnant daughter learn about the symptoms of postpartum depression and make a list of resources in advance so that if your daughter gets depressed after giving birth you'll be able to get help more quickly.

Goals for the New Year

Rather than create a New Year's Resolution, sit down with your entire family and talk about each person's goals for this new year.

A goal is something that they can accomplish completely through their own effort. Compare this to a desire, which can only be accomplished with the cooperation of other people.

There are lots of areas in which you can set goals: Work, education, relaxation, relationships, spiritual, financial, health, etc.

First have everyone list some ideas on their own paper. Then review each one and decide if it is a goal or a desire.

Next analyze the goals, using the acronym SMARTPLUS. The quoted explanations below are from the book "Retire - And Start Your Own Business" by Dennis & Martha Sargent.

S = Specific. A goal should be focused.

M = Measureable. How will you know when the goal has been achieved?

A = Attainable. "If a goal is too easy, it's not likely to motiviate you. If it's too hard, you may give up hope. Only you can decide how to challenge yourself without going overboard."

R = Rewarding. "Achieving your goal should make you feel great. It doesn't matter if anyone else recognizes your achievement, as long as you do. It should be something you really want, not something that someone else things you ought to do."

T = Timely. "Setting a time frame for a goal will help to ensure that you spend time on it. You may have daily goals, monthly goals and lifetime goals."

P = Positive. "It's usually much more effective to stat your goals in a positive way" because it is a better motivator. State what you will do, not what you won't do.

L = Linked. "Link your goals to the balance of work, play, and learning you envision."

U = Unbundled. Does your goal contain subgoals that you can break out into steps?

S = Shifting. "A key to achieve your goals is maintaining focus, but don't think this means your goals are set in stone. Goals can, and do, change. That's why it's important to keep an eye on your progress and consider whether your goals need adjustment."

Now write out goal statements. For each goal, write answer to these questions: "I will know I've met this goal when:...." and "I will accomplishg this goal by/within:...."

Stress and Support

A study of 2,921 mothers revealed that single mothers were twice as likely as married mothers to experience a bout of depression in the prior year.

Single mothers also reported higher levels of stress, fewer contacts with family and friends, less involvement with church or social groups and less overall social support.

Source: Cairney, John and Michael Boyle et al. “Stress, Social Support and Depression in Single and Married Mothers.” Social Psychiatry and Psychiatric Epidemiology 38 (August 2003): 442-449.

Talk to your pregnant daughter about this statistic. Does she plan to be a single parent, or to marry the baby's father? What are her thoughts about how she can better handle the stress of being a parent after her baby is born? How will she maintain contact with friends and family? How will she get to church at least once a week? What social groups will she attend regularly? For example, does your church have a single parent's support group? Or a Mothers of Preschoolers (MOPS) group? Does your pregnant daughter have a history of depression? If so, she should be prepared to take quick action if she gets depressed after the baby is born.

If your family does not have the resources to help your pregnant daughter with these needs for emotional and social support and she does not plan to marry the baby's father, consider whether an adoption plan would provide benefits for both the child and your daughter.

Help your daughter get emotional support right now, during her pregnancy, by attending classes at your local pregnancy help center. Your daughter can learn about parenting and adoption, decision-making skills, relationship skills, and maybe even financial skills and job skills if those topics are available.

Words Matter

Family & Consumer Sciences at Michigan State University Extension created a free program called "Caring for My Family." One of the lessons in this program is called "Words Matter- Positive Strokes ". Consider printing out this lesson and discussing it with your spouse, your family, your pregnant daughter, and maybe even the father of the baby.

Having a pregnant teen or college-aged daughter in your family can be very emotional for the entire family. Many of those emotions may be negative: fear, anger, shame, embarrassment, confusion, depression, blame, etc. Your entire family needs extra love and support during this experience. With so much emotion and possibly lots of negativity, each member of your family can feel wounded. This lesson looks at how your family can talk to each other to help support and heal each other rather than tear each other to shreds.

"People have a “hunger” or desire to have their human psychological needs met. One desire is the need to feel that others recognize the positive things about you."

While it may be true that your daughter has acted sinfully by being involved in sex outside of marriage, this action does not define her entire person. She still has many positive qualities despite her actions. Similarly, while it might be true that you were not the perfect attentive parent, this action does not define your entire person either. There are many positive qualities about you despite your parenting actions.

With your family and daughter, read over the worksheet in this lesson, titled "Strokes":
"Eric Berne points out in his book Games People Play that humans are “stroke hungry.” This means that in order to have a full and meaningful life, a person has to be acknowledged by others. A stroke is defined as a unit of human recognition. As infants, we receive most of our strokes through touch; in fact, studies have shown that infants have died because of a lack of touch. Touch remains a stroke throughout life, but as we mature, words and various non-verbal ways of getting strokes are added. If we don’t get enough strokes, we suffer from stroke hunger. It is important for us to understand that strokes are NOT A LUXURY BUT A BASIC NECESSITY for us to survive."

"Strokes can be positive or negative. A simple hug is a positive stroke and usually makes the recipient feel good. This is the kind of strokes we like to receive. When people do not get positive strokes, they would rather have negative strokes than none at all. For example, a person can learn to survive being yelled at or ridiculed more easily than being ignored or treated with indifference. With negative strokes, at least the individual’s presence is acknowledged. Positive and negative strokes can also be given for doing something, for behaving in a certain way. This is called a conditional stroke."

How do the various members of your family give out strokes? Pay more attention to the strokes your family members are giving and receiving today. What qualities in yourself do you wish your family would appreciate more? Do you give more negative or postivie strokes to your daughter now that she is pregnant? Do you tend to give out conditional strokes (focusing on behavior) rather than unconditional strokes? Could you think of ways to affirm your daughter as a person? What good qualities does she have? What positive actions has she taken recently?

The lesson also talks about "discounting":
"In order to increase our self-esteem, we must be aware of how we strengthen ourselves. The term 'discounting' means anything that devalues us as human beings. Discounting can have negative effects. When you receive a compliment, accept it as a positive stroke. Don’t discount the compliment by having negative thoughts or disagreeing. Some of the ways that people discount a compliment or positive stroke is to turn it into a negative. They might respond by looking embarrassed, shaking heads, looking down, or disagreeing with the compliment. For example, if a person tells you, “You look nice in those clothes.” A person who has low self-esteem may discount the compliment by blushing and responding with, “This old thing. It’s about ready for the rag bag.” Look for body language that indicates ways in which you or others discount positive strokes."

What habits do your family members have that they use to discount compliments? Talk about these habits. You and your family may find it helpful to get emotional support and counseling from a pregnancy help center, your church leadership, or a professional counselor. Don't let this experience of your daughter's pregnancy destroy your family: get the help you need!

Reducing Conflict and Anger

Family & Consumer Sciences at Michigan State University Extension created a free program called "Caring for My Family." One of the lessons in this program is called "Resolving Conflicts and Anger- Improving Situations Through Communication ". Consider printing out this lesson and discussing it with your spouse, your family, your pregnant daughter, and maybe even the father of the baby.

You know that your daughter's pregnancy can stir up a lot of emotion in your family. We've discussed several times how each person in the family may be processing their own grief cycle of shock, anger, depression, and bargaining. This lesson teaches a method of communicating that may help your family reduce the conflict and anger.

First, let's look at the lesson's questionnaire. Have each person fill out the questions, then compare answers.

When I am having a problem, disagreement or am in conflict with someone, I usually… (Check all that apply.)

• Put off dealing with the situation
• Get mad, get loud so I get my way
• Try to meet the other person half way
• Criticize or attack the other person
• Give a lot of reasons to show I’m right
• Just give in but find another way to punish the person
• Treat the other person as if s/he is a child who needs a parent to explain how the conflict will be resolved
• Try to help the other person get what s/he wants
• Complain or sulk until I get my way
• Explain my point of view, ask the other person to do the same, and listen to his/her response
• Keep my ideas to myself
• Change the subject
• Find humor in the situation and try not to take yourself too seriously
• Try to understand the other person’s point of view
• Get another person to decide who’s right
• Try to work out a compromise that we both can agree to
  

The type of person I find it easiest to discuss a problem/conflict with is…

Because…

The type of person I find it hardest to discuss a problem/conflict with is…

Because…

Ideally, I would like to communicate my needs during a conflict in the following way(s)...

Often times when people are angry, they don't communicate as carefully as when they are calm. Discuss the worksheets in the lesson, and see if your entire family can start practicing this way of communicating.

"Sometimes people in anger, begin a conversation or an argument with phrases like, “You always,” or “You never,” that make the receiver of the message very defensive."

"One communication strategy to help reduce conflict is to use the “W.I.N. Strategy.” WIN stands for: “When you..., I feel..., I need...”

"The WIN strategy changes the emphasis from an attack on the other person, to how the other person’s actions make the speaker feel."

The WIN strategy:

W = When you (state the specific behavior that bothers you)
I = I feel (express your feeling or thought)
N = I need/want (state the specific behavior you would like instead)

Teen sex and depression

A recent article on LifeSiteNews titled "Sexually Active Teenage Girls "Twice As Likely" To Suffer From Depression" is as follows:

Research which appeared recently in the Journal of Health Economics has found that young girls who are sexually active often experience feelings of guilt, low self-esteem, regret and shame, and are far more likely to suffer from depression than those who remain chaste.

The study, by Joseph J. Sabia and Daniel I. Rees, of 14,000 adolescents aged between 14 and 17, used data from the U.S. government funded National Longitudinal Survey of Adolescent Health.

The study found that sexually active teen girls have more than double the rate of depression of those who are not sexually active - 19 percent compared to 9.2 percent.

The conclusion the study reached was that "sexually active female adolescents are at increased risk of exhibiting the symptoms of depression relative to their counterparts who are not sexually active."

Dr. Trevor Stammers, a lecturer on sexual ethics and chairman of the Christian Medical Fellowship in the UK, said the new study confirmed that most girls "retrospectively showed regret about early intercourse."

"It also shows as closely as we have been able to show so far that there is a genuine link between increased risk of depression and adolescent females engaging in sex," Dr. Stammers said in a British Daily Mail report. "My experience is that, for girls, depression, regret and shame are very common."

Link to full text of this study, titled, "The effect of adolescent virginity status on psychological well-being".

Talk with all your kids about this research. If your teens have not become sexually active, discuss how this research can help them say no to sex until they are married. With your kids, read about sexual integrity and how this means more than simply waiting until marriage, but also includes a lifetime of sex the way that God intended it to be.

If your teen daughters have had sex, do they regret it? Have they had feelings of guilt, low self-esteem, regret and shame, or depression? If so, help them find counseling to heal the wounds caused by their sexual activity. With your kids, read about sexual integrity and how they can choose to not have sex again until they are married. Sex outside marriage is like any other sin: it can be forgiven and put in the past. 1 John 1:9 promises that if we confess our sins, that He will forgive us and cleanse us of all unrighteousness. This means He promises to cleanse us of sexual sin too. Your daughters do not need to label themselves as shameful if they confess and ask forgiveness from God.

Infant abandonment

The Buffalo News recently ran an article titled "Mother charged with killing infant daughter kept pregnancy a secret, police say". This article tells a small piece of the story of 19-year-old college student Alicia Zebrun who apparently hid her pregnancy from her family, gave birth alone at home, then put her newborn daughter into a shoe box where she died. According to a quote in the article, this type of incident happens about once per day in the U.S. This sort of situation is also the basis for the "Safe-Haven Laws" that all 50 states have where a newborn can be left at a specific location. See the National Safe Haven Alliance for more information about these laws and the details for your state. There has also been a recent set of articles about parents abandoning their older kids at Safe Haven locations.

Like pregnancy in teens and college students, there is no perfect stereotype for women who hide their pregnancy and then leave their child to die: any socio-economic group can be represented. In this article, neighbors said Alicia was a good kid and the children in the Zebrun family had a strong upbringing by "excellent parents" who were strict. Neighbors believe Alicia's mother and step-father would have helped her with the pregnancy and baby becuase they were "all about kids."

So why do some women do this?
One commentator in the article guesses that "For whatever reason, they were extremely frightened. They may have felt fearful about disclosing the pregnancy for whatever reason. We don’t know."

Another commentator in the article says "The girls and young women who kill or abandon their newborns generally are deeply ashamed and often refuse to acknowledge their pregnancies 'until the very end when it’s undeniable,' he said. Faced with a baby they don’t want, they do the unthinkable. 'They’re not thinking,' Kaye said. 'They’re acting.' "

So what can we do?
Kaye believes the only way to stop it is for parents and communities to be more involved with their daughters. He pointed out one case in which a girl said she hid her pregnancy from her family and ended up killing her baby because her father had told her he’d kill her if she ever came home pregnant. “The father broke down in tears,” Kaye said. “ ‘This is my fault . . . I didn’t mean it. But I actually said it,’ ” he recounted. “The community needs to say this is an example of us failing our kids,” Kaye said. “We need to do a better as a community rather than skapegoating this girl.”

Talk to all your children about this story. Tell them that while you will probably be angry or upset to learn they were pregnant (or were drinking or using drugs), that you would prefer that your kids talked to you instead of keeping a secret. You may have said something in the past such as "If you ever come home pregnant, I'll (kill you, kick you out of the house, etc.)." Do you really mean this? Would you really murder your own child? Or are you simply trying to express that you would be hurt, disappointed, and angry for a while? If you've ever said an extreme statement like this, tell your kids that you don't mean it and then tell them what you really mean instead. Tell your kids that you love them even when they make mistakes with serious consequences. Tell your kids that you want to help them when they have a problem, even if the news of the problem may be hard to hear. Be involved in your kids' lives so much that you would NOTICE if your daughter was pregnant. Brainstorm ways you can be involved in their lives without going to extremes. There is a balance in there somewhere so that you are neither a clueless parent nor an invasive parent.

In our book "How To Survive Your Teen's Pregnancy", the chapter titled "First Steps" list three things you need to do as soon as you discover your teen or college student daughter is pregnant. First, get her the medical attention she needs, and then find her the emotional support she needs. For example, help your pregnant daughter get parenting classes and help her learn about stress management. Your local pregnancy help center may be able to offer your family these classes, and may also have peer support sessions and group sessions to help your pregnant daughter cope with the changes that are coming into her life.

Bulimia and pregnancy

The Norwegian Institute of Health issued a recent news release titled "Pregnant women with bulimia have more anxiety and depression". Much of that news release is repeated here.

What is Bulimia?
Bulimia (bulimia nervosa) is episodes of binge eating combined with various behaviours to compensate for the large intake of food and to avoid weight gain. These behaviours include vomiting, use of laxatives, periods of fasting or training. Vomiting leads to disturbances in the body’s salt balance and enamel erosion of teeth. People with bulimia are often of normal weight or overweight. Approximately 30 percent of persons with bulimia have a history of anorexia. Eating disorders affect both young and old but often occur for the first time in adolescence. Anorexia nervosa and bulimia are about ten times more common among women than men.

Who were the women in the study?
Out of more than 41,000 pregnant Norwegian women, 96 (0.2 %) met the criteria for broadly defined bulimia (bulimia nervosa) in the first trimester of pregnancy. 67 (0.16%) of the women reported that they had also had bulimia six months before pregnancy, while 26 (0.06%) had developed bulimia after becoming pregnant. It is unknown whether these women had bulimia earlier in life.

What did the study show?
Women who have bulimia in pregnancy have more symptoms of anxiety and depression compared to pregnant women without eating disorders.

They also have lower self-esteem and are more dissatisfied with life and their relationship with their partner.

Women with bulimia reported a higher prevalence of life-long physical abuse, sexual abuse and major depression compared with others, says Cecilie Knoph Berg at the Division of Mental Health at the NIPH.

Women who had bulimia six months before pregnancy but who were symptom-free in the first trimester, experienced higher self-esteem and satisfaction with life compared to other women with persistent symptoms.

According to the American Pregnancy Association, bulimia in pregnancy can have serious consequences for both mother and child:

• Premature labor (labor before the 37th week of pregnancy)
• Low birth weight (baby weighing less than 5.5 pounds)
• Stillbirth or fetal death (preborn baby dies in the womb after the 20th week of pregnancy)
• Likelihood of Cesarean birth
• Delayed fetal growth
• Respiratory problems
• Gestational diabetes
• Complications during labor
• Depression
• Miscarriage (preborn baby dies in the womb before the 20th week of pregnancy)
• Preeclampsia (high blood pressure during pregnancy)

Talk to your pregnant daughter about her eating habits before pregnancy and now that she is pregnant. Has she often eaten a lot of food, and then purged in some manner? If so, what methods did she use to purge the food? How often has she done this? Does she still have this habit now that she is pregnant?

If your pregnant daughter may have an eating disorder, she needs professional medical help as soon as possible. Her own physical and mental health depend on her getting help. And the physical health of your grandchild, her child, depend on her getting help.

Self-Esteem

Family & Consumer Sciences at Michigan State University Extension created a free program called "Caring for My Family." One of the lessons in this program is called "Building my self-esteem: self-talk skills". Consider printing out this lesson and discussing it with your spouse, your family, your pregnant daughter, and maybe even the father of the baby.

This lesson says that "Self Esteem is defined as the beliefs that you hold about yourself and the value that you place on those beliefs."

Did your pregnant daughter have a good level of self-esteem before she got pregnant? Or did low self-esteem play a part in her sexual activity that led to pregnancy? Does she value herself and her body? Or is she willing to trade her body in order to feel some sort of love or respect? How is her self-esteem now that she is pregnant? Ask your daughter what kinds of things she says to herself. Does she say to herself, "I made a mistake but I can fix that area of weakness" or does she say to herself, "I'm so stupid. I'm such a slut. I'm worthless. No one could truly love me unless I give them sex"?

How about your own self-esteem now that your daughter is pregnant? Are you telling yourself things like "I'm a failure as a parent"?

This lesson says that "High self-esteem is the realization that you can make mistakes and still like yourself despite your mistakes. Accepting your shortcomings and working on improving
yourself are important steps towards building your selfesteem."

Why is self-esteem important? Because when a "person believes that something is true about him or herself, it will affect his or her actions. Thoughts can become a self-fulfilling prophecy.
The way we interpret other people’s actions and words will be based on what we think about ourselves. The way we feel about ourselves affects our relationships."

If your daughter believes that she is worthless, or that she is a slut, she will tend to act that way. She may allow herself to be in unhealthy relationships because she doesn't believe that she is worthy of a healthy relationship. Now that she is pregnant, your daughter's self-esteem may plummet because of the unkind things that people say about her at school, church, or even in your family. Yet her self-esteem is even more important now that she is responsible not only for her own life but for the life of your grandchild, her child, as well. For her own physical safety as well as the safety of your grandchild, your daughter needs enough self-esteem to help her feel worthy of getting out of any abusive relationships, taking care of herself by eating right and getting medical care, and making choices that can improve her future and her child's future.

Improving self-esteem takes time and effort, just like getting physically fit.

This lessons says that step one to improving self-esteem is to "first become aware of your beliefs about yourself and then actively work to change the ones that are untrue, irrational, and destructive to you." Have your daughter write a list of things she doesn't like about herself. Then she should pick one of the items and say outloud a statement that is the opposite. For example, if she wrote down a negative like "I am clumsy" then she should say something positive like "I am graceful." For each statement on her list of negatives, write down its positive. Read these positive statements outloud. When she notices that the tapes in her head are repeating anything negative, she should say outloud to herself the positive opposite instead. With enough repetition, she can replace the negative self-talk with talk that is more positive. If she can't start out with the actively positive statements, she should at least practice telling herself things like "I will do better next time," and "I can do this."

The above activity focused on weaknesses. Now lets look at strengths. Have your daughter write out these lists:
1) Things I am pretty good at:
2) Things other people compliment me on:
3) Things I have worked hard on (or am working hard on):
4) Things I am proud of about myself:
5) Things I accomplished this year:
6) A dream (goal) I am working on:

Step two is to imagine the person you would like to become. Have your daughter write a description of how she would like to be described five years from now. What qualities would she like to have? What kind of parent would she like to be? What kind of employee would she like to be? What kind of friend would she like to be? What kind of student would she like to be? Ask your daughter to start acting as if she were that person right now. In recovery groups, they use the phrase "fake it till you make it" to summarize this step. For example, if she wants to be more patient with other people, she should figure out what actions patient people take. Then when she feels impatient she should take patient actions even though she feels impatient. Over time, this will help her actually feel the emotion of patience.

Step three is to learn to take care of yourself physically, emotionally, intellectually, socially, and spiritually. For each of these areas, have your daughter write down three things that she can do to improve herself. The first should be something she can do TODAY to improve that area. The next should be something she can do over the next month to improve that area. The third should be something she can work on for the next year to improve that area.

Parents, you probably have some areas of your life that could use a little improvement too. Complete these exercises yourself and see if your family life is more satisfying as the whole family makes changes.

You or your daughter may benefit from talking about this issue with an objective third party, such as a professional counselor, pastor, or peer counselor. See if you can spot the difference between low self-esteem in your daughter and depression. If your daughter is depressed, get her the medical and counseling help she needs as soon as possible.

Managing Anger

Family & Consumer Sciences at Michigan State University Extension created a free program called "Caring for My Family." One of the lessons in this program is called "Managing Anger". Consider printing out this lesson and discussing it with your spouse, your family, your pregnant daughter, and maybe even the father of the baby.

Anger is a very common emotional reaction in a family that learns that their single daughter (sister) is pregnant. As we've discussed on many occassions, anger is a normal part of the grief cycle. Your family is grieving many things related to a unmarried daughter's pregnancy. Don't beat yourself up for feeling anger. But DO learn how to express is appropriately, and how to manage anger so that it is not overwhelming. Anger should not control your actions or your decisions.

The lesson has a great worksheet to help people learn about their anger style. Print out a copy for each person, and have them score each of the questions. This is a copy of the questions on the anger survey:

1. I am blunt and forceful when things don’t go my way.
2. I avoid or withdraw from people when I am angry with them.
3. I complain about people behind their back, but not to their face.
4. I disagree with others without attacking them on a personal level or becoming defensive.
5. I don’t keep grudges or seek revenge when problems cannot be resolved.
6. I don’t like to let other people know when I am angry.
7. I feel like hitting someone who makes me very angry.
8. I feel uncomfortable expressing my anger.
9. I have a tendency to be depressed or moody.
10. I look for mutually agreeable solutions when people disagree with me.
11. I politely, but firmly tell others when I am angry.
12. I pout and feel sorry for myself when I am angry.
13. I suppress my anger by drinking, taking drugs, or overeating.
14. I swear loudly to blow off steam.
15. I take some time to calm down before talking with others about disagreements.
16. I try not to let my anger show.
17. I use sarcasm and “little jokes or names” to make people look bad or feel bad.
18. If I’m very upset, I’ll hit something.
19. If things are bad enough, I’ll throw something.
20. When I am angry I become silent, to make it obvious that I am unhappy.

Before you discuss your scores, talk about the main points of the lesson:

• Anger is a normal and necessary emotion.
• It is not wrong to experience feelings of anger.
• Everyone experiences feelings of anger; some people experience it more intensely and more often than other people.
• Anger is your body’s way of telling you that something is wrong. It is your body’s response to an unmet need, expectation or belief. For example, you become angry when someone cuts in front of you in line because you believe that people should wait their turn.
• Anger can feel wrong to some people because they have been taught that feeling/expressing anger is not good.
• Anger can appear wrong when people express it in inappropriate ways, such as using violence.
• When expressed appropriately, anger can lead to having your needs met, without hindering the needs of others.
• Appropriate expressions of anger can lead to stronger relationships and more satisfying situations.

Talk with your family about anger: Can anger result in something good happening? If so, give an example. Give an example of something bad that can happen when someone expresses anger.

Tally up each person's response to the anger survey, using the Key in the lesson. What is each person's current method of handling anger? Read the descriptions of each anger management style from the lesson. How has each person demonstrated their anger style during the stress of your daughter's pregnancy so far?

Anger management Style A - Open Agression: Using physical or verbal force to respond to a situation that makes you angry. Open aggression often leads to more anger and new problems. Try learning Style D - Assertive Problem Solving.

Style B - Suppressed Anger: Pretending that you are not angry, stuffing your anger and hoping it will go away. People who have this style of anger management may develop headaches,
ulcers, stomachaches, or other physical illnesses because their anger is simmering below the surface. It also does not get rid of the problem that is causing the anger. It would be better to switch to Style D – Assertive Problem Solving.

Style C - Passive Aggressive: Showing anger in indirect ways, such as pouting, refusing to talk, slamming doors, stomping feet, sarcasm, and gossiping. These responses often lead to more anger and new problems. Try learning Style D - Assertive Problem Solving instead.

Style D - Assertive Problem Solving: First, be aware that you are angry. Express your anger in an honest and polite way. Confront people without making personal attacks. Don't become defensive. Brainstorm solutions to the problem that would be mutually acceptable. Release your angry feelings and forgive, let go of grudges and bitterness.

Assertive Problem Solving can be remembered by the acrostic ACTS:

A - Be AWARE of your anger. How does your body react when you start to get angry? Pay attention to how your body is feeling.

C - CONTROL your response. Think before you act. What reponse choices are available? What are the pros and cons of each? What solutions are available? What are the pros and cons of each solution? Your goal is to meet your needs without hindering the needs of others.

T - TALK about the problem in a calm, polite and assertive way. Talk about differences without using personal attacks and without becoming defensive. Use the "WIN" method of confrontation: "When...(something happens)", "I feel...". "I NEED/want...(particular action to happen)." For example, "When we don’t have enough money to pay our bills I feel angry. I want us to talk about how we can budget our money so that we have enough money to cover our bills.”

S - SOLVE the problem in a mutually acceptable way. If the situation is not solvable, then you have three choices:

1) Change your way of thinking about the event. So, in relation to your daughter's pregnancy, you might need to change your way of thinking about her pregnancy. She is carrying your grandchild, not just some blob of tissue. As difficult as life may become going forward, this child, your grandchild, will also be a blessing. Your daughter can't become un-pregnant. Abortion will not change the fact that she was pregnant. It will simply make her the mother of a dead child, and you the grandparent of a dead grandchild. So change your way of thinking about her pregnancy.

2) Get help and counseling. You can find resources and counseling for your pregnant daughter and maybe other family members at your local pregnancy help center, your church, private counselors, social services, charities, and your friends and family. Reach out to your support network and brainstorm positive solutions to the challenges your family faces. Avoid courses of action that will hurt and damage each other physically, emotionally, and spiritually. This is a time to pull together, not to tear each other down and destroy the family.

3) Withdraw from the situation. If you or your family member(s) are at risk of being physically abused by someone's anger, get help to escape from harm. If you feel angry enough to hurt someone, leave until you have calmed down. Avoid alcohol and drugs when you are angry - they can help you to act violently or in aggressive ways that are harmful to yourself and others.

Examining Priorities

Family & Consumer Sciences at Michigan State University Extension created a free program called "Caring for My Family." One of the lessons in this program is called "Powerful Priorities". Consider printing out this lesson and discussing it with your pregnant daughter, and maybe even the father of the baby.

The lesson says, "We have many things in our lives that we feel are important. However, there is just a limited amount of time, energy, and money that is available to us. Often we have to choose between the priorities in our lives. We have to decide which of our priorities are the most important to us." Print out a copy of the following list of topics (or the worksheet in the PDF lesson) for each person in this discussion (yourself, spouse, daughter, father of baby, etc.).

List of topics:

• Education
• Wealth – Financial Security
• Health
• House (Clean, Orderly)
• Material Possessions (clothes, appliances, etc.)
• Spiritual
• Family
• Children
• Friends
• Good Looks – Attractiveness – Neat Appearance
• Spouse/Boyfriend/Companion
• Adventure
• Recreation – Leisure Activities
• Social Reform – Helping Others Less Fortunate
• Politics
• Other topics you pick:

Have each person number these topics in the order that they are important as priorities to that person. Before discussing the numbering, also number each topic with how you think another person would number them. For example, after picking her own priorities, your daughter should number the list according to how she thinks the baby's father would number these topics.

Now share why you numbered the topics the way you did, and talk about the differences in priorities that each person has.

Is the way that your daughter numbered priorities different from the way the baby's father did?

Is it okay for people in a relationship to have different priorities? Discuss how these differences in priorities might impact their relationship and their parenting.

Differences in priorities are the food for many fights. Discuss each difference on the lists: is the value of a particular priority vastly different between your daughter and the baby's father? If so, try to understand each point of view about that priority topic. Is there an acceptable compromise for that topic? You may choose to have these discussions with a religious leader or counselor so that they can provide an objective viewpoint and help keep the conversation on topic.