Counseling the Post Abortive Woman: Audio, Outline & PDFs

  1. Complications and Consequences from Abortion
  2. Physical – see link at the bottom of this post
  3. Emotional
  4. Denial
  5. Statistically many women stay in denial of their abortion for 7-10 years
  6. Complicating factors of denial
  7. 60% of post-abortive woman report having some level of ongoing emotional distress.
  8. Problems of the present are most likely connected to the unresolved past.
  9. 30% report having severe distress after an abortion
  • Depression
  • Anxiety attacks
  • Suicidal tendencies
  • Sexual dysfunction, promiscuity
  • “Low self-esteem”
  • Fits of rage
  • Eating disorders
  • Difficulty bonding with subsequent children
  • Nightmares and flashbacks
  • Numbing of emotions
  • Difficulty falling asleep
  1. Post Abortion Syndrome (see link at the bottom of this post)
  2. Problems are debilitating
  3. Feelings are overwhelming
  4. She cannot function
  5. Abortion advocates deny reality of PAS
  • Consider it “a myth”
  1. Spiritual
  2. The spiritual consequences are the most devastating and least discussed aspect of abortion.
  3. Abortion violates her moral code (Psalm 69:5)
  4. Post-abortive women feel separated from God and are full of real guilt, fear, and shame.
  5. Spiritual consequences are intended to drive them to their knees in confession and repentance for their sin.
  6. Issues to Focus On In A Post-Abortion Counseling Ministry
  7. Her Responsibility
    1. This does not mean condemnation, shaming, or pity
  8. Ask probing questions
  • About circumstances surrounding pregnancy
  1. Do not assume anything
    • About her abortion decision
    • About the procedure
  1. c) Expect a variety of emotional responses.
  2. d) Be patient with her.

1) Allow her to experience the weight of what God is allowing her to feel.

  1. e) Help her to recognize her culpability – this is critical.

1) No blame shifting

  1. f) Go slow. This may take weeks.
  2. g) Perfect place for the Gospel
  1. Guilt
    1. Feelings of guilt
  2. She will feel overwhelming guilt and shame
  3. Feelings of guilt are a consequence
  • David (Ps. 38; 44:15-16; 55)
  • Satan will add to her torment
    1. “Real” guilt
  • Allow her to experience the weight of “real guilt.”
  • “Real guilt” goes beyond her guilty feelings.
  • She must see her sin as God sees it so she can see His forgiveness.
  1. Resolving the guilt
  2. Confessing areas of real guilt, not feelings of guilt
    • Sexual immorality
    • Making a selfish decision
    • Deception
      1. Lies to her parents, boyfriend, husband about being pregnant before the abortion
      2. Lies about where she was during the abortion
      3. Lies afterward about having the abortion
  1. Having the abortion/ending the baby’s life
  2. Confession and repentance are the only means by which a post-abortive woman or man can be reconciled to God, first for salvation and then to reconcile the abortion choice.
  • It is critical to understand that all sin is forgivable in Christ, and the post-abortive person must run to Him for forgiveness (Romans 8).
  1. An opportunity to present the gospel to someone who is bearing much more than the guilt of her abortion choice.
  2. Because our counsel is biblical in nature, the counselee has to receive the Word of God as her authority in this matter.


  1. Shame
    1. The difference between guilt and shame:
      1. Guilt – what I have done is bad.
      2. Shame- I am bad because of what I have done.
    2. Unresolved shame results in
      1. Self-destructive behaviors
      2. Depression
      3. Eating disorders
      4. Not informing medical personnel of previous abortions
      5. Hesitating to go to the ER with post-abortive complications
      6. Masking the shame with promiscuity, alcohol, drugs
      7. Self-condemning talk that reinforces the shame
      8. The Christian woman
        • Multiplies shame because of her faith
        • Believes God has rejected her because of abortion
        • Tries to hide from God (Gen. 3) by avoiding church, prayer, Bible reading
        • Apostasy
      9. Resolving the Shame
      10. Guilt and shame are intended to be heeded, listened to, and worked through.
  • The counselor must present a strong case for the counselee’s identity in Christ.
  • Teach her to renew her mind.
  • Remind her what the Bible says about when we confess our sin to God
  • Remind her what the Bible says about her position in Christ.
  1. In Christ she is not shameful.
  2. In Christ she is not hated by God
  3. She is not evil and as a Christian cannot consider herself to be so.


  1. Fear/Anxiety
  2. She has fear on various levels
  3. Fear of discovery
  4. Fear of judgment
    • By God
    • By others
  5. Fear of punishment/retribution
  • By God
  • Future children being deformed/dying
  • Infertility
  1. Fears living the rest of her life with the secret, the pain and the knowledge of what she’s done
  2. Overcoming Fear
  3. Teach Justification
    • Justice has been served.
    • She has been found “guilty” by God for the abortion – and every other sin– and Christ has paid the penalty for it.
  4. Teach her about the Character of God.
  5. Teach her the difference between consequences for actions and punishment from God.
  6. Teach her to remind herself of truth when the memories surface and thoughts drive her to despair.
  7. Teach her not to meditate on her past sin.
  8. Lack of Assurance
    1. Her abortion decision causes her to doubt
  9. her abilities
  10. her decision-making
  11. her judgment
  12. her ability to parent future children
  13. her salvation
  14. her ability to be forgiven
  15. her ability to be a wife
    1. Giving Assurance
  16. Peter’s denial of Christ
  17. Study the life of David.
  18. Go to the Bible for wisdom and guidance.
  19. Form relationships with people who will lead her biblically.
    • This will be difficult for her if other people she trusted led her to abort.
  20. Work with her through biblical decision making and the sovereignty of God.
  21. Recommended resource: Step By Step, by James C. Petty


  1. Anger
    1. She may have anger in a number of areas and to a variety of degrees.
  2. At those who helped, encouraged, assisted, paid for the abortion
  3. At the boy/man who impregnated her
  4. At the Pro-life movement
  5. At the Pro-choice movement/abortion industry
  6. At God
  7. At herself
    1. It is not acceptable to blame shift (Proverbs 20:22).
    2. It is not acceptable for her to remain angry with anyone for the abortion (Colossians 3:8).
    3. Anger will keep her in bondage to the past and will feed the roots of bitterness (Hebrews 10:12).
  8. Bitterness
  9. Bitterness results from unresolved anger
  10. At what her life has become
  11. At her decision to abort
  12. At those who have children
  13. At her parent/man
  14. At the pro-life movement
  15. At the pro-choice movement
  16. At God
  17. Bitterness is bondage (Colossians 3:8)
  18. Anger feed the roots of bitterness (Hebrews 10:12).
  19. It becomes a circular pattern.
  20. Bitterness is worse because it’s perpetual anger.
  21. Resolving anger and bitterness
  22. Determine if any of her anger righteous.
  23. Help her to look at her sinful heart of anger.
  24. Help her to see her sinful responses when angry.
  25. Questions aimed at the heart will expose what and who she is really angry with.
  26. Help her to see her part in the abortion decision – going back to accepting responsibility for her own actions.
  27. Forgiveness
    1. Biblical forgiveness
  28. Forgiveness is a command.
  29. She must learn biblical forgiveness and ask the Lord’s help in forgiving everyone who was involved in her abortion (Romans 12:19).
  30. She must accept God’s forgiveness for her part in having an abortion, which is the only way to unload sinful anger (Psalm 38:18, Psalm 32:5).
  31. She chooses to forgive on the basis of what she has been forgiven.
  • Use the Parable of the Unforgiving Servant in Matthew 18.
  1. Forgiveness is an Act of Faith.
  • It is not a feeling.
  1. Forgiveness is a promise not to dwell on the incident mentally (Philippians 4:8).
    1. Forgiving yourself
  2. There is no biblical support for forgiving yourself.
  3. Negates the finished work of Christ
  4. Grief
  5. Grief is often unresolved
  6. Pro-abortion literature and counsel often denies her feelings and experiences as being real.
  7. She cannot share her loss with anyone.
  8. Can be very complicated
  9. She often believes she has no right to grieve.
  10. She carries the same grief as any woman who loses a child.
  11. Resolving the Grief
  12. The purpose of grieving is in part to accept the loss of someone you loved.
  13. Grieving is to be for a period of time.
  14. Grieving is to be moving forward.
  15. We never “forget,” but if our grieving is healthy we are not immersed in grief for the rest of our lives.
  16. Loss due to abortion is different from losing a person with whom we’ve had a “living relationship.”
  17. The grieving may have been silent and secret since the procedure was done.
  18. Your counselee may cry, scream, and wail uncontrollably when she is finally able to grieve the loss of her baby out loud.
  19. Remembering Baby
  20. Write a letter.
  21. Create a memorial stone.
  22. A piece of jewelry with the baby’s expected birth month
  23. Planting a tree
  24. Cautions in Grieving
  25. You must be careful not to encourage your counselee to engage in assigning the baby a gender and formulating a “life” for the baby in her mind.
  26. She must not try to communicate with the baby or make assumptions about the baby that the Bible does not state.
  27. She may have a “feeling” that her baby was a boy or girl, but unless she knows the baby’s gender from testing she is speculating.
  28. Abortion sorrow and grief can be ‘redeeming’ and indeed can only be healing when experienced as a redemptive type of grief.
  29. It is important that she not create an idol out of the baby

1) Worship the baby

2) Make baby the focus of her life

  1. Discourage formulating a “life” and gender for her baby.
  2. Primary reason for grief

“Abortion should not be fought on the basis that killing a human being is wrong because he or she is so valuable, but on the basis that, when a child bearing God’s image is slaughtered, it is God who is attacked because that child bears His image. … An attack on the image of God is serious, not because of man’s great worth, but because of the One whose image he reflects.” ‒Jay Adams, A Call to Discernment, pp. 18-19


Post-Abortion Stress Checklist

Physical Consequences of Abortion

This presentation was given by Julie Ganschow at the B3 Conference held in March of 2015. Mark your calendars for the upcoming conference: COMING March 2-4, 2017! B3 Conference on Marriage & Family! Plenary speaker Dr. Nicholas Ellen. Nicolas A. Ellen is the Senior Pastor of Community of Faith Bible Church and an instructor at CBS. Pastor Ellen has also developed a biblical counseling training center called Expository Counseling CenterLLC. Pastor Ellen is a certified Biblical Counselor with the Association of Certified Biblical Counselors and a senior member of the Biblical Counseling Framework Association. He and his wife Venessa have two children, Venezia and Lindsey.