The five-step program begins with parents naming and writing a letter to their unborn child.

It ends with a memorial service for the child, the last step in helping women—and  men—cope with what Margaret Breen calls “post-abortion aftermath." 

Breen, program manager of the Chicago Archdiocese’s Respect Life Office, said  she has counseled mostly women over the last five years but some men also seek her services. They call the referral hotline for her office and Breen gives them advice and refers them to a cleric or mental health professional.

“When they call, they tell their story and then I tell them about the five steps,” Breen said. “I gear the five steps toward the man because it’s a different perspective from the woman who carries the baby in her womb.”

“It’s almost like a 12-step healing program, like Alcoholics Anonymous,” Breen added. “It’s a lot of forgiveness."

Anti-abortion activists contend that many people suffer emotional and mental anguish after an abortion, what they refer to as post-abortion syndrome for women and post-abortion aftermath or trauma for men. But many medical and mental health professionals contest the idea of these post-abortion conditions.

Neither post-abortion syndrome nor post-abortion trauma are listed in the Diagnostic and Statistical Manual of Mental Disorders, a manual published by the American Psychiatric Association that categorizes psychiatric diagnoses and provides information about their causes.

Dr. Nada Stotland, president-elect of the American Psychiatric Association and a psychiatry professor at Rush University Medical Center, said post-abortion illnesses aren’t included in the manual because they don’t exist.

“There is no such thing,” Stotland said. “This syndrome was made up. There’s actually a history of a deliberate attempt to make abortion illegal by claiming it hurts women. Now they’re trying to invent a syndrome for men as well.”

With the recent 35th anniversary of Roe vs. Wade, the landmark ruling that made abortion legal, anti-abortion and abortion rights advocates are again debating the issue. Though the debate is framed as exclusively concerning women, some anti-abortion advocates argue that abortion is as much about men as it is about women.

Counseling services and scores of Web sites are devoted to post-abortion treatment for men. A "Reclaiming Fatherhood" conference was even held last November in San Francisco focusing on the post-abortion experiences of men. 

Male  post-abortion experiences differ, depending on their involvement in the decision, said Jason Baier, president of the Fatherhood Forever Foundation in Phoenix, Ariz., an organization that provides resources to men after an abortion.

“There are at least seven different ways that men can be involved or not involved in the abortion decision,” Baier said. “The two main ones [involve] the guy that insisted on an abortion and abandoned his girlfriend or wife in their time of need. A lot of times, those guys end up feeling a lot of guilt. The flip side is the guy who had no say in the matter and wanted his child, but really couldn’t do anything to stop the abortion. He’s going to feel a lot of grief.”

Baier is speaking from personal experience. In 1995, his former fiancé decided to have an abortion because she said they weren’t ready financially. Baier, who was 23 at the time, said he offered to raise the child on his own. He was at work when his fiancé had the abortion and said he found out about it afterward by her sister.

“Immediately after she told me, I had a nervous breakdown and went into severe depression. I had no idea I would even react that way,” Baier said. “My depression was at first inward and then it started turning outwards into anger --anger towards other people and anger towards the whole world for allowing something like this to happen to me.” 

Baier, who said he had no history of mental illness before the abortion, spent 30 days in an outpatient hospital after a psychiatrist diagnosed him with psychosis. Though he admits he started drinking before the abortion, Baier said the situation caused him to abuse alcohol. He established the Fatherhood Forever Foundation in 2005 to help men undergoing similar experiences.

Psychologist Catherine Coyle is author of the book "Men and Abortion: A Path to Healing. As co-director of the Alliance for Post-Abortion Research and Training in Wisconsin, she also said men experience grief after an abortion.

“Much of what they experience after is similar to women. We’re not that different. When we suffer a loss, we grieve” Coyle said. “But how they [men] express that grief may be very different. They are more inclined to contain it.”

“When we attempt to work with them following abortion, we need to respect that they have different ways of coping,” Coyle added.

Coyle said her anti-abortion beliefs spurred her interest in post-abortion healing. She conducted surveys on post-abortion experiences of men and discovered many regretted encouraging or playing passive roles in the abortion decision.

Coyle admits the research is scarce on men’s experiences after abortion. Though there were more than 854,000 legal abortions performed nationally as of 2002 and 46,000 abortions performed in Illinois in 2006 alone, no hard data details the number of men who experience emotional stress or seek counseling after an abortion.

“Men have been written out of the abortion equation,” Coyle said. “They don’t have equal rights when it comes to reproductive choice and that applies to married men as well as casual sex partners.”

Coyle, Baier and Breen all said they help people from different religious backgrounds, but most of the men they’ve counseled identify themselves as Christian. In Illinois, Catholic dioceses in Chicago, Belleville, Rockford, Joliet, Peoria and Springfield offer post-abortion healing.

Most of these initiatives are offshoots of Project Rachel, a program established by the Catholic Church in 1984. The program initially provided counseling services to women after abortion, but now includes men.

Post-abortion trauma for men is categorized by a wide range of symptoms, according to the National Office of Post-Abortion Healing and Reconciliation. The organization provides consultation for secular and religious organizations trying to establish post-abortion healing programs. Its Web site lists symptoms such as relationship struggles, rage, addictions, sexual compulsions, sleeplessness and loneliness, among others.

Coyle and Bair said post-abortion conditions should be medically recognized.

But Stotland said it takes seven or eight years, hundreds of researchers scouring medical literature and extensive field work to categorize something as a psychiatric disease.  She said the medical community hasn’t found any evidence of a discreet, identifiable disorder that is solely linked to abortion.

“A mental disorder is a coherent set of signs and symptoms that are recognized and can be duplicated,” Stotland said. “If I was to examine a patient and somebody else was to examine that patient, he or she would come to the same conclusion.”

“The symptoms I’ve heard described cover the whole gamut of feelings and symptoms and there’s a big confusion,” Stotland said.  “It doesn’t mean that people don’t have a whole host of feelings after they have abortions or babies, and it doesn’t mean that nobody has a psychiatric illness after having an abortion. Many people have a psychiatric illness before having an abortion.”

But those who disagree said post-abortion illnesses are very similar to post-traumatic stress disorder and argued that political motivations play a role in whether conditions are recognized as illnesses.

“Like many social issues, it has become politicized,” Coyle said. “Anyone who thinks that doesn’t trickle down into science is very naïve.”

Stotland said it is not the medical establishment that is politically motivated in regard to abortion.

“It is neither accurate nor a service to humanity to try to convince people that a certain procedure will make them sick,” she said.

Regardless of how their feelings are categorized, Breen said that, after an abortion, both men and women are in need of healing.

“Society says there is no need for this type of healing,” Breen said. “I’m not a therapist, I’m not a psychologist and I’m not a social worker. I’m a lay facilitator. I don’t pretend to know anything about psychology. All I know is that people have these wounds.”