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I'm writing a sci-fi novel with some very real scenarios. And this scenario is particularly dark and emotionally charged for a lot of people. If you can read and respond objectively, I'd appreciate it.

The protagonist is the survivor of a botched abortion, but she doesn't know it yet. Besides some physical setbacks, I picture her to have unexplained anxiety and almost PTSD symptoms. But I'm really not sure if this is medically realistic, since she wouldn't remember the botched abortion. My character doesn't know anything about what happened to her. She has a good adopted family.

I could take creative license and say that the subconscious remembers what the conscious mind does not. But I'd still like to be more or less realistic.

Thank you.

EDIT: Just thought this might be helpful: The character also had one or two major operations as an infant, to help her survive. Again, not consciously remembered. Also, I should have clarified this before...but it's not necessary for my character to have PTSD like symptoms. I was just exploring the possibility, thinking it may add depth.

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    – HDE 226868 ♦
    Commented Jul 1, 2021 at 17:46

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This is fairly normal.

PTSD can develop without memory of the trauma.

Adults can develop symptoms of post-traumatic stress disorder even if they have no explicit memory of an early childhood trauma, according to research by UCLA psychologists.

The study, which will be published Aug. 15 in the journal Biological Psychiatry, found that among the many forms of memory, only some may be critical for the development of post-traumatic stress disorder. The research suggests that explicit memory — which can be voluntarily recalled from prior experience and articulated — may not be a requirement for PTSD, but that other, more primitive forms of learning may be required.

At least six previous reports have found that some people who have experienced terrible life events that resulted in brain damage developed syndromes similar to PTSD even though they had no recollection of the events themselves.

Adults routinely do horrible things to children, like beating them up, raping them, and mutilation of their body parts, and there have been quite a few studies that show, like the above, that the stress response from such events can induce ptsd even without memory.

If she had a painful non consensual medical operation while unconscious she could have ptsd from that despite not being conscious while it happened.

This can happen prentally as well. There's a reason that lots of mothers who want successful children play relaxing music to their babies and try to stay in a good mood and do nice things and don't try to abort their fetuses. If the mother has extremely stressful experiences all those stress hormones can impact the baby.

The normal symptoms are things like autism, attention deficit disorder, anxiety and anger, or borderline personality disorder.

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    $\begingroup$ Thank you, this is very helpful. Sorry I had to bring up such a dark subject. $\endgroup$
    – cal
    Commented Jun 30, 2021 at 14:16
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    $\begingroup$ The prenatal study was on rats not humans and I consider it highly dubious. If you have evidence of accepted diagnosis of PTSD as a result of prenatal only trauma please post it. The study claiming PTSD can exist without memory has two flaws : (1) it is clear that an extreme traumatizing event or events is still required and (2) in most (possibly all) cases the family situations were such that early childhood was likely extremely traumatizing anyway and proper account of this is not taken as PTSD can be the result of an accumulation of experiences, not just a single extreme one. $\endgroup$
    – StephenG - Help Ukraine
    Commented Jun 30, 2021 at 14:30
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    $\begingroup$ Human experimentation, especially stuff like traumatizing fetuses to see what happens, is generally illegal, and so non human studies are useful. Anyway, OP didn't say a ptsd diagnosis, they said ptsd like symptoms. I linked a study on that which noted the poor temperament of infants who had been in stressful situations. $\endgroup$
    – Nepene Nep
    Commented Jun 30, 2021 at 14:39
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    $\begingroup$ @NepeneNep Fair enough. No offense intended. $\endgroup$
    – StephenG - Help Ukraine
    Commented Jun 30, 2021 at 14:42
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    $\begingroup$ There is nothing in both of your sources that supports your contention 'This is fairly normal'. The first source states that mice exhibit higher anxiety and fear after an early trauma (not prenatal or birth trauma), but does not imply a causative relationship with PTSD. The second source has even fewer conclusive findings, moreover, the researchers did not examine parenting styles at all (they mention that these styles may play an important role). $\endgroup$
    – Otkin
    Commented Jun 30, 2021 at 19:19
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I am not aware of anyone with PTSD who does not remember what triggered it. I do not see why your character would have PTSD in this situation.

I do know that abortion survivors who learn their siblings were aborted often feel survivors guilt and massive insecurity about being loved

Guilt and insecurity are not at all the same thing as PTSD. Your character should not develop PTSD from learning they were an abortion survivor, even if the events were extreme. They could develop depression or severe anxiety (which is not the same as PTSD) or paranoia or a variety of other conditions, but PTSD generally requires extremely traumatizing conditions, typically characterized by a situation where the individual experience a traumatizing situation where they feel they have no way to influence or control events. It can happen in first responders who find themselves overwhelmed by extreme conditions, soldiers, victims of assaults or robberies (where the effects go beyond ordinary trauma), car crashes and so on. It can be a result of cummulative exposure to such conditions.

PTSD would not, IMO, be a response to expect from someone who learned they were an abortion survivor and had no memories.

I picture her to have unexplained anxiety and almost PTSD symptoms

I would say that "almost" does not work. YOu will either be diagnosed with PTSD or not. Anxiety is not enough (although it would be a symptom and is typically situational and extreme). Trauma and anxiety after e.g. an accident or assault does not always (I am happy to say) result in PTSD.

Here is a link to the Mayo Clinic page on PTSD.

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  • $\begingroup$ Thanks. I guess the heart of the question is what she can remember. Does what happens to us as infants or even in pre-birth affect us psychologically? Is it remembered by our subconscious? If so, a botched abortion may be expected to produce PTSD symptoms. Just not sure if there are examples of this. I appreciate your feedback. $\endgroup$
    – cal
    Commented Jun 30, 2021 at 14:29
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    $\begingroup$ @cal We do not share memories from our parents in a manner so they they could communicate trauma. Damage can be done to brain development in the womb so I am reluctant to say it is impossible. I have never personally heard of a generally accepted case of PTSD for which only prenatal effects are a likely cause. Substance abuse is generally the most likely reason for prenatal causes of brain related problems, but not AFAIK, PTSD. There are claims of people remembering being in the womb. I've always regarded these as dubious, but not necessarily impossible. $\endgroup$
    – StephenG - Help Ukraine
    Commented Jun 30, 2021 at 14:42
  • $\begingroup$ To clarify, I wasn't intending to discuss shared memories. More like events that directly impact a developing person (such as trauma in the womb, during birth, or closely following birth). Though birth itself can be traumatic...an attempted abortion may have decidedly different psychological effects than a difficult birth. $\endgroup$
    – cal
    Commented Jun 30, 2021 at 15:16
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    $\begingroup$ @cal: One would wonder how a blind individual with no experience to frame it would differentiate between a failed abortion and, say, an emergency C-section or a difficult birth that required forceps assistance or the like. Children under three months old don't even realize their own feet are a part of them (side-note: it is f-ing adorable when they finally discover them); differentiating various medical devices and sources of pain by touch, and only being traumatized by one of them, seems like asking a bit much. $\endgroup$
    – ShadowRanger
    Commented Jul 1, 2021 at 14:40
  • $\begingroup$ @ShadowRanger That's a very good point, thank you. I totally get what you mean! But if you read about abortion, it's likely more traumatizing than a C-Section. For example, in Melissa Ohden's case, she was a failed Saline Abortion. In this process, a toxic solution is injected into the amniotic fluid and is meant to scald the baby to death. This can take up to 72 hours. Melissa miraculously survived, as a nurse took pity on her when she saw she was alive after being delivered. $\endgroup$
    – cal
    Commented Jul 2, 2021 at 15:09
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Medically speaking, no one remembers anything before about 3 years of age, +/- 12 months. While the brain does form memories, apparently the part of the brain that indexes them isn't ready for primetime yet, making those memories permanently inaccessible.

And outside of pop pscyhology, there's no evidence that such things would permanently affect someone considering that they have no memory of them.

The number of doctors providing late term abortion is rather low in the United States (and similarly low elsewhere in the world). The public tends to not know their names except when something happens like when Tillerson was assassinated 15 years ago or when Goznell was prosecuted (he was shoddy as a doctor, his clinic was unsafe, but politicians were reluctant to prosecute for fear it could backfire on them).

The latter is probably the closest the real-world gets to your premise. He was accused of botching abortions, and infants were born alive. In the several alleged incidents where that happened, he or others were said to have euthanized those.

Thus, no survivors. I would speculate that in all such cases where any doctor was willing to attempt a procedure so late in pregnancy that the infant could conceivably survive, they would "finish the job" should their malpractice cause the baby to be born alive. It's politically fraught to not do so. They would have willing accomplices already in power if there were need to cover anything up.

That said, there are any number of obstetrics modes of failure that can result in lifelong injuries to the infant, many of them physically crippling. Think physical ailments, not psychological.

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    – Monty Wild ♦
    Commented Jul 2, 2021 at 14:58
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    $\begingroup$ "Medically speaking, no one remembers anything before about 3 years of age, +/- 12 months." <- While technically true, prenatal conditions change an infant's demeanor in ways can affect the mother/infant relationship and impact their core personality for their entire life. $\endgroup$
    – Nosajimiki
    Commented Sep 11 at 22:32
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I remember reading, some time ago, that it was possible to tell children born from mothers who carried out their pregnancy during stressful times (war, famine, etc.) can be told from those whose mothers had less stressful pregnancies. If I remember correctly, they were more sensitive to stress factors and had higher level of cortisol in their blood stream.

A botched abortion per se is an instantaneous event, however I can imagine that the pre- and post-abortion, especially a botched abortion, can be assimilated to a stressful situation, which can leave a signature on the newborn. However this doesn't mean that the newborn will remember it.

What can happen is that the botched abortion leaves some physical damage, resulting in a physical memento of the event.

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    $\begingroup$ There was a study recently that children and grandchildren of holocaust survivors who were born after the war experienced statistically significant higher rates of anxiety behaviors, but it was unclear whether this was because of epigenetics of the parents or "nurture" from being told stories of what happened. $\endgroup$
    – stix
    Commented Jun 30, 2021 at 16:47
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    $\begingroup$ I think I know what studies you are talking about. The described effects also relate to the lack of nutrition, not just stress. $\endgroup$
    – Otkin
    Commented Jun 30, 2021 at 18:57
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The protagonist is the survivor of a botched abortion, but she doesn't know it yet. Besides some physical setbacks, I picture her to have unexplained anxiety and almost PTSD symptoms.

Anxiety is possible since people can have unexplained anxiety even if they are born normally and have good families. Brain trauma or physical deficiencies caused by failed abortion may further aggravate the symptoms.

'Almost PTSD symptoms' is not specific enough to say whether they are possible or not. Brain damage can result in a variety of symptoms.

PTSD is not fully understood and prenatal traumas are even less understood (also because it is not always possible to distinguish between nature vs. nurture effects). However, it is highly unlikely that someone can develop PTSD due to the circumstances of their birth.

my character doesn't know anything about what happened to her. She has a good adopted family.

Please do not underestimate the effects of these two factors. If your character does not know anything about what happened to her and has a good adopted family she is very likely to grow up as a happy and well-developed person. Even if her birth caused some trauma, a good family can help her to cope with it both mentally and physically.

This makes PTSD even more unlikely. Anxiety can still be present, but should not reach uncontrollable levels. A good family environment can heal (or at least lessen) almost any psychological injury, especially in children.

If you absolutely need your character to be crippled, a physical trauma would be a much better explanation.

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  • $\begingroup$ Thank you for your input :-) $\endgroup$
    – cal
    Commented Jun 30, 2021 at 23:10
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How much she would have unconsciously remembered is unclear. The brain is one of the most complex things in existence to us. No one can be completely sure of much. This goes even further for the unconscious mind.

I think made a good case that this is medically realistic for a sci-fi story.

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  • $\begingroup$ Small issue: perinatal mental illness happens to the mother. If you read the question, it was about something happening to the child. $\endgroup$
    – Keith Morrison
    Commented Jun 30, 2021 at 20:03
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    $\begingroup$ You are absolutely right. For a writer to be I'm bad with medical reports. I had read something along the lines of Too much stress for the mother affects the baby or Abortion Miscalculation affects baby a while back. I though this was the same one, but I own up to that mistake. I did know the question was about the child, and I stand by it being at the very least medically realistically enough for the sci-fi story. Particularly because they seem to be treat the subject respectfully. $\endgroup$
    – Clair
    Commented Jun 30, 2021 at 20:18
  • $\begingroup$ Thank you, @Clair! I certainly appreciate you input. You're right, the brain is very complex...and I think there's much we are still learning about it. $\endgroup$
    – cal
    Commented Jun 30, 2021 at 23:17
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As a frame challenge, you've decided the character has PTSD from a young age. Make up anything else that could have caused whatever symptoms you need her to have. Stay far, far away from botched abortions. It's the wrong kind of controversial. You could even safely have her find out her mother decided to have an abortion, but wasn't able to get there.

NightWatch, Sergei Lukyanenko

Botched abortions are currently a favorite issue of anti-abortion groups (your real-life example is an anti-abortion crusader). More-so, playing up the trauma of abortions (for the mother) has long been a pro-life tactic. Putting "abortion" + "PTSD" in the same sentence is going to hit that button. Readers will assume the book is pro-life propaganda -- not a big draw for SciFi fans. If you just want to write a book that doesn't accidentally drag in controversies that will alienate potential readers, skip it.

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    $\begingroup$ Well, I understand where you're coming from. Thanks for the input. Charles Dickens, Alexander Dumas, Harriet Beecher Stowe -- all were fine with addressing societal issues. I think writers should not shy away from them. I'll try to be accurate, and to do what's best for the story :-) $\endgroup$
    – cal
    Commented Jul 1, 2021 at 11:56
  • $\begingroup$ Also, I'm afraid you're only assuming my character is a pro-life crusader. I have never specified that. I think I should add that it's not necessary for my character to have PTSD like symptoms. I was researching the possibility, just as a way of adding depth. I should have made this more clear in my question, and I'll edit my question to include that info :-) $\endgroup$
    – cal
    Commented Jul 1, 2021 at 11:57

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