“I’m struggling a bit this morning,” said one of my clients at the start of our session on the morning of June 24, 2022. “I just heard on the news about the decision to cancel Roe vs. Wade. There was so much for me to process that I had to turn it off.”
Although this client had no personal experience with elective abortion, she had a complicated birth history that included a recent pregnancy in which she was uncertain whether the baby would survive. During our session that day, she acknowledged how privileged she was to have had a medical team communicate with her about all the options available and the potential outcomes for her and the baby. Most importantly, she recognized the importance of having a say in decisions about her reproductive care.
Our session took place a few hours after the fall of roe, which overturned 50 years of abortion rights. I spent time in that session, and many others that week, with clients talking about “what ifs.”
As a therapist and academic specializing in the mental health of people during the perinatal period, during the period during pregnancy and postpartum, I have witnessed firsthand the psychological impacts of reproductive trauma during pregnancy and after childbirth. It gives me insight into how the new restrictions on reproductive health care resulting from Roe’s overthrow are inextricably linked to psychological well-being.
Research supports the need for access to abortion
Prior to Roe’s cancellation, research had already demonstrated the importance of access to safe abortions. The landmark Rejection studyconducted from 2008 to 2013, examined the effects of obtaining or refusing a desired abortion by studying the health outcomes of nearly 1,000 women seeking an abortion at 30 facilities across the United States
The results of this study showed that people were more likely to experience high psychological issues, such as anxiety and depression, when denied an abortion compared to people who have had one. The study also demonstrated that people who were denied an abortion were more likely to undergo long-term economic hardship and domestic violence.
Other research has also shown a increased risk of suicide for people unable to legally terminate an unwanted pregnancy.
Plus, research shows that most women who have an abortion feel like they made the right decision. More than 95% of women in a study 2020 reported that abortion was the right decision looking back five years, with Previous search also in support of these conclusions. Yet some states continue to implement mandatory waiting periods and counseling based on unfounded assumptions that people will regret their decision and have negative psychological consequences.
How Abortion Bans Affect Mental Health
The perinatal period puts people at increased risk for the beginning and relapse mental health disorders. Increased restrictions on abortion care, coupled with proven risk factors for perinatal mood disorders and anxiety, may increase the risk of psychological distress.
With Roe’s overthrow, experts expect half of U.S. states ban abortion-related health care In the coming months. Although this is an ever-changing landscape, as of the end of August 2022, 10 states have banned abortion and five states have banned abortion after six weeks of pregnancy.
A 2019 study predicted that there would be a approximately 13% reduction in abortions in the United States immediately following a Roe reversal due to new state restrictions and increased travel distances to state facilities that allow abortions. This equates to between 93,546 and 143,561 women prevented from having a desired abortion in the first year after Roe.
Current statistics suggest that perinatal mental health disorders affect 1 in 5 women throughout pregnancy and postpartum and beyond 34% report traumatic childbirth. Risk factors such as negative emotions surrounding childbirth and a perceived lack of control increase the likelihood of experiencing birth trauma. These risk factors are what a person would face if they sought an abortion and were denied access to reproductive health care.
More risks for those who are already vulnerable
Some sectors of the US population are disproportionately more vulnerable than others to developing perinatal mood and anxiety disorders. Roughly 1 in 3 women of color and until 60% of low-income women have mental health problems during pregnancy or within a year of giving birth. Historically, Black and Hispanic women also have disproportionately higher abortion rates than white women, as do low income women.
In a survey of over 1,000 abortion patients Asked about the reasons for their abortion, 48% of women indicated that they did not want to be a single parent or that they had relationship problems. These are two other proven factors associated with the risk of perinatal mood and anxiety disorders.
Not only are there increased mental health risks for parents of color and those who are economically disadvantaged, single or in relationship distress, but there are also concerning disparities between these groups in rates of start and continue treatment during the perinatal period.
As abortion services become increasingly restricted in the United States, there are less expected impacts on reproductive health care it will also have immense psychological effects. For example, parents who would otherwise have terminated the pregnancy due to severe birth defects or fatal medical issues detected in the fetus will no longer have this option in some states.
There is already a shortage of resources and support for families of children with disabilities and complex developmental and medical needs, despite the known higher risk for parental stress and relational difficulties between partners. At this point it is not clear if expansion needed for brackets will arise as the need increases.
Accessing Post-Roe Aids
In states that prohibit abortion, there will be dramatic disparities in people’s ability to access abortion. For accurate and up-to-date information about safe and legal abortion care, the U.S. Department of Health and Human Services provides information on Americans’ Rights to Reproductive Health Care and Resources.
In time, the short-term and long-term psychological impacts of the post-Roe era will unfold. What is certain now is that mental health care providers should prepare to meet the mental health needs of those deprived of abortion care following the Supreme Court’s decision to overturn Roe c . Wade.