Opinion: Without access to abortion, mental health problems will grow

Updated 2 years ago on October 17, 2022

The morning the Supreme Court struck down federal abortion protections, I reflected on the decision at home with my son and his girlfriend. For each of us, the decision was deeply personal. My son expressed concern about what would happen if he had a contraceptive mishap.

For his girlfriend, a 19-year-old from Mississippi, the decision left her feeling hopeless, with no control over her body and her future. She described what she thought would be the devastating effect of denying young people access to abortion in her home state, where abstinence-only sex education is mandatory and pharmacists are allowed to deny requests for emergency contraception. Then, on July 6, the last abortion clinic in Mississippi closed.

To me, this decision contradicts years of careful research on the subject. I study the psychological consequences of denying access to abortion, and I fear that we are only seeing the beginning of the far-reaching consequences that this decision will have on the well-being of pregnant women and their families.

My research shows that the burden people feel from limiting their body autonomy - having to overcome more barriers and potentially facing increasing stigma about abortion - is very likely to increase psychological distress. Those denied abortions experience increased levels of stress, anxiety, and low self-esteem.

In addition to the emotional problems associated with trying to exercise their reproductive autonomy, people who are denied an abortion are more likely to remain in contact with an abusive partner and will experience economic hardship and insecurity for years because they were forced to carry a child they could not afford to raise. These problems are passed on to their children and can exacerbate mental health problems.

The Dobbs decision is expected to disproportionately harm people of color and other marginalized groups and further exacerbate structural inequalities. We must consider the multiple groups who will be most affected. These include residents of states that ban abortion, those with limited resources to travel, such as young women, caregivers, people who cannot take time off work, and those who are incarcerated or too ill to travel. Those who discover their pregnancies late in life or have conditions diagnosed late in pregnancy will have less time to get medical care at a medical facility.

Stress and anxiety can intensify in all people of reproductive age - women, men, and gender-expansive people, pregnant and not - as they face the new reality that their reproductive and bodily autonomy has been taken away.

After the Roe vs. Wade decision, nearly half the country will likely lose access to abortion. This would increase the need to travel, the cost of treatment, and the difficulty of finding a clinic and making an appointment. A surge in patients going to a limited number of states, such as California, Colorado and Illinois, would likely affect people even in places where abortion is still available. Expanding access to medical abortion in these states through alternative models, such as telemedicine and advance provision, could help meet this demand.

Although options for people living in states where abortion is illegal are extremely limited, information on how to access and use medical abortion is available and can be a safe substitute for risky or ineffective methods. We have strong evidence that the medical abortion pill is safe and effective for self-administration.

Nonprofit and community health groups play an important role in providing information as well as emotional and financial support to people without access to abortion. Helplines, such as All-Options, can provide emotional help with the decision to become pregnant, and the National Network of Abortion Victims Funds can provide financial assistance for travel, lodging, and related services.

If you are having an abortion on your own, using the pill, there are mobile apps and hotlines that provide information and emotional support. However, there are real concerns about the criminalization of those who self-abort, especially those who already disproportionately fall victim to the criminal justice system. It is important to know your legal rights regarding self-induced abortion and to know where to get legal help if needed. With the number of mental health problems likely to increase in the post-Ro world, our support systems are critical to addressing this issue.

M. Antonia Biggs is an assistant professor and social psychologist in the New Standards in Reproductive Health program at the University of California, San Francisco.

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