Abortion Access in the United States and Its Impact on Mental Health
Introduction
The topic of abortion is a deeply personal one that should be approached with compassion and care. While the abortion debate has been and continues to be a hyper-charged topic, especially since the United States Supreme Court overturned Roe, it is our view that supporting the right to choose stands on the side of justice. Having the right to choose allows decisions to rightfully be made by the pregnant person whose life will be the most impacted. The terms "pro-choice" and "anti-choice" refer to the two conflicting viewpoints in the debate. Pro-choice individuals and organizations advocate for pregnant people to have autonomy over their own bodies and reproductive systems and believe that they should be the ones to decide when and if they want to have children.
On the other hand, anti-choice proponents view abortion as an offense against humanity, often coming from extreme religious beliefs; they advocate for its illegality in all cases. Since Roe was overturned, we have seen heinous rulings that strip away the right, even in cases of rape, incest, and the health of the p’s health. Many of these extreme religious people and organizations are even pushing to take away access to birth control pills.
States Where Abortion is Banned
The legality of abortion varies by state in the United States. As of May 2023, there are currently 14 states with laws that ban abortion in most circumstances since the Supreme Court overturned Roe v. Wade, the landmark 1973 case that established the constitutional right to abortion in the US. The NY Times has an update to date tracker that is an excellent resource for staying on top of these attacks. (1)
The 14 states in which abortion is banned with no exceptions (including cases where it is known the baby will die after delivery) include:
Alabama
Arkansas
Idaho
Kentucky
Louisiana
Mississippi
Missouri
North Dakota
Ohio
Oklahoma
South Carolina
South Dakota
Tennessee
Texas
In addition to these 14 states, Arizona, Florida, Utah, and North Carolina have passed laws restricting access to abortion in various ways, such as mandatory waiting periods, gestational age limits (such as Georgia, which recently passed a six weeks ban, which someone would not even know they were pregnant at that point), or restrictions on insurance coverage for abortion services. (2) These laws make it nearly impossible for individuals to access safe and legal abortion services and profoundly impact their mental and physical well-being.
The Stigma Surrounding Abortion
There is a stigma surrounding abortion that makes it difficult to talk about. Unfortunately, it's not just those who have an abortion but also the people who support them and advocate for their rights to access abortion.
First, we must identify what we are discussing when we say “stigma.”
So, what is this stigma? Stigma is defined as negative beliefs or biases. It's all around us: everywhere in the media, politics, our communities. We've all been exposed to things that make us question our beliefs and values because of living in a society where people always try to make us feel bad about ourselves for being different from them or doing things different from their beauty standards or morality.
This leads us back to the original point. When we talk about abortion stigma, we're talking about how difficult it is for those who are pregnant to be open about their decision-making process without being judged.
The impact of stigma can be even more significant for individuals from marginalized communities, such as Black women, those who are low-income, other people of color, and those who are part of the LGBTQ+ community. These individuals often face additional barriers to accessing safe and legal abortion services and experience greater shame and stigma surrounding their decision to have an abortion. In addition, the impact of stigma in abortion shames those who are pregnant and seek it, which can lead to feelings of guilt, indignity, and isolation for those who have had it. It also makes it difficult for those who have had abortions to access care and support after the procedure.
Mental Health Impact of Abortion
The issue of abortion isn't just about rights—it's about access to healthcare for millions of pregnant people across the country. Reproductive health care matters to those who are pregnant as access allows them to have choices. Either way, whatever one chooses is a significant decision that impacts the pregnant one and can impact their relationships with partners, friends, or family. It affects those who are pregnant financially by increasing the cost of care for pregnancy or raising children while also decreasing government assistance available for those who need it most (such as those who utilize Medicaid insurance, which often does not cover abortion services). Finally, being pregnant is difficult for most and can significantly affect someone’s body. And as we have seen, maternal mortality rates are continually increasing for Black/African American women due to systemic and medical racism (3).
Global studies indicate no association between having an abortion and experiencing mental health issues. However, it has been established that limiting the availability of safe and legal abortions can lead to adverse effects. (4)
According to research, individuals who are unable to obtain abortions tend to suffer from poorer physical and mental health, as well as worse economic outcomes than those who have access to them. However, the same research also shows that it does NOT cause significant psychological problems.
A study involving over 1,000 women from 21 states examined those who wanted and received an abortion versus those who were denied. It revealed that those permitted to obtain an abortion did not exhibit a greater likelihood of reporting negative emotions, symptoms of poor mental health, or suicidal thoughts than those denied an abortion. (5)
Restricting access to abortion is more likely to lead to mental health problems. One’s ability to control when and if one wants to have a child is often associated with socioeconomic standing. These restrictions “will most likely affect those who are living in poverty, people of color sexual and gender identity minorities, as well as those who live in rural or medically underserved areas,” according to APA President Frank C. Worrell, Ph.D. (6)
Research in psychology indicates that being denied access to abortion can raise the risk of experiencing domestic abuse for individuals compelled to remain in contact with abusive partners. This can endanger both individuals and their children (2).
Conclusion
In conclusion, abortion is sensitive and controversial, with significant implications for mental health and well-being. Access to safe and legal abortion is essential for promoting positive mental health and health outcomes. Efforts to restrict access to abortion can significantly negatively impact individuals, families, and society.
The stigma surrounding abortion and the unequal distribution of abortion services are also important issues that must be addressed. It is crucial to ensure that individuals have access to accurate information and support when making decisions about their reproductive health and that they can access safe and legal abortion services without fear of judgment or legal repercussions.
Overall, the debate around abortion highlights the need for compassionate and evidence-based approaches to reproductive health and underscores the importance of protecting and expanding access to safe and legal abortion services. By doing so, we can promote individuals' and communities' mental and physical health and well-being and work towards a more just and equitable society.
References:
Tracking the States Where Abortion Is Now Banned. https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html
Human Rights Crisis: Abortion in the United States After Dobbs. https://www.hrw.org/news/2023/04/18/human-rights-crisis-abortion-united-states-after-dobbs
Maternal Mortality Rates in the United States, 2020. https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm
An Overview of Abortion Laws. https://www.guttmacher.org/state-policy/explore/overview-abortion-laws
The facts about abortion and mental health. https://www.apa.org/monitor/2022/09/news-facts-abortion-mental-health
Restricting access to abortion will likely lead to mental health harm, APA asserts. https://www.apa.org/news/press/releases/2022/05/restricting-abortion-mental-health-harms