Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations

Ogbu-Nwobodo, Lucy; Shim, Ruth S.; Vinson, Sarah Y.; Fitelson, Elizabeth; Biggs, M. Antonia; McLemore, Monica R.; Thomas, Marilyn; Godzich, Micaela; Mangurian, Christina

doi:10.1056/nejmms2211124

Cited by 19 publications

(18 citation statements)

References 39 publications

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“…One of the by-products of the robust feminist psychology research debunking claims that abortion causes “mental illness” (Major et al, 2009; Steinberg et al, 2016) is the evidence that people with pre-pregnancy mental health concerns may be more likely to access abortion than people without a mental health diagnosis (Ogbu-Nwobodo et al, 2022). One study of over 2,000 women in the Netherlands found that those who accessed abortion were three times more likely to have a prior mental health disorder (Van Ditzhuijzen et al, 2013).…”

Section: Health Capital Psychological Distress and Pregnancy Decision...mentioning

confidence: 99%

Pregnancy Decision Making for Women With Mental Health Conditions: The Roles of Distress, Lay Beliefs, and Self-Efficacy

Klann,

Wong

2023

Psychology of Women Quarterly

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Millions of people face unintended pregnancy each year, including thousands who are living with a mental health disorder, and must decide to terminate the pregnancy, become a parent, or place a child for adoption. While people of various genders, such as nonbinary people and transgender men, also face pregnancy, the current study highlighted the perspectives of women in particular, seeking to understand what unique circumstances may predict their pregnancy decision making in the context of mental health concerns. A sample of 327 women of reproductive age who self-identified as having a mental health condition were asked to consider the hypothetical situation of an unintended pregnancy and completed measures of psychological distress, parenting self-efficacy, and likelihood of choosing abortion. Qualitative data was transformed into two composite lay belief variables (perceived harm from pregnancy and mental health resilience) for inclusion in the model. Indirect effects revealed that psychological distress was related to higher likelihood of choosing an abortion through greater perceived harm from pregnancy and to lower likelihood of choosing an abortion through greater mental health resilience and higher parenting self-efficacy. The findings provide a nuanced view of pregnancy decision making from the perspective of women with mental health concerns.

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Section: Health Capital Psychological Distress and Pregnancy Decision...mentioning

confidence: 99%

Pregnancy Decision Making for Women With Mental Health Conditions: The Roles of Distress, Lay Beliefs, and Self-Efficacy

Klann,

Wong

2023

Psychology of Women Quarterly

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“…Historically marginalized populations and those who experience systemic inequity and the intersection of multiple social determinants of health (ie sexism, racism, poverty, lack of access to care, neighborhood segregation and unsafe neighborhoods, etc) already face health disparities related to sexual and reproductive health care services, including abortion care. With the Dobbs decision, these inequities will continue to worsen, with Black, Indigenous, immigrant, and rural communities potentially experiencing further poor outcomes in maternal mortality and morbidity 4 …”

Section: Introductionmentioning

confidence: 99%

The Provision of Abortion Care via Telehealth in the United States: A Rapid Review

Brown,

Neerland,

Weinfurter

et al. 2023

J Midwife Womens Health

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IntroductionThe recent Supreme Court decision Dobbs v. Jackson Women's Health that has overruled Roe v. Wade has resulted in severe limitations of abortion access throughout the United States. Telehealth has been put forth as one solution for improving access for reproductive health care, including abortion services. Telehealth has demonstrated safety and efficacy in several health care disciplines; however, its use for abortion care and services has not been explored and synthesized.MethodsAs part of a larger review on telehealth and general reproductive health, our team identified a moderate amount of literature on telehealth and abortion care. We conducted a rapid review searching for eligible studies in MEDLINE, Embase, and CINAHL. Information was extracted from each included study to explore 4 key areas of inquiry: (1) clinical effectiveness, (2) patient and provider experiences, (3) barriers and facilitators, and (4) the impact of the coronavirus disease 2019 (COVID‐19) pandemic.ResultsTwenty‐five studies on the use of telehealth for providing abortion services published between 2011 and 2022 were included. Telehealth for medical abortion increased during the COVID‐19 pandemic and was found to be safe and clinically effective, with high patient satisfaction. Overall, telehealth improved access and removed barriers for patients including lack of transportation. Legal restrictions in certain states were cited as the primary barriers. Studies contained limited information on the perspectives and experiences of health care providers and diverse patient populations.DiscussionAbortion care via telehealth is safe and effective with high satisfaction and may also remove barriers to care including transportation and fear. Removing restrictions on telehealth for the provision of abortion services may further improve access to care and promote greater health equity.

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“…1,2 The discussion includes how some restrictions on abortion may harm the mental health of those having or seeking abortions, as well as have the most serious effects on the mental health of females from marginalized groups. 3,4 A recent study published by Zandberg and colleagues 5 found that states that enacted more restrictive abortion policies between 1974 and 2016 had higher rates of suicide among women of reproductive age but not among those who have passed reproductive age. The authors hypothesize that these observed effects of increased anxiety and stress may be because it is harder to access an abortion.…”

mentioning

confidence: 99%

“…The public health discussion of the effects of overturning Roe v Wade in June 2022 extend beyond the number of abortions, where and how people are having abortions, maternal mortality, or even infant mortality . The discussion includes how some restrictions on abortion may harm the mental health of those having or seeking abortions, as well as have the most serious effects on the mental health of females from marginalized groups . A recent study published by Zandberg and colleagues found that states that enacted more restrictive abortion policies between 1974 and 2016 had higher rates of suicide among women of reproductive age but not among those who have passed reproductive age.…”

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confidence: 99%

Mental Health Symptoms When Abortion Access Is Restricted

Steinberg

2024

JAMA

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The public health discussion of the effects of overturning Roe v Wade in June 2022 extend beyond the number of abortions, where and how people are having abortions, maternal mortality, or even infant mortality. 1,2 The discussion includes how some restrictions on abortion may harm the mental health of those having or seeking abortions, as well as have the most serious effects on the mental health of females from marginalized groups. 3,4 A recent study published by Zandberg and colleagues 5 found that states that enacted more restrictive abortion policies between 1974 and 2016 had higher rates of suicide among women of reproductive age but not among those who have passed reproductive age. The authors hypothesize that these observed effects of increased anxiety and stress may be because it is harder to access an abortion. The Zandberg et al findings are provocative and suggest that research in the current context after the Dobbs decision such as that published in this issue of JAMA 6 is warranted.Thornburg and colleagues 6 examined whether symptoms of anxiety and depression increased more in the adult general population (18-88 years) living in the 13 states with trigger bans-existing laws that would ban abortions after Roe v Wade was overturned-than in those without such bans after the Dobbs decision and after the Dobbs draft was leaked. Unlike the Zandberg et al study, mental health (ie, anxiety and depressive symptoms) was assessed in nationally representative repeated cross-sectional samples from the Household Pulse Survey, collected between December 2021 and January 2023. Because the design did

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Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations

Cited by 19 publications

References 39 publications

Pregnancy Decision Making for Women With Mental Health Conditions: The Roles of Distress, Lay Beliefs, and Self-Efficacy

Pregnancy Decision Making for Women With Mental Health Conditions: The Roles of Distress, Lay Beliefs, and Self-Efficacy

The Provision of Abortion Care via Telehealth in the United States: A Rapid Review

Mental Health Symptoms When Abortion Access Is Restricted

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