Abortions don’t have to be traumatic. But the overturning of Roe v. Wade could make it that way.
Jenna Ryu- It's assumed that abortion procedures cause pain and trauma, but research shows that isn't true.
- Studies found that having an abortion doesn't increase the mental health risk: Being denied one does.
- Experts warn that overturning Roe v. Wade will only exacerbate the various stressors of unwanted pregnancy.
Disclaimer: The interviews in this article were conducted prior to the Supreme Court's decision to overturn Roe v. Wade on June 24, 2022. This article has been updated to reflect the official ruling.
The most commonly reported feeling after an abortion isn't pain. It's relief. That's according to numerous studies.
But there's an assumption that abortions cause trauma, when the reality is they can be a way of resolving stress for those who don't want to be pregnant. Both experts and research have supported that the procedure itself doesn't increase one's risk for negative mental health outcomes. Rather, it's the trauma of being denied one that does— a widely-studied phenomenon that is rarely talked about.
"For many people, abortion is a positive part of their life that allows them to do things like get away from an abusive partner or have the life and kids they have now," says Gretchen Ely, a professor of social work at the University of Tennessee. "They're able to direct themselves in a way that would cause less distress across the course of their life when they have the choice to get an abortion."
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Friday, the Supreme Court overturned Roe v. Wade, erasing reproductive rights in place for nearly five decades. The watershed decision means Americans no longer have a constitutional right to abortion, and Republican lawmakers are set to ban abortion in about half of states.
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But experts in sexual and mental health warn this decision wouldn't minimize trauma and suffering. And it could exacerbate it.
"Before these measures, even if people were scared, we could talk to them and support them," Bhavik Kumar, a Texas-based provider at Planned Parenthood Center for Choice, told USA TODAY prior to the news. "But now, I'm hearing new concerns about, 'Where am I supposed to go?' 'When is the soonest I can be seen?'
"It's that uncertainty — the unknown of something so time-sensitive — that triggers so much of the abortion trauma. And typically as providers, we could help them through some of that. But with the overturning of Roe v. Wade, it becomes a lot harder for us to prevent and address these mental health risks," Kumar says.
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Being denied an abortion leads to mental health problems
Despite widespread assumptions that people who get abortions are consumed by guilt, regret and even depression, research shows the stakes are higher for those denied an abortion.
In a study conducted over the course of 10 years, researchers tracked the experiences of women who received abortions and those who had been denied due to gestational age limits. They found that having an abortion did not increase one's risk for anxiety, depression or PTSD.
"We found very clearly that people who were denied an abortion were at risk for short-term and elevated levels of stress, anxiety, low self esteem and lower life satisfaction," explains Antonia Biggs, a social psychologist who led the mental health analyses on the hallmark Turnaway study.
Yet some have criticized the methodology of this study. Michael New, a research associate of political science and social research at the Catholic University of America, notes the study tracked participants' responses over a five-year period, which he argues is not long enough, stating feelings of regret can manifest "even years after an abortion has taken place."
New points to a meta-analysis done by Dr. Priscilla Coleman found a casual link between abortion and suicidality and drug use. However, opponents have criticized that conclusion, saying it didn't take into account mental health problems before the abortion.
And additional research has also supported that post-abortion mental health is more strongly associated with outside factors that aren't unique to the abortion itself. Those include low social support, personality factors like low self esteem and a prior history of mental health problems. And according to a recent UC San Francisco study over 95% of women reported that abortion was the right decision for them.
According to Amanda Fialk, a licensed clinical social worker and chief clinical officer at The Dorm, these studies are often overshadowed by the commonly-held belief that abortion causes mental instability.
"When things aren't accurately spoken about in social environments or in the home, stories get made up about what the abortion procedure is, what it isn't, and a very false narrative is perpetuated," explains Fialk. "However, people need to know that having high barriers to an abortion has far worse impacts on one's mental health. What we know is those who are denied abortions have decreased life satisfaction compared to those who are able to access a safe abortion."
So far, the consequences of these misconceptions can be seen in Texas, where one of the previously most restrictive abortion laws in the country has banned abortions after six weeks of pregnancy. In the last year, Kumar, who works in Houston, says he's already witnessed the beginning of a "devastating impact."
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"When I'm providing care, there's typically little trauma in those who access care, but there's much more trauma, stress, concern, and anxiety for those who are denied one because there's so much uncertainty," Kumar says.
The cost of overturning Roe v. Wade
Regardless of age, beliefs or relationship status, finding out you're pregnant when you don't want to be is traumatic.
According to the American Psychological Association, experiencing unwanted pregnancies can lead to mental health ramifications, such as lower self-esteem and higher levels of anxiety. Along with physical and psychological symptoms, women seeking abortions also tend to bear the brunt of misogynist criticisms.
But with the official overturn of Roe v. Wade, experts predict people will have to worry about finding childcare during mandatory waiting periods, taking time off for work, and affording lodging and travel expenses — that is, if they're able to secure an appointment.
These laws also add onto the existing structural stigma that abortion is immoral, shameful and something that shouldn't be talked about. This can lead people to internalize these beliefs, and resulting in psychological distress and social isolation, experts warn.
"I've had young clients call the overturning of Roe v. Wade terrifying and out-of-control," says Fialk. "Because of these narratives, many feel like they're losing their autonomy, their sense of self-determination and feel helpless and devalued as merely a vessel breeding a fetus, and not an actual human being."
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What should abortion be like?
Even with all the recent talk about abortions, we often forget what the process should look like.
Experts say it doesn't take much; all it involves is access to a provider who respects your decision, confidentiality and autonomy— just like any other medical procedure.
"You want to be informed. You want to be respected. And you don't want to be judged," says Biggs. "People want to have a choice to have a simple procedure in a discrete manner, and expedient care is crucial. Having care close to you, having it covered by insurance — these are things we'd want for proper abortion care."
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Kumar adds that it's his priority to provide his patients with as much control and autonomy over their bodies and their futures.
"The most important thing for me is asking (patients) what can make this experience better? Do they need music? Do they want the lights off? It's whatever we can do as providers to give them as much control as we can safely allow to the best of our abilities," he says.
Experts in mental health say these simple measures can prevent the physical risks of a self-managed abortion, as well as the various stressors of an unwanted pregnancy.
"When people know they don't want to be pregnant, the part that upsets them is worrying about terminating the pregnancy to go on with their life course," Ely says. "So making it comfortable, safe and easy is really the best solution to prevent mental health risks and to alleviate existing negative situations."
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