Study: Restricted Access To Abortion May Trigger Psychiatric Illness in Pregnant Individuals

Restricted access to abortion, following the decision of the Supreme Court to overturn Roe v. Wade, can cause major psychiatric illness for individuals with unwanted pregnancies, according to a recent commentary published in JAMA Psychiatry written by Northwestern Medicine and Columbia University psychiatrists.

“Unwanted pregnancies generate severe stress for individuals with limited resources to access safe abortions, which may be several hundred miles or more away,” wrote Katherine Wisner, Asher Professor of Psychiatry and Behavioral Sciences and professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, and Paul Appelbaum, the Dollard Professor of Psychiatry, Medicine and Law at Columbia University.

Restricted access disproportionately affects people of color, those with disability, and unmarried mothers, Wisner and Appelbaum wrote. Further, the risk of any patient with unwanted pregnancy not having access to abortion can increase the risk of developing psychiatric illness 3-fold.

When an individual decides to get an abortion, they must have money for transportation, if they have other children they must arrange to have care, and/or adjusting their means of getting paid without the option of sick leave, Wisner said. And most individuals who do elect for an abortion already have children of their own, Wisner wrote.

She presented a scenario of an impoverished mother of children who has an unwanted pregnancy. If the individual is already financially burdened and becomes pregnant (now 1 of the 55% of Americans expected to give birth while in poverty), she may not be able to afford to take care of her current family, childcare, or cover the costs of pregnancy with another child, Wisner wrote.

“That is incredibly stressful. If the person has any kind of psychiatric vulnerability, like depression or an anxiety disorder, this powerful new stressor is imposed upon them,” Wisner said.

Wisner added that the magnitude of this stress could increase a patient’s risk of developing psychiatric illness in those who have never had an illness before. There are individuals who had psychiatric illness associated with a previous pregnancy. If the patient suffered from postpartum psychosis or suicidal thoughts/attempts, their risk of psychosis is much higher if they are pregnant again, Wisner wrote.

The stress a patient feels with unwanted pregnancy can manifest in the developing child. According to Wisner, severe stress has the same impact as a drug or disease on the developmental of the child. As a result, the child could suffer from a multitude of problems or psychiatric illness.

There are patients with a psychiatric illness not associated with pregnancy, such as bipolar disorder, who need medication such as lithium to manage their psychiatric health—but lithium is dangerous for the fetus, Wisner wrote.

“If they live in a state that restricts abortions, what do they do? Stop taking lithium during pregnancy and risk relapsing into a psychotic episode? Or take the lithium and risk giving birth to a child who may need extensive medical care?” Wisner wrote.

Reference

Northwestern University. Restricted abortion access will cause psychiatric harm. February 9, 2023. Accessed February 10, 2023. https://www.eurekalert.org/news-releases/979325