The most recent iteration is courtesy of a case currently in front of the U.S. Supreme Court: Dobbs v. Jackson Women’s Health Organization. It will determine the constitutionality of a 2018 Mississippi law banning abortions after 15 weeks. Beyond the dangerously restrictive measures being discussed, multiple conservative justices of the U.S. Supreme Court have made statements that undermine the toll of pregnancy and present poor alternatives to abortion. One shocking statement, in particular, came from the most recently appointed Supreme Court Justice, Amy Coney Barrett. “Insofar as you and many of your amici focus on the ways in which forced parenting, forced motherhood, would hinder women’s access to the workplace and to equal opportunities, it’s also focused on the consequences of parenting and the obligations of motherhood that flow from pregnancy,” said Barrett. “Why don’t the safe-haven laws take care of that problem?” She continued: “It seems to me that the choice more focused would be between, say, the ability to get an abortion at 23 weeks or the state requiring the woman to go 15, 16 weeks more and then terminate parental rights at the conclusion. Why—why didn’t you address the safe haven laws and why don’t they matter?” In short, Barrett suggests that the only burden worth addressing is that of parenthood and disregards any physical or mental health issues that could arise during pregnancy.
All Pregnancies Come With Risks
Barrett’s stance is not only willfully ignorant but dismissive of the immense struggles pregnant people may face. Even in the case of a wanted pregnancy, people contend with tremendous physical and mental health risks and discomforts. “Pregnancy is associated with an increased risk for blood clots and for hemorrhage with the delivery. It’s a serious condition and needs optimal prenatal care to optimize outcomes,” says Dr. Felice Gersh, an OB/GYN, the founder and director of the Integrative Medical Group of Irvine, and the author of Menopause: 50 Things You Need to Know. The United States has the highest rates for mortality of pregnant people of any developed country, with a majority occurring post-birth. This number continues to rise, with a rate of 20.1 per 100,000 people in 2019, compared to 17.4 per 100,000 people in 2018. Black people are at an incredibly higher risk, with a mortality rate of 44 per 100,000 people in 2019.
Mental Health Impact
Then there’s pregnancy’s effect on mental health: About one in eight people who give birth will experience postpartum depression. However, in some states, the frequency increases to one in five. Postpartum depression symptoms can first present anywhere from a few weeks to a year after giving birth and include excessive crying, struggling to bond with their child, hopelessness, panic attacks, and suicidal thoughts. People can also experience depression during pregnancy. “Pregnancy is known to be a time of increased risk for mood disorders, particularly in women who have a history of depression or bipolar disorder,” says Dr. Gail Saltz, a psychiatrist, psychoanalyst, and author of The Power of Different: The Link Between Disorder and Genius. “But, it can also happen in those with no history. Hormonal changes and the stress of pregnancy increase this risk.” People must contend with these issues during and after pregnancy with potentially little time or support. Worldwide the United States is one of only a handful of countries without guaranteed parental leave. In short: “Pregnancy and delivery can be traumatic under the best of circumstances,” says Dr. Elisabeth Netherton, a psychiatrist with Mindpath Health.
Forced Pregnancies Can Cause Additional Mental Health Issues
Then you have people who are pregnant unwillingly and, if unable to get an abortion, have a continual stressful trigger that they are being forced to do something potentially dangerous. A forced pregnancy is incredibly distressing. “We experience events as traumatic when we are not able to escape them or are not able to exercise choice about what happens to our bodies and when and why,” says Netherton. She explains that people who cannot terminate their pregnancy may have a higher chance of postpartum mental health issues. A long-term 2016 study from the American Journal of Public Health looked at people who completed their pregnancies before abortion became legal. Compared to people with wanted pregnancies, those who had unwanted pregnancies were more likely to have poorer mental health later in life. As Gersh explains, pregnant people experience “a higher state of stress and are more likely to have pregnancy-related complications. Stress can impact virtually every aspect of mental and physical health, and can negatively affect fetal development and the health of the child throughout their life.” A person’s mental health issues may be exacerbated even further if the pregnancy resulted from rape or if the baby or pregnant person have severe medical problems. Then there are the emotions many people face around adoption. A person may feel guilt, fear of regretting their decision, or stress about what has become of their child. These feelings may arise soon after giving birth or later on in life, especially if they choose to have another child, says Saltz. While adoption is the right choice for many people carrying unwanted pregnancies, it it not the case for all. Without access to safe, legal abortions, people face enormous risks and lose control of their lives and body. “Our goal as mental health practitioners is to help our patients plan for their pregnancies with their mental health in mind,” says Netherton. “A necessary component of this process then is a person’s ability to exercise choice around their fertility.”
