We can’t forget mental health in this nation’s abortion debate
As a certified obstetrician / gynecologist who has practiced for almost 20 years, I want to address an issue that seems to have been overlooked in the debate about access to abortion: the mental health issues surrounding pregnancy. We talk a lot about bans and restrictions on abortion as a physical health issue, but they also have a profound impact on the life of a pregnant person. mental health.
My dad was also OB / GYN. He shared stories of women who died in his care due to complications from illegal abortions before Roe v. Wade. I now speak on behalf of my patients. I am not speaking on behalf of my employer.
Mental health awareness and support is a big part of my OB / GYN practice. We all know about postpartum depression, but I’m referring to other aspects of mental health.
Over the years, I have treated patients with a wide variety of conditions. I have treated women with anxiety and depression. I have treated patients with bipolar disorder and they are afraid of passing these genes on to a child. If they were to conceive, termination seems to be their only option, for the mental health well-being of the next generation. I help women cope with the grief of stillbirth and the fear of being pregnant again and losing another baby. I have counseled patients who have had to terminate much desired pregnancies because the mother would die due to health problems exacerbated by the pregnancy.
I am grateful to practice in Colorado where we can safely provide termination options for patients up to 24 weeks pregnant. But as I keep a close eye on what’s going on in Texas and on the Supreme Court, I had to speak up. I am not an abortionist. But on behalf of my patients, I am so grateful that I can refer them to safe, well-trained physicians when termination of pregnancy is the right answer.
We are all aware of the opioid crisis in our country. If a person is pregnant and does not want to be, they can self-medicate with drugs and alcohol, which harms themselves and the fetus. If a person cannot afford to support a child and is forced to carry the pregnancy, what is best for the child?
Especially for people who have underlying mental health issues, forcing them to become pregnant would likely exacerbate any mental health issues: anxiety, depression, reactivation of past trauma, substance abuse, etc.
Being able to give a child up for adoption is a very difficult choice for many people. And let’s not forget that planning to give a child up for adoption requires the person to go through pregnancy and childbirth. Childbirth can be life threatening to both mother and fetus. I respect my patient’s choice not to risk her own life for a baby she does not want or cannot care for. For some people, pressure from their community or family members may cause them to choose to keep a child, at their own expense.
In a recent analysis of maternal mortality by the Colorado Department of Public Health & Environment (CDPHE), the most common causes of the 145 pregnancy-related deaths between 2008 and 2013 were injuries (44) and mental health problems ( 40); in fact, these two causes accounted for nearly six in ten maternal deaths. âMaternal mortalityâ statistics include the first year after the birth of a baby.
And please don’t start with the ‘if they don’t want kids, they shouldn’t have sex’ argument – Texas’ new ban doesn’t provide an exemption for rape or incest. Thanks not imply that these people volunteered for their abuse or attack.
I need to have all the options available to treat my patients safely, no matter what they look like. Period.
Restrictions on abortion place unnecessary stress on patients who are already going through an emotional roller coaster ride surrounding pregnancy and parenthood. Neither patients nor doctors need politicians to look over their shoulders and make personal decisions for them at a time when they are under enormous physical and emotional pressure.
Politicians who have no understanding of the individual circumstances of my patients do not have to restrict the choices of my patients. A fetus cannot survive outside its mother’s body until about 24 weeks. Just seeing fetal heart activity at six weeks does not mean there is a viable baby present.
People in Texas are forced to maintain most pregnancies right now. This situation cannot be beneficial for the mental health of these patients. The stress of having to find transportation and the money to travel hundreds or thousands of miles to another state just to maintain their own bodily autonomy is not fair. This is simply not the case.
Abortion must remain an option as a fundamental part of health care, both for the physical AND mental well-being of the people of this country. I implore the justices of the Supreme Court of the United States to consider the implications for the people of this country. Please protect us, the Constitution and the well-being of our patients.
Allison Herman, MD, practices obstetrics in Denver.
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