Last year, as lawmakers raced to pass a new anti-abortion bill in the state, Charlotte Driscoll, 26, a bipolar and suicidal North Carolinian, sat on a state House committee. I worried out loud at the meeting.
She finally found a drug that worked for her called lamotrigine.
“But unfortunately, it makes birth control no longer effective. And birth control makes lamotrigine no longer effective,” she told the North Carolina House Rules, Scheduling, and Operations Committee in May.
She said that, when combined with other health complications, means she has irregular periods and is not eligible for an IUD, a type of long-term contraceptive.
“Outside the 12-week window, it was easy to find out I was pregnant,” she said of North Carolina’s strict new ban. “Abortion is too complicated to legislate like this.”
As state legislatures reconsider abortion bans following the 2022 Supreme Court decision overturning Roe v. Wade, Driscoll and others have expressed concerns about the intersection of mental health and abortion. There is.
Both North Carolina and South Carolina enacted stricter abortion bans last year. This would no longer qualify mental health conditions or suicidal thoughts as exceptions to medical emergencies.
Anti-abortion groups have long raised concerns that abortion promotes depression and other mental health conditions, but Driscoll and others living with mental health conditions have different concerns. Pregnancy can put you at risk of having to stop your medication. We need to keep them alive.
“The brain is just an organ in the body, and it’s the brain that gets sick,” says Stephanie Berg, a psychiatrist who heads the Prisma Perinatal Mood Disorders Clinic in South Carolina. “It absolutely has to be treated like any other physical illness.”
Measuring mental health in relation to the decision to consider, have, or cancel an abortion is difficult.
Until the Supreme Court’s decision, patients did not have to state why they were seeking an abortion. But Dobbs changed that. Ashley Craley-Rideau, senior director of policy and government relations at the Women’s Rights and Empowerment Network, said women seeking abortions are now forced to deal with the mental health consequences of their pregnancies “more than ever before.” He says that he is no longer able to earn money. , or WREN, based in South Carolina.
Many state laws passed or enacted in the wake of the Dobbs decision now specifically exclude mental health from the medical exemptions that allow abortion.
N. Dawn Bingham, a clinical associate professor of obstetrics and gynecology at the University of South Carolina Columbia School of Medicine, calls the exclusion of mental health “a very closed world view that people can raise mental health issues on their own.” He explained. At their own discretion. ”
“Those who wrote these laws did not aim to alleviate suffering or sympathize with physiological and clinical clinical problems; “They don’t even understand that that’s part of a similar view of individuals,” Bingham said, “and of course clinically.”
Kelsey Leap, a licensed clinical social worker based in North Carolina, has been partially focused on providing abortion-specific support since fall 2021.
“I have a lot of people who keep coming to me for counseling, but we don’t just talk about abortion all the time,” she said. “The best predictor of post-abortion mental health is before the abortion.”
national policy
Spencer Wetmore was annoyed.
While the South Carolina House Judiciary Committee did not have a debate along party lines over the then-current bill banning most abortions after six weeks of pregnancy, one of her concerns remained unaddressed. There wasn’t. The bill does not allow for exceptions for mental health emergencies.
“It was important to me to raise that as an issue and talk about that experience,” the South Carolina representative said during CQ roll call in November.
Eight years ago, Wetmore, a Democrat, stopped taking medication for anxiety and depression during her pregnancy, which she said is not an option for everyone.
At a Judiciary Committee hearing in May, Wetmore argued that mental health minimization affects patients with schizophrenia, severe depression, and post-traumatic stress disorder, and that “a complex web of laws exists”. ”, he expressed concern that the state’s ability to recruit doctors could further deteriorate.
House Judiciary Chairman Weston J. Newton, a Republican, said the language is “an effort to tighten qualifications” to prevent undocumented abuse.
Democratic Rep. Ivory Tory Thigpen said she was concerned this could complicate the situation for people with severe depression or schizophrenia.
“We can come up with thousands of scenarios and examples,” he said.
“We can pick out hundreds of different potential medical scenarios,” Newton responded to Thigpen. “I don’t mean to be vague, but…I think all of these factors need to come together to determine whether the conditions are met.”
Vicki Ringer, communications director for Planned Parenthood South Atlantic, said the South Carolina bill’s exceptions are too narrow and raise similar questions for victims of sexual assault and domestic violence. he pointed out.
She said abortion opponents see mental health exceptions as “an easy way out, in the same way that a lot of people think rape is an easy way out. And we don’t want it to happen.” “I know that I haven’t.”
“The fact that mental health is never considered an aspect worthy of discussion or protection in South Carolina is not surprising,” she says. “Mental health is simply something people make up, and it’s treated as an easy answer when things don’t go your way or when you behave inappropriately.”
Wetmore said he contacted the two privately after his committee spoke on the bill’s mental health language.
“By the way, have they ever made an effort to fix that? No, because there was a perception that mental health can be easily manipulated,” she told CQ roll call. “It never led to remediation efforts like my other points.”
Abortion rights groups filed their third post-Dobbs lawsuit in South Carolina on February 5, arguing that the wording of the current ban is too vague for doctors to comply with, and that it is a mental health issue. raised concerns.
But some think it makes sense for mental health to be excluded from the exception.
Katie Daniel, national policy director for the anti-abortion group Susan B. Anthony Pro-Life America, said states are narrowing their definitions and that “a health and medical emergency is a situation where people, such as being in a hospital, It means what you expect it to mean.” And we modeled it on what has worked in other states.
“Our biggest concern is that too often abortion is offered as a solution to problems, rather than actually addressing the problems directly,” she said. “We don’t think it’s beneficial for women, regardless of their desire to become pregnant.”
Kimberly Tissot, president and CEO of disability rights organization ABLE SC, said people with mental illnesses use medications to maintain their independence, and their daily lives are disrupted. He argued that it could be debilitating. Limited access to mental health resources also means you may not have the option of coming off a medication or transitioning to another medication if necessary during an unplanned pregnancy. Then Mr. Tissot said.
“No one should be made worse off by a ban, and that’s what I’m concerned about,” Tissot said, adding that the issue is one that many lawmakers don’t want to discuss publicly. he added. “I think the overall skew in mental illness is really pressing.”
This report is part of a series supported through the Rosalynn Carter Fellowship for Mental Health Journalism.
If you or someone you know is experiencing a mental health crisis, call the 24-hour toll-free 988 Suicide and Crisis Lifeline (9-8-8) to speak to a trained counselor. Please connect to.