CHICAGO (AP) — The weeks after Kanya Harris found out she was pregnant were some of the hardest of her life.
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Final exams were approaching for third-year university students. Her doctors told her she had an ovarian cyst and that she was at high risk for an ectopic pregnancy. Her wait times at an abortion clinic near where she lives in Bethesda, Maryland, seemed incredibly long. And because of the state’s abortion ban, she was unable to visit her family in Kentucky.
Harris regularly had panic attacks. She felt like it was all too much, she said.
“My mental health is the worst it has ever been in my life,” said Harris, who had an abortion last May.
As advocates push forward with a ballot measure effort aimed at protecting abortion rights this year, important differences emerge in the language of the proposed legislation. That includes mental health exceptions.
Missouri’s proposal would allow lawmakers to restrict abortions after the fetus is deemed viable, except “when the abortion is necessary to protect the life or physical or mental health of the pregnant person.” become. Similar measures have been proposed in Arizona. In 2022, Michigan voters passed an abortion rights amendment with a mental health exception to viability.
Meanwhile, the proposed ballot language in Arkansas only mentions “physical health” and does not include an exception for mental health. Proposed abortion rights initiatives in other states, including Florida, Montana and Nebraska, do not explicitly mention mental health.
“It breaks my heart to hear about policies that ignore mental health,” said Harris, now 21. “Abortion can save someone’s life, even if they are experiencing a mental health emergency.” Told.
Most states that ban abortion include exceptions for life-threatening emergencies, but some include exceptions for “serious mental illness” that could lead to the death of the mother or fetus. is only in Alabama. Lawmakers added the provision after pressure from state medical associations concerned about the high risk of suicide among women.
The law, passed in 2019, was one of the strictest abortion regulations in the country at the time. Exceptions were made in cases of rape and incest, and abortion was considered a serious crime. Alabama began enforcing its ban in 2022 after the U.S. Supreme Court overturned Roe v. Wade, which once granted the federal government the right to abortion.
Abortion bans in at least 10 states – Florida, Georgia, Idaho, Iowa, Kentucky, Louisiana, Ohio, Tennessee, West Virginia, and Wyoming – explicitly exclude mental health conditions as a possible exception. Others are more vague, allowing exemptions for women’s “life and health” without defining whether mental health is included.
Medical experts say even states that allow mental health exceptions require patients to jump through hoops that may be inaccessible to some people, especially low-income people. . Alabama, for example, requires a state-licensed psychiatrist with at least three years of clinical experience to qualify a mental health condition as an emergency.
clock: What you need to know as the fight over abortion rights moves to state ballots in 2024
On some days, when Harris got home from class, she would “feel overwhelmed and collapse on the floor,” she said. For two months, she cried every day. But Harris says she is reluctant to talk about her experiences with mental health professionals because abortion is banned in her home state and she faces prejudice from her doctors. No, she said.
“People don’t have to jump through hoops and demonstrate pain to get the care they need,” she says.
According to the U.S. Centers for Disease Control and Prevention and the U.S. Centers for Disease Control, mental health conditions were the leading underlying cause of pregnancy-related deaths from 2017 to 2019, with approximately 23% of pregnancy-related deaths due to suicide and substance use disorders. Mental health conditions such as ingestion are believed to be the cause. Prevention.
According to the CDC, about 1 in 8 women experience postpartum depression. However, mental health issues during pregnancy, particularly the psychological trauma experienced by those forced into unwanted pregnancies, are not well researched, says Santa Clara University Law Professor Michelle, who studies the impact of abortion regulations.・Mr. Overman says.
“These statistics and the stories of women’s suffering really haunt me,” Overman said. “As a society, we don’t have a great track record of treating mental health in the same way as physical health.”
Paul Appelbaum, a psychiatrist at Columbia University, said policies that discount mental health as less important than physical health are putting lives at risk. She said there was also growing evidence that being denied an abortion causes significant psychological distress. This suffering is evident in recent stories of women forced to flee their states or continue their pregnancies despite serious health risks.
“I am extremely concerned about the exclusion of mental health exceptions in these ballot measures,” said Appelbaum, a former president of the American Psychiatric Association. “This is absolutely cruel and will result in pregnant women suffering and dying in these states.”
Jamie Trevino, a Missouri obstetrician-gynecologist and fellow with Physicians for Reproductive Health, has learned how being denied abortion care can impact a patient’s well-being, including their mental health. He said he had seen it firsthand.
“For my patients, this is a devastating, everyday reality,” she said, adding that she appreciated the mental health exemption in the language of the state’s proposed ballot measure.
Mallory Schwartz, a spokeswoman for the Missouri Constitutional Freedom Group, said the initiative’s language was “written to ensure that doctors, not politicians, can decide what’s best for patients. ” he said.
Conversely, the Arkansas initiative includes only exemptions “to protect the life of a pregnant woman, or to protect a pregnant woman from disability, physical disease, or physical injury.”
Jenny Diaz, executive director of For AR People, said an earlier version of the proposal included broader exceptions. Initially, she said, “We wanted the wording of the constitutional amendment to be as broad as possible, and if possible, to take into account issues such as mental health.”
But when presented with a proposal that included an exception to “protect the life and health” of the mother, the state’s attorney general (a Republican) rejected the language, saying “health” needed to be defined.
“That was a signal that we had to make a choice,” Diaz said. “And another unfortunate factor is that the majority of voters in Arkansas are less likely to support mental health as a reason for abortion after a certain period of time. A version that explicitly mentions mental health. We felt it was unlikely to pass.”
read more: Controversy over viability divides abortion rights groups and complicates ballot measure efforts
Diaz said advocates in Arkansas were concerned that the opponent’s campaign would target mental health exceptions.
The National Right to Life Commission’s Model State Law on Abortion Bans explicitly excludes mental health exceptions. Ingrid Durand, NRLC’s state legislative director, said these exceptions allow pregnant women to “kind of circumvent these laws and still terminate a pregnancy with a viable child.”
“We specifically exclude the mental health exemption because it creates loopholes in the law and allows the unborn child to suffer due to sometimes treatable, sometimes temporary conditions that the mother may be experiencing. “I saw it put me at risk of death,” she said.
Asked if targeting mental health exceptions would be part of the campaign’s strategy to oppose abortion ballot measures in 2024, she said, “I can’t necessarily say that it will be part of the strategy.” said. Still, Duran said, “It’s heartbreaking to see mental health exceptions like this.”
Santa Clara University’s Oberman said he hopes the anti-abortion movement will “employ strategies that minimize and ignore the mental health consequences of forced pregnancies.”
“Mental health issues in pregnant women continue to be hidden and highly stigmatized,” she says. “That clouds our judgment of what a medical emergency is during pregnancy.”
