Demonstrators in front of the U.S. Supreme Court

Mental health experts fear abortion restrictions will harm marginalized groups


In a new paper in The New England Journal of Medicine (NEJM), researchers led by UC Davis and UC San Francisco describe how abortion restrictions will disproportionately harm the mental health of pregnant people from historically marginalized groups. The researchers say people who are Black, Indigenous, low-income, identify as sexual and gender minorities, or belong to other marginalized groups already face higher rates of complication and death related to pregnancy. Based on prior data, the authors believe new abortion restrictions following a Supreme Court decision made earlier this year will further harm those groups.

The article “Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations” appears in the current issue of NEJM. The authors are national experts on mental health. They include Ruth Shim of the Department of Psychiatry and Behavioral Sciences at UC Davis, and Lucy Ogbu-Nwobodo and Christina Mangurian of the Department of Psychiatry and Behavioral Sciences at UC San Francisco.

The authors address the U.S. Supreme Court case Dobbs v. Jackson Women’s Health Organization. The June 2022 decision held that the Constitution does not confer a right to abortion and overturned Roe v. Wade.

Citing published scholarship, the researchers examine the Dobbs decision through an “intersectional lens encompassing structural racism, reproductive injustice, and mental health, since people with a history of mental health conditions, trauma, and substance use disorders are more vulnerable to stigma, discrimination, and adverse health outcomes in pregnancy and beyond.”

The researchers note that, relative to their percentages in the general population, Black and Latina women are overrepresented as patients seeking abortion in the U.S. Low-income women are the most overrepresented of all. The authors argue that the restriction of abortion will worsen health inequities for groups “including cisgender women; nonbinary, intersex, and Two Spirit people; and transgender men.”

“When people think about the implications of restricting access to abortion, they often assume that individuals have alternative options, like traveling to another state for abortion services,” Shim said. “People who are oppressed and marginalized, especially those with mental illnesses and substance use disorders, often don’t have the same resources as people from more privileged backgrounds. What would abortion restriction mean for them? My co-authors and I were interested in exploring the impact on this population that is undervalued and often overlooked.”

“We know that women who are denied abortion are more likely to experience pregnancy complications, including eclampsia and death,” said Mangurian, referring to the Turnaway Study, which examined the long-term adverse effects of unwanted pregnancies. “What many people don’t know is that these women are also more likely to remain in abusive relationships, experience economic hardship, and suffer from anxiety and low self-esteem—all of which are harmful to women and their children.”

Other contributors to the article include Sarah Y. Vinson from the Morehouse School of Medicine; Elizabeth M. Fitelson from Columbia University; M. Antonia Biggs from UC San Francisco; Monica R. McLemore from the University of Washington School of Nursing; Marilyn Thomas from UC San Francisco; and Micaela Godzich from UC Davis.