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US Abortion Restrictions and the Neuropsychiatric Health of Pregnant Individuals and Families

By July 23, 2025No Comments

Recent changes in the legal landscape in the United States have affected access to abortion, and this restricted access has profound effects on both physical and mental health of reproductive-aged women and their families.

Observations  Denial of abortion care has substantial consequences for the mental health of pregnant individuals and their children. We review rates of mental health symptoms and disorders in abortion-seeking individuals, those who are denied care, and those who are subject to laws restricting care. We also cover how these effects are experienced by those in marginalized communities, including rural populations and those of limited financial resources, and how resulting distress affects children born to those denied abortions. Finally, we review the current and shifting legal landscape and how it affects clinicians aiming to care for those experiencing mental health sequelae from the denial of abortion care.

Conclusions In a growing number of states, psychiatrists and other mental health professionals are faced with the challenge of assisting patients facing mental illness who cannot obtain abortions in their state of residence. This places psychiatrists in an uncomfortable position between their moral obligations and the law. Referrals to organizations that provide support for out-of-state travel to access an abortion or to obtain medications by mail to achieve an abortion is available. For example, clinicians can call the CARLA line54 to find patients from any state who need hospital-based abortion care an appointment at a hospital in Chicago and the financial resources needed to travel and pay for care. Patients traveling for care at outpatient clinics can search for financial assistance from sources like the National Network of Abortion Funds55 and the National Abortion Federation’s hotline.56 Patients across the country in their first trimester can access medication abortion through asynchronous telemedicine with the MAP program, staffed by Massachusetts physicians operating under that state’s shield law who mail the medication to patients in every state.57 Understanding when the law is violated is challenging when the bans themselves, and their exceptions, are written in vague language. Patients seeking legal advice can be referred to the If/When/How Repro Legal Helpline,58 and clinicians seeking legal advice or legal defense can call the Abortion Defense Network.59

The clinical goal should be to support the patient to access a desired abortion, but there will always be patients who cannot access the desired care. Therefore, psychiatrists and psychologists will also need to support the patients who have no other option but to continue their undesired pregnancy. There is an urgent need for research on strategies to manage psychiatric disorders associated with restricted reproductive health services. The health of the mother is a critical element in fetal and infant well-being. Individuals who are forced to continue an unwanted pregnancy deserve the social and resource support required to deliver healthy infants who can be raised in an environment that allows the family to thrive.

From: JAMA Psychiatry

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