Emotional crisis excluded from abortion exemption in some states

Mental health advocates say abortion bans in some states have a cruel quirk. There are exemptions for life-threatening emergencies, but psychiatric crises are not considered.

it makes no sense Arizona A mother of three who committed suicide during her fourth pregnancy, she says an abortion saved her life. Or to researcher Kara Jibin, who nearly died in a suicide attempt during her pregnancy, whose research suggests these crises are not uncommon.

Although Zivin had a healthy baby, she sympathizes with women facing mental health emergencies who feel they have no choice but to end the pregnancy.

“people We often try to treat mental health as something separate from physical health. It’s as if the brain has been removed from the rest of the body,” Jibin said. University of Michigan Professor of psychiatry, obstetrics and gynecology, and health care.

Since Roe v. Wade was overturned in June, the abortion crackdown enacted or enforced presents a dichotomy. At least eight states that grant exemptions for life-threatening conditions emphasize physical health. Maternal mental health is not included.

Some of these exemptions are vaguely written. Others are explicit. law Georgia, Nebraska, and West Virginia state that medical emergencies do not include threats of suicide. A county judge’s ruling that overturned Georgia’s law on Tuesday is being appealed.

Some opponents of abortion say the law is intended to keep women from feigning mental illness and letting doctors terminate their pregnancies.

Patricia, 31, a married woman, was “your neighborhood’s average chicana,” and says her suffering was painfully real. The Phoenix woman told The Associated Press on condition that she only use her first name, citing her safety concerns and privacy.

She says a severe wave of depression hit her in the summer of 2018, breaking “not just her heart, but her heart and soul.” She could not eat, sleep, or properly care for her three young daughters. Her panic and her suicidal thoughts hit her. A few weeks later, when she found out she was pregnant again, she knew she wasn’t fit to have another child.

Her abortion was legal in Arizona at the time. The state recently enacted a near-total ban, which has been temporarily put on hold.

Postpartum depression is well known — US studies show that it affects about 1 in 8 women, but evidence suggests that depression during pregnancy may be even more common there is.

A September report from the U.S. Centers for Disease Control and Prevention (CDC) found that from 2017 to 2019, mental health conditions, including suicide and drug use, were the leading underlying causes of pregnancy-related deaths, followed by bleeding, heart disease, and infections. He said he got over the illness.

Zivin co-authored a study published last year that found an increase in suicidal ideation and behavior among individuals with U.S. commercial insurance before, during and after pregnancy. Rates were low, but among people with anxiety and depression, they increased from 1 he/10,000 in 2006 to almost 3 him/10,000 in 2017.

Zivin didn’t consider ending the pregnancy 10 years ago, but said she understands why suicidal women feel the only option is an abortion. She called the Qualified Exemption Act “unlucky” and said the politicians who wrote it “do not recognize or understand the burden of mental illness.”

Observers noted that before abortion was legalized in the 1973 Roe v. Wade decision, a diagnosis of mental illness allowed some women to have an abortion, and in some states, a psychiatrist was required to certify the diagnosis. Note that I had to.

Opponents of abortion claim that many pre-Law women feigned mental illness and that psychiatrists became their accomplices.

Carol Joffe, professor of obstetrics and gynecology at the University of California, San Francisco, said the old law “essentially forced psychiatrists to spread the truth.

She noted that California once required two psychiatrists to approve such an abortion.

“It was like everything else related to health care and abortion. It was class by class,” she said. “Most of these psychiatrists didn’t do it for free. You had to have the money.”

Legislation banning mental health exceptions shows apathy towards “the very real mental illnesses of some pregnant women” and “shows how inadequate it is for politicians to formulate health policy.” “There is,” Joffe said.

Rep. Ed Setzler, a Georgia Republican who sponsored the law, said, “The claims of stress and emotional distress do not reach the level at which Congress was persuaded that a child’s life must be taken as a result. “

Eric Johnston, president of the Alabama Pro-Life Coalition, wrote a near-total abortion ban for the state and said it included a suicide waiver at the request of the state medical association. Only suicidal women diagnosed by a doctor who request an abortion in a hospital are exempt.

“If you put it in there and don’t define it rigorously, it’s a hole big enough for a truck to go through,” he said.

The National Rights to Life Committee, an anti-abortion group that has lobbied for these measures, defended the restrictions.

“Mothers facing serious mental health problems should seek counseling and mental health care. Abortions do not alleviate mental health problems,” spokesperson Laura Echevarría said. says.

According to the American Psychological Association, there is evidence that denied abortions can cause emotional distress.

Michelle Overman, a law professor at Santa Clara University and an expert on reproductive health ethics, said an abortion ban without exceptions for severe mental illness is cruel and misguided.

Even if targeting women who try to disguise their mental illness is behind these measures, the law will inevitably affect those who really suffer.

The thinking behind these laws “doesn’t really think about what it would look like to face a patient with severe mental illness,” Oberman said. “It’s amazing how things look,” she said. “They are real and life-threatening.”

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Contributed by Associated Press writer Kim Chandler of Montgomery, Alabama and Jeff Amy of Atlanta.

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follow APs Medical writer Lindsey Tanner for @LindseyTanner.

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The Associated Press’ Health Sciences Division is supported by the Howard Hughes Medical Institute’s Science Education Division. AP is solely responsible for all content.