sunny.png
Saturday January 28th, 2023 12:52PM

Mental crises excluded from some state abortion exemptions

By The Associated Press

Mental health advocates say there’s a cruel quirk in abortion bans in several states: There are exemptions for life-threatening emergencies, but psychiatric crises don’t count.

It makes no sense to an Arizona mother of three who became suicidal during her fourth pregnancy and says an abortion saved her life. Or to researcher Kara Zivin, who nearly died from a suicide attempt in pregnancy and whose work suggests these crises are not uncommon.

Zivin had a healthy baby, but she sympathizes with women facing mental health emergencies who believe their only option is to end a pregnancy.

“People often try to treat mental health as distinct from physical health, as if your brain is somehow removed from the rest of your body,” said Zivin, a University of Michigan professor of psychiatry, obstetrics and gynecology, and health management.

Abortion crackdowns enacted or enforced since Roe v. Wade was overturned in June illustrate the dichotomy. In at least eight states that allow exemptions for life-threatening conditions, physical health is the focus. The mother’s mental health is not included.

Some of these exemptions are murkily written. Others are explicit. Laws in Georgia, Nebraska and West Virginia specify that medical emergencies don’t include suicide threats. A county judge's ruling overturning Georgia's law on Tuesday is being appealed. Florida’s exemption includes life-threatening illnesses “other than a psychological condition.”

Some abortion foes say the laws are intended to keep women from faking mental illness to get doctors to end their pregnancies.

Patricia, who is 31, married and “your average neighborhood Chicana,” says her agony was painfully real. The Phoenix woman spoke to The Associated Press on condition that only her first name was used, citing safety concerns and privacy.

She says a wave of severe depression hit her the summer of 2018 and broke “not only my mind, but my heart and soul.” She couldn’t eat, sleep or properly care for her three young daughters. Panic and suicidal thoughts bombarded her. When she learned a few weeks later that she was pregnant again, she knew she was in no shape to mother another one.

Her abortion was legal in Arizona at the time. The state recently enacted a near-total ban, though it is temporarily on hold.

Postpartum depression is well-recognized — U.S. studies show it affects about 1 in 8 women — but evidence suggests depression during pregnancy may be even more common.

Mental health conditions including suicide and substance use became the leading underlying cause of pregnancy-related deaths in 2017-2019, ahead of bleeding, heart conditions and infections, the Centers for Disease Control and Prevention said in a September report.

Zivin co-authored a study published last year that found that suicidal thoughts and behavior among commercially insured U.S. individuals before, during and after pregnancy were rising. The rates were low, but they increased among those with anxiety or depression from 1 per 10,000 in 2006 to almost 3 per 10,000 in 2017.

Zivin did not consider ending her pregnancy 10 years ago but said she understands why a woman who becomes suicidal would feel that abortion is her only option. She called the limited exemption laws “unfortunate” and said politicians who wrote them “don’t appreciate or understand the burden of mental illness.”

Observers note that before the 1973 Roe v. Wade decision legalizing abortion, a mental illness diagnosis enabled some women to get abortions and some states required psychiatrists to certify the diagnosis.

Abortion foes contend that many women pre-Roe faked mental illness and that psychiatrists became their accomplices.

The old laws “essentially forced psychiatrists to stretch the truth," said Carole Joffe, a OB-GYN professor at the University of California, San Francisco.

She noted that California once required two psychiatrists to sign off on such abortions.

“It was like everything else having to do with health care and abortion pre-Roe. It was class-based.” she said. "Most of these psychiatrists didn’t do it for free. You had to have the money."

The laws banning mental health exceptions show indifference “to the very real mental illness that some pregnant people have” and shows "how inappropriate it is for politicians to make health care policy," Joffe said.

Rep. Ed Setzler, a Georgia Republican who sponsored that state's law, argued that "a claim of stress or mental anguish just doesn’t rise to the level that the legislature was persuaded that the life of the child should be ended as a result.”

Eric Johnston, president of Alabama Pro Life Coalition, wrote that state’s near-total abortion ban and said a suicide exemption was included at the request of the state medical association. The narrowly drawn measure only exempts suicidal women who are diagnosed by a psychiatrist and requires that the abortion be performed at a hospital.

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

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

“A mother facing serious mental health issues should receive counseling and mental health care. Having an abortion will not mitigate mental health issues,” said spokeswoman Laura Echevarria.

According to the American Psychological Association, there is evidence that being denied an abortion may cause mental distress.

Michelle Oberman, a Santa Clara University law professor and expert in reproductive health ethics, said abortion bans that make no exception for severe mental illness are cruel and misguided.

Even if targeting women attempting to fake mental illness is among reasons behind these measures, the laws will inevitably affect those who are truly suffering, she said.

The mindset behind these laws “doesn’t really think through what it would look like to be facing patients with severe mental illness,’’ Oberman said. “What mental health emergencies look like is sort of jaw-dropping,’’ she said. “They’re real and they’re life-threatening.’’

___

Associated Press writers Kim Chandler in Montgomery, Alabama, and Jeff Amy in Atlanta contributed.

___

Follow AP Medical Writer Lindsey Tanner at @LindseyTanner.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

  • Associated Categories: U.S. News, Associated Press (AP), AP National News, Top U.S. News short headlines, AP Health, AP Business, AP Online - Georgia News, AP Health - Women's health
© Copyright 2023 AccessWDUN.com
All rights reserved. This material may not be published, broadcast, rewritten, or redistributed without permission.
Oklahoma prepares to execute man for 3-year-old's killing
Oklahoma is preparing to execute a man for the torture killing of his girlfriend's 3-year-old son in 1993
9:13AM ( 16 minutes ago )
Universities focus on athletes' mental health after crises
There is no playbook to instruct how athletic departments are to respond to the tragic death of one of their athletes
9:06AM ( 23 minutes ago )
New CEO of FTX blasts its handling of financial information
The new CEO of the collapse cryptocurrency trading firm FTX, who oversaw Enron’s bankruptcy, said he has never seen such a “complete failure” of corporate control
9:00AM ( 29 minutes ago )
Associated Press (AP)
Chinese city plans 250,000 quarantine beds to fight virus
China’s southern metropolis of Guangzhou plans to build quarantine facilities with almost 250,000 beds to help fight surging coronavirus outbreaks
8:35AM ( 54 minutes ago )
Elizabeth Holmes faces judgment day for her Theranos crimes
A federal judge on Friday will decide whether disgraced Theranos CEO Elizabeth Holmes should serve a lengthy prison sentence for duping investors and endangering patients while peddling a bogus blood-testing technology
6:01AM ( 3 hours ago )
Chinese leaders face anger over 2nd child's quarantine death
Chinese authorities are facing more public anger after a second child’s death was blamed on overzealous anti-virus enforcement, adding to frustration at controls that are confining millions of people to their homes and sparked fights with health workers
12:45AM ( 8 hours ago )
AP Health
Russia launches new Ukraine barrage as grain deal extended
Russian airstrikes have targeted Ukraine’s energy facilities again, as the first snow of the season fell in Kyiv
8:37AM ( 52 minutes ago )
UK push to restore finances means higher taxes, energy bills
Millions of British people face higher taxes and steeper energy bills after the government announced an emergency budget aimed at restoring the government’s economic credibility and shoring up the battered public finances
8:24AM ( 1 hour ago )
Macy's heads into holidays strongly, boosts 2022 guidance
Macy’s reported declines in profits and sales for the fiscal third quarter as the department store faces a pullback from shoppers stung by inflation
8:15AM ( 1 hour ago )
AP Business
Judge overturns Georgia's ban on abortion after 6 weeks
Georgia’s ban on abortion starting around six weeks into a pregnancy has been overturned by a judge
1:07PM ( 1 day ago )
In election, support for abortion rights was about much more
Support for abortion rights drove women to the polls in Tuesday’s elections
7:16AM ( 6 days ago )
Montana vote adds to win streak for abortion rights backers
Abortion rights supporters secured another win Thursday as voters in Montana rejected a ballot measure that would have forced medical workers to intercede in the rare case of a baby born after an attempted abortion
6:51PM ( 6 days ago )
AP Health - Women's health
Oklahoma prepares to execute man for 3-year-old's killing
Oklahoma is preparing to execute a man for the torture killing of his girlfriend's 3-year-old son in 1993
9:13AM ( 16 minutes ago )
Universities focus on athletes' mental health after crises
There is no playbook to instruct how athletic departments are to respond to the tragic death of one of their athletes
9:06AM ( 23 minutes ago )
New CEO of FTX blasts its handling of financial information
The new CEO of the collapse cryptocurrency trading firm FTX, who oversaw Enron’s bankruptcy, said he has never seen such a “complete failure” of corporate control
9:00AM ( 29 minutes ago )
Think Barbiecore and all things pink for holiday gifts
The style dubbed Barbiecore has legs ahead of next year’s release of the live-action “Barbie” movie starring Margo Robbie and Ryan Gosling
9:00AM ( 30 minutes ago )
Nancy Pelosi to announce 'future plans' after GOP wins House
House Speaker Nancy Pelosi is expected to address her plans with colleagues on Thursday in the wake of Democrats narrowly losing control of the House to Republicans
8:56AM ( 34 minutes ago )